Tolterodine


Tolterodine, sold under the brand names Detrol among others, is medication used to treat frequent urination, urinary incontinence, or urinary urgency. Effects are seen within an hour. It is taken by mouth.
Common side effects include headache, dry mouth, constipation, and dizziness. Serious side effects may include angioedema, urinary retention, and QT prolongation. Use in pregnancy and breastfeeding are of unclear safety. It works by blocking muscarinic receptors in the bladder thus decreasing bladder contractions.
Tolterodine was approved for medical use in 1998. It is available as a generic medication. A month supply costs the NHS about GB£2.09 per month as of 2019. In the United States the wholesale cost of this amount is about US$37.16. In 2017, it was the 229th most commonly prescribed medication in the United States, with more than two million prescriptions.

Medical uses

Detrusor overactivity is the most common form of urinary incontinence in older adults. It is characterized by uninhibited bladder contractions causing an uncontrollable urge to void. Urinary frequency, urge incontinence and nocturnal incontinence occur. Abnormal bladder contractions that coincide with the urge to void can be measured by urodynamic studies. Treatment is bladder retraining, pelvic floor therapy or with drugs that inhibit bladder contractions such as oxybutynin and tolterodine.

Side effects

Known side effects:
The following reactions have been reported in patients who have taken tolterodine since it has become available:
Tolterodine is not recommended for use in people with myasthenia gravis and angle closure glaucoma.

Pharmacology

Tolterodine acts on M2 and M3 subtypes of muscarinic receptors whereas older antimuscarinic treatments for overactive bladder act more specifically on M3 receptors.
Tolterodine, although it acts on all types of receptors, has fewer side effects than oxybutynin as tolterodine targets the bladder more than other areas of the body. This means that less drug needs to be given daily and so there are fewer side effects.

Brand names

It is marketed by Pfizer in Canada and the United States by its brand name Detrol. In Egypt it is also found under the trade names Tolterodine by Sabaa and Incont L.A. by Adwia.