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Tolterodine: Drug information

Tolterodine: Drug information
(For additional information see "Tolterodine: Patient drug information" and see "Tolterodine: Pediatric drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Brand Names: US
  • Detrol;
  • Detrol LA
Brand Names: Canada
  • APO-Tolterodine [DSC];
  • Detrol;
  • Detrol LA;
  • JAMP-Tolterodine;
  • MINT-Tolterodine;
  • MYLAN-Tolterodine ER [DSC];
  • SANDOZ Tolterodine LA;
  • TEVA-Tolterodine;
  • TEVA-Tolterodine LA
Pharmacologic Category
  • Anticholinergic Agent
Dosing: Adult
Treatment of overactive bladder

Treatment of overactive bladder: Oral:

Immediate release tablet: 2 mg twice daily; the dose may be lowered to 1 mg twice daily based on individual response and tolerability

Extended release capsule: 4 mg once daily; dose may be lowered to 2 mg once daily based on individual response and tolerability

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

Immediate release tablet: Significantly reduced renal function (studies conducted in patients with CrCl 10 to 30 mL/minute): 1 mg twice daily; use with caution

Extended release capsule:

CrCl 10 to 30 mL/minute: 2 mg once daily

CrCl <10 mL/minute: Use is not recommended; has not been studied.

Dosing: Hepatic Impairment: Adult

Immediate release tablet: Significantly reduced hepatic function: 1 mg twice daily; use with caution

Extended release capsule:

Mild to moderate impairment (Child-Pugh class A or B): 2 mg once daily

Severe impairment (Child-Pugh class C): Use is not recommended; has not been studied.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. As reported with immediate release tablet, unless otherwise specified.

>10%: Gastrointestinal: Xerostomia (35%; extended release capsules: 23%)

1% to 10%:

Cardiovascular: Chest pain (2%)

Central nervous system: Headache (7%; extended release capsules: 6%), dizziness (5%; extended release capsules: 2%), fatigue (4%; extended release capsules: 2%), drowsiness (immediate and extended release: 3%), anxiety (extended release capsules: 1%)

Dermatologic: Xeroderma (1%)

Endocrine & metabolic: Weight gain (1%)

Gastrointestinal: Constipation (7%; extended release capsules: 6%), abdominal pain (5%; extended release capsules: 4%), diarrhea (4%), dyspepsia (4%; extended release capsules: 3%)

Genitourinary: Dysuria (2%; extended-release capsules: 1%)

Infection: Infection (1%)

Neuromuscular & skeletal: Arthralgia (2%)

Ophthalmic: Xerophthalmia (immediate and extended release: 3%), visual disturbance (2%; extended release capsules: 1%)

Respiratory: Flu-like symptoms (3%), bronchitis (2%), sinusitis (extended release capsules: 2%)

<1%, postmarketing, and/or case reports: Anaphylaxis, angioedema, confusion, dementia (aggravated), disorientation, hallucination, memory impairment, palpitations, peripheral edema, prolonged QT interval on ECG, tachycardia

Contraindications

Hypersensitivity to tolterodine or fesoterodine (both are metabolized to 5-hydroxymethyl tolterodine) or any component of the formulation; urinary retention; gastric retention; uncontrolled narrow-angle glaucoma

Warnings/Precautions

Concerns related to adverse effects:

• Angioedema: Cases of angioedema have been reported; some cases have occurred after a single dose. Discontinue immediately if angioedema and associated difficulty breathing, airway obstruction, or hypotension develop.

• CNS effects: May cause drowsiness, dizziness, and/or blurred vision, which may impair physical or mental abilities; patients must be cautioned about performing tasks which require mental alertness (eg, operating machinery or driving). Dose reduction or discontinuation should be considered if CNS effects occur.

• QT prolongation: Has been associated with QTc prolongation at high (supratherapeutic) doses. The manufacturer recommends caution in patients with congenital prolonged QT or in patients receiving concurrent therapy with QTc-prolonging drugs (class Ia or III antiarrhythmics). However, the extent of QTc prolongation even at supratherapeutic dosages was less than 15 msec. Individuals who are CYP2D6 poor metabolizers or in the presence of inhibitors of CYP2D6 and CYP3A4 may be more likely to exhibit prolongation.

Disease-related concerns:

• Alzheimer disease: Preliminary data suggests that long-term use of anticholinergics may potentially adversely affect the clinical course of Alzheimer disease in patients receiving cholinesterase inhibitors (Lu 2003; Sink 2008). Additional monitoring for decreases in cognition, functional abilities and increased problematic behaviors should be considered in patients with dementia receiving dual therapy with an acetylcholinesterase inhibitor and a bladder anticholinergic, such as tolterodine.

• Bladder flow obstruction: Use with caution in patients with bladder flow obstruction (eg, benign prostatic hypertrophy); may increase the risk of urinary retention.

• GI obstructive disorders: Use with caution in patients with decreased GI motility or gastrointestinal obstructive disorders (ie, pyloric stenosis); may increase the risk of gastric retention.

• Glaucoma: Use with caution in patients with controlled (treated) narrow-angle glaucoma.

• Hepatic impairment: Use with caution in patients with hepatic impairment; dosage adjustment is required.

• Myasthenia gravis: Use with caution in patients with myasthenia gravis.

• Renal impairment: Use with caution in patients with renal impairment; dosage adjustment is required.

Concurrent drug therapy issues:

• CYP3A4 inhibitors: Dosage adjustment is recommended in patients receiving CYP3A4 inhibitors; a lower dose of tolterodine is recommended.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Capsule Extended Release 24 Hour, Oral, as tartrate:

Detrol LA: 2 mg, 4 mg [contains fd&c blue #2 (indigotine,indigo carmine)]

Generic: 2 mg, 4 mg

Tablet, Oral, as tartrate:

Detrol: 1 mg, 2 mg

Generic: 1 mg, 2 mg

Generic Equivalent Available: US

Yes

Pricing: US

Capsule ER 24 Hour Therapy Pack (Detrol LA Oral)

2 mg (per each): $15.70

4 mg (per each): $15.70

Capsule ER 24 Hour Therapy Pack (Tolterodine Tartrate ER Oral)

2 mg (per each): $8.04 - $13.14

4 mg (per each): $8.04 - $13.14

Tablets (Detrol Oral)

1 mg (per each): $9.64

2 mg (per each): $9.90

Tablets (Tolterodine Tartrate Oral)

1 mg (per each): $1.00 - $3.31

2 mg (per each): $1.00 - $3.40

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Capsule Extended Release 24 Hour, Oral, as tartrate:

Detrol LA: 2 mg, 4 mg [contains fd&c blue #2 (indigotine,indigo carmine)]

Generic: 2 mg, 4 mg

Tablet, Oral, as tartrate:

Detrol: 1 mg, 2 mg

Generic: 1 mg, 2 mg

Administration: Adult

ER capsule: Swallow whole; do not crush, chew, or open.

Bariatric surgery: Some institutions may have specific protocols that conflict with these recommendations; refer to institutional protocols as appropriate. IR tablet formulation is available. If safety and efficacy can be effectively monitored, no change in formulation or administration is required after bariatric surgery.

Administration: Pediatric

Oral: Administer without regard to food; do not break, crush, or chew extended-release capsules.

Use: Labeled Indications

Treatment of patients with an overactive bladder with symptoms of urge urinary incontinence, urgency, or frequency

Medication Safety Issues
Sound-alike/look-alike issues:

Tolterodine may be confused with fesoterodine, tolcapone

Detrol may be confused with Ditropan

Older Adult: High-Risk Medication:

Beers Criteria: Tolterodine is identified in the Beers Criteria as a potentially inappropriate medication in patients 65 years and older due to its strong anticholinergic properties (Beers Criteria [AGS 2023]).

Metabolism/Transport Effects

Substrate of CYP2C19 (minor), CYP2C9 (minor), CYP2D6 (major), CYP3A4 (major); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Acetylcholinesterase Inhibitors: May diminish the therapeutic effect of Anticholinergic Agents. Anticholinergic Agents may diminish the therapeutic effect of Acetylcholinesterase Inhibitors. Risk C: Monitor therapy

Aclidinium: May enhance the anticholinergic effect of Anticholinergic Agents. Risk X: Avoid combination

Ajmaline: May increase the serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Risk C: Monitor therapy

Amantadine: May enhance the anticholinergic effect of Anticholinergic Agents. Risk C: Monitor therapy

Anticholinergic Agents: May enhance the adverse/toxic effect of other Anticholinergic Agents. Risk C: Monitor therapy

Artemether and Lumefantrine: May increase the serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Risk C: Monitor therapy

Botulinum Toxin-Containing Products: May enhance the anticholinergic effect of Anticholinergic Agents. Risk C: Monitor therapy

Cannabinoid-Containing Products: Anticholinergic Agents may enhance the tachycardic effect of Cannabinoid-Containing Products. Risk C: Monitor therapy

Chloral Betaine: May enhance the adverse/toxic effect of Anticholinergic Agents. Risk C: Monitor therapy

Chlorprothixene: Anticholinergic Agents may enhance the anticholinergic effect of Chlorprothixene. Risk C: Monitor therapy

Cimetropium: Anticholinergic Agents may enhance the anticholinergic effect of Cimetropium. Risk X: Avoid combination

Clofazimine: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Risk C: Monitor therapy

CloZAPine: Anticholinergic Agents may enhance the constipating effect of CloZAPine. Management: Consider alternatives to this combination whenever possible. If combined, monitor closely for signs and symptoms of gastrointestinal hypomotility and consider prophylactic laxative treatment. Risk D: Consider therapy modification

CYP2D6 Inhibitors (Strong): May increase the serum concentration of Tolterodine. Risk C: Monitor therapy

CYP3A4 Inhibitors (Moderate): May increase the serum concentration of Tolterodine. Risk C: Monitor therapy

CYP3A4 Inhibitors (Strong): May increase the serum concentration of Tolterodine. Management: The maximum recommended dose of tolterodine is 2 mg per day (1 mg twice daily for immediate-release tablets or 2 mg daily for extended-release capsules) when used together with a strong CYP3A4 inhibitor. Risk D: Consider therapy modification

Eluxadoline: Anticholinergic Agents may enhance the constipating effect of Eluxadoline. Risk X: Avoid combination

Fexinidazole: May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Risk X: Avoid combination

Fusidic Acid (Systemic): May increase the serum concentration of CYP3A4 Substrates (High risk with Inhibitors). Risk X: Avoid combination

Gastrointestinal Agents (Prokinetic): Anticholinergic Agents may diminish the therapeutic effect of Gastrointestinal Agents (Prokinetic). Risk C: Monitor therapy

Glucagon: Anticholinergic Agents may enhance the adverse/toxic effect of Glucagon. Specifically, the risk of gastrointestinal adverse effects may be increased. Risk C: Monitor therapy

Glycopyrrolate (Oral Inhalation): Anticholinergic Agents may enhance the anticholinergic effect of Glycopyrrolate (Oral Inhalation). Risk X: Avoid combination

Glycopyrronium (Topical): May enhance the anticholinergic effect of Anticholinergic Agents. Risk X: Avoid combination

Ipratropium (Oral Inhalation): May enhance the anticholinergic effect of Anticholinergic Agents. Risk X: Avoid combination

Itopride: Anticholinergic Agents may diminish the therapeutic effect of Itopride. Risk C: Monitor therapy

Levosulpiride: Anticholinergic Agents may diminish the therapeutic effect of Levosulpiride. Risk X: Avoid combination

Mianserin: May enhance the anticholinergic effect of Anticholinergic Agents. Risk C: Monitor therapy

Mirabegron: Anticholinergic Agents may enhance the adverse/toxic effect of Mirabegron. Risk C: Monitor therapy

Nitroglycerin: Anticholinergic Agents may decrease the absorption of Nitroglycerin. Specifically, anticholinergic agents may decrease the dissolution of sublingual nitroglycerin tablets, possibly impairing or slowing nitroglycerin absorption. Risk C: Monitor therapy

Opioid Agonists: Anticholinergic Agents may enhance the adverse/toxic effect of Opioid Agonists. Specifically, the risk for constipation and urinary retention may be increased with this combination. Risk C: Monitor therapy

Oxatomide: May enhance the anticholinergic effect of Anticholinergic Agents. Risk X: Avoid combination

Peginterferon Alfa-2b: May decrease the serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Peginterferon Alfa-2b may increase the serum concentration of CYP2D6 Substrates (High risk with Inhibitors). Risk C: Monitor therapy

Potassium Chloride: Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Chloride. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride. Risk X: Avoid combination

Potassium Citrate: Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Citrate. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium citrate. Risk X: Avoid combination

Pramlintide: May enhance the anticholinergic effect of Anticholinergic Agents. These effects are specific to the GI tract. Risk X: Avoid combination

Ramosetron: Anticholinergic Agents may enhance the constipating effect of Ramosetron. Risk C: Monitor therapy

Revefenacin: Anticholinergic Agents may enhance the anticholinergic effect of Revefenacin. Risk X: Avoid combination

Rivastigmine: Anticholinergic Agents may diminish the therapeutic effect of Rivastigmine. Rivastigmine may diminish the therapeutic effect of Anticholinergic Agents. Management: Use of rivastigmine with an anticholinergic agent is not recommended unless clinically necessary. If the combination is necessary, monitor for reduced anticholinergic effects. Risk D: Consider therapy modification

Secretin: Anticholinergic Agents may diminish the therapeutic effect of Secretin. Management: Avoid concomitant use of anticholinergic agents and secretin. Discontinue anticholinergic agents at least 5 half-lives prior to administration of secretin. Risk D: Consider therapy modification

Thiazide and Thiazide-Like Diuretics: Anticholinergic Agents may increase the serum concentration of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor therapy

Tiotropium: Anticholinergic Agents may enhance the anticholinergic effect of Tiotropium. Risk X: Avoid combination

Topiramate: Anticholinergic Agents may enhance the adverse/toxic effect of Topiramate. Risk C: Monitor therapy

Umeclidinium: May enhance the anticholinergic effect of Anticholinergic Agents. Risk X: Avoid combination

Warfarin: Tolterodine may enhance the anticoagulant effect of Warfarin. Risk C: Monitor therapy

Food Interactions

Food increases bioavailability (~53% increase) of tolterodine tablets (dose adjustment not necessary); does not affect the pharmacokinetics of tolterodine extended release capsules. As a CYP3A4 inhibitor, grapefruit juice may increase the serum level and/or toxicity of tolterodine, but unlikely secondary to high oral bioavailability. Management: Monitor patients closely with concurrent grapefruit juice use.

Pregnancy Considerations

Adverse events were observed in some animal reproduction studies.

Breastfeeding Considerations

It is not known if tolterodine is present in breast milk.

According to the manufacturer, the decision to breastfeed during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and benefits of treatment to the mother.

Monitoring Parameters

Anticholinergic effects (ie, dry mouth, constipation, dizziness); renal function (BUN, creatinine); hepatic function; postvoid residual urine volume at baseline and as clinically indicated thereafter (ACOG 2015; AUA [Lerner 2021]).

Mechanism of Action

Tolterodine is a competitive antagonist of muscarinic receptors. In animal models, tolterodine demonstrates selectivity for urinary bladder receptors over salivary receptors. Urinary bladder contraction is mediated by muscarinic receptors. Tolterodine increases residual urine volume and decreases detrusor muscle pressure.

Pharmacokinetics (Adult Data Unless Noted)

Absorption: Immediate release tablet: Rapid; ≥77%

Distribution: IV: Vd: 113 ± 27 L

Protein binding: >96% (primarily to alpha1-acid glycoprotein)

Metabolism: Extensively hepatic, primarily via CYP2D6 to 5-hydroxymethyltolterodine (active) and 3A4 usually (minor pathway). In patients with a genetic deficiency of CYP2D6, metabolism via 3A4 predominates.

Bioavailability: Immediate release tablet: Increased 53% with food

Half-life elimination:

Immediate release tablet: Extensive metabolizers: ~2 hours; Poor metabolizers: ~10 hours

Extended release capsule: Extensive metabolizers: ~7 hours; Poor metabolizers: ~18 hours

Time to peak: Immediate release tablet: 1-2 hours; Extended release capsule: 2-6 hours

Excretion: Urine (77%); feces (17%); primarily as metabolites (<1% unchanged drug) of which the active 5-hydroxymethyl metabolite accounts for 5% to 14% (<1% in poor metabolizers); as unchanged drug (<1%; <2.5% in poor metabolizers)

Pharmacokinetics: Additional Considerations (Adult Data Unless Noted)

Altered kidney function: In patients with CrCl 10 to 30 mL/min, immediate-release tolterodine and metabolite levels were 2- to 3-fold higher compared with healthy patients. ER tolterodine has not been studied in patients with CrCl less than 10 mL/min.

Hepatic function impairment: The elimination half-life of immediate-release tolterodine was longer and Cl was substantially lower in cirrhotic patients compared with healthy patients.

Older adult: Serum concentrations of immediate-release tolterodine and 5-HMT were 20% to 50% higher in elderly patients.

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Detrusitol;
  • (AR) Argentina: Breminal | Coli Q | Detrusitol | Toltem | Urginol;
  • (AT) Austria: Detrusitol | Tolterodin accord | Tolterodin Actavis | Tolterodin easypharm | Tolterodin pfizer | Tolterodin ratiopharm;
  • (AU) Australia: Detrusitol | Tolterodine tartrate;
  • (BD) Bangladesh: Detrusin | Terodin | Tolorin | Tolter | Toltrex | Ucol;
  • (BE) Belgium: Detrusitol | Tolterodine teva;
  • (BG) Bulgaria: Detrusitol;
  • (BR) Brazil: Detrusitol;
  • (CH) Switzerland: Detrusitol;
  • (CL) Chile: Detrusitol | Eltoven | Urostop;
  • (CN) China: Bu mai ding | Detrusitol | Le zai | Ning tong | She ni ting | Si pei er | Tolterodine tartra | Tolterodine tartrate;
  • (CO) Colombia: Detrusitol | Toldy | Tolterodina;
  • (CZ) Czech Republic: Detrusitol | Uroflow;
  • (DE) Germany: Detrusitol | Tolterodin | Tolterodin 1A Pharma | Tolterodin accord | Tolterodin Actavis | Tolterodin Hexal | Tolterodin pfizer | Tolterodin puren | Tolterodin ratiopharm | Tolterodine aristo;
  • (DO) Dominican Republic: Detrusitol | Eltoven;
  • (EC) Ecuador: Detrusitol | Eltoven;
  • (EE) Estonia: Detrusitol | Tolterodine accord | Uroflow;
  • (EG) Egypt: Conturine | Cystoridine | Detrusitol | Incont | Noctopex | Sedoter | Terodine | Tolterodine | Urgeleve | Uricontrol;
  • (ES) Spain: Detrusitol | Urotrol;
  • (FI) Finland: Detrusitol;
  • (FR) France: Detrusitol | Tolterodine accord;
  • (GB) United Kingdom: Detrusitol | Tolterodine | Tolterodine Kent;
  • (GR) Greece: Detrulon | Detrusitol;
  • (HK) Hong Kong: Accord tolterodine | Detrusitol;
  • (HU) Hungary: Detrusitol;
  • (ID) Indonesia: Detrusitol;
  • (IE) Ireland: Detrusitol | Tolterodine tartrate;
  • (IL) Israel: Detrusitol;
  • (IN) India: Concyst | Detrusitol | Roliten | Terol La | Tolter | Tolu | Torq;
  • (IT) Italy: Detrusitol;
  • (JO) Jordan: Detrusitol;
  • (KR) Korea, Republic of: Binex tolterodin er | Binex Tolterodine | Ckd tolterodine sr | Derutol sr | Deterodine sr | Detrodin sr | Detrusitol | Dirutol | Eurocarin sr | Loxirodine | Neocitol sr | Olodin sr | Sedatol | Sedatol sr | Telodin | Toladine sr | Tolersta | Toloin | Tolostar | Toltarodin | Toltedin | Toltedine | Tolten | Tolterin | Tolteros sr | Toltomin | Tt rodine sr | Uretol | Urisis | Urocarine | Urodin | Urofree | Uroq sr | Urositol | Urotin S | Urotrol | Uterodin | Uvidi;
  • (KW) Kuwait: Detrusitol;
  • (LB) Lebanon: Detrusitol;
  • (LT) Lithuania: Detrusitol | Uroflow;
  • (LU) Luxembourg: Detrusitol | Tolterodin ratiopharm;
  • (LV) Latvia: Detrusitol;
  • (MA) Morocco: Urodine;
  • (MX) Mexico: Alarod | Asertral | Blad | Detrusitol | Dinafar | Fanerik | Ficsatol | Hipolter | Jania | Micrepis | Quimural | Tefilinb | Tolterodina | Tolterodina ultra | Ucrinix | Urotrol;
  • (MY) Malaysia: Detrusitol;
  • (NL) Netherlands: Detrusitol | Tolterodine;
  • (NO) Norway: Detrusitol;
  • (NZ) New Zealand: Arrow Tolterodine | Detrusitol;
  • (PE) Peru: Detrusitol | Terodin;
  • (PH) Philippines: Detrusitol;
  • (PK) Pakistan: Detriflow | Detrusitol | Ezeecon | Tolcare | Toldin | Tolferid | Tolter | Uniterole;
  • (PL) Poland: Defur | Detrusitol | Tolterodine accord | Uroflow | Uroflow sr;
  • (PR) Puerto Rico: Detrol | Tolterodine tartrate;
  • (PT) Portugal: Detrusitol;
  • (PY) Paraguay: Eltoven | Tolterodina imedic | Tornade;
  • (QA) Qatar: Detrusitol;
  • (RO) Romania: Uroflow;
  • (RU) Russian Federation: Detrusitol | Detruzitol | Roliten | Uroflex | Urotol;
  • (SA) Saudi Arabia: Detrusitol;
  • (SE) Sweden: Detrusitol | Tolterodin ebb | Tolterodin Orifarm | Tolterodin sandoz | Tolterodin teva | Tolterodine accord;
  • (SG) Singapore: Detrusitol;
  • (SI) Slovenia: Detrusitol;
  • (SK) Slovakia: Detrusitol;
  • (TH) Thailand: Detrusitol;
  • (TR) Turkey: Detrusitol | Toldin | Toltex;
  • (TW) Taiwan: Detrusitol | Terodine | Torodine;
  • (UA) Ukraine: Detrusitol | Roliten | Urotol;
  • (UY) Uruguay: Fluserin | Tolterox | Toltin;
  • (VE) Venezuela, Bolivarian Republic of: Detrusitol;
  • (ZA) South Africa: Detrusitol
  1. 2023 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052-2081. doi:10.1111/jgs.18372 [PubMed 37139824]
  2. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 155: Urinary Incontinence in Women. Obstet Gynecol. 2015;126(5):e66-81. [PubMed 26488524]
  3. Detrol (tolterodine) [prescribing information]. New York, NY: Pfizer; November 2016.
  4. Detrol LA (tolterodine) [prescribing information]. New York, NY: Pfizer; July 2018.
  5. Lerner LB, McVary KT, Barry MJ, et al. Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA guideline part I, initial work-up and medical management. J Urol. 2021;206(4):806-817. doi:10.1097/JU.0000000000002183 [PubMed 34384237]
  6. Lu CJ, Tune LE. Chronic exposure to anticholinergic medications adversely affects the course of Alzheimer disease. Am J Geriatr Psychiatry. 2003;11(4):458-461. [PubMed 12837675]
  7. Shamliyan T, Wyman J, Kane RL. Nonsurgical Treatments for Urinary Incontinence in Adult Women: Diagnosis and Comparative Effectiveness. Rockville (MD): Agency for Healthcare Research and Quality (US); April 2012. [PubMed 22624162]
  8. Sink KM, Thomas J 3rd, Xu H, Craig B, Kritchevsky S, Sands LP. Dual use of bladder anticholinergics and cholinesterase inhibitors: long-term functional and cognitive outcomes. J Am Geriatr Soc. 2008;56(5):847-853. doi: 10.1111/j.1532-5415.2008.01681.x. [PubMed 18384584]
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