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Tolterodine 💊
💊 Tolterodine is used for urge incontinence rather than stress incontinence. It may be tried as a short course in patients with urge or mixed urge/stress symptoms.
📖 About
Always check the BNF link here for up-to-date prescribing advice.
- Antimuscarinic drug, related to oxybutynin but often better tolerated.
- Acts on bladder smooth muscle to reduce detrusor overactivity.
⚙️ Mechanism of Action
- Competitive muscarinic acetylcholine receptor antagonist.
- Reduces involuntary bladder contractions.
- Increases bladder capacity and delays urgency.
🎯 Indications
- Urinary frequency, urgency, and urge incontinence 🚻.
- Mixed stress/urge incontinence (as part of trial therapy).
- Reduces detrusor instability and improves bladder storage.
🔗 Interactions
- Avoid co-prescribing with other antimuscarinics (e.g. tricyclic antidepressants).
- Ketoconazole and other CYP3A4 inhibitors may ↑ tolterodine concentrations.
⛔ Contraindications / Cautions
- ⚠️ Narrow-angle glaucoma (risk of acute angle closure).
- ⚠️ Myasthenia gravis.
- ⚠️ Congenital or acquired QT prolongation (risk of arrhythmia).
- Caution in elderly patients due to CNS side effects.
⚠️ Side Effects
- Dry mouth, constipation, blurred vision 👁️.
- Urinary retention 💧.
- Tachycardia, palpitations ❤️.
- Confusion, cognitive impairment, drowsiness 🧠 (particularly in elderly).
- Peripheral oedema.
💊 Dose
- Tolterodine 1–2 mg twice daily (lower dose in elderly or frail patients).
- Modified-release preparation available for once-daily use.
📚 References
- BNF – Tolterodine
- NICE CG171 – Urinary incontinence in women.
- Oxford Handbook of Urology.
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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