|Type of medicine||Antimuscarinic|
|Used for||Urinary symptoms such as frequency, urgency and incontinence|
|Available as||Tablets and prolonged-release capsules|
Tolterodine is used to treat symptoms such as urinary frequency, which is a need to pass urine more often than normal, and urinary urgency, which is a need to pass urine more urgently than usual. You also may pass urine when you do not mean to. There are several different causes of these urinary symptoms, such as weakened pelvic floor muscles, problems causing your bladder muscles to contract too much or too early, or something causing an obstruction. Sometimes the cause of these symptoms is unknown.
Tolterodine works by reducing the overactivity of your bladder. This helps to control the release of urine and eases your symptoms.
Before taking tolterodine
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start taking tolterodine it is important that your doctor or pharmacist knows:
- If you are pregnant, trying for a baby or breast-feeding.
- If you have a condition which can cause a blockage in your stomach, bowel, or urinary system.
- If you have glaucoma (an increased pressure in your eyes).
- If you have hiatus hernia, an overactive thyroid, or high blood pressure.
- If you have liver or kidney problems.
- If you have a heart condition, such as an abnormal heart rhythm, problems with the blood vessels in your heart, or heart failure.
- If you have problems with your prostate.
- If you have myasthenia gravis (this is a condition causing muscle weakness).
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
- If you have ever had an allergic reaction to a medicine.
How to take tolterodine
- Before you start this treatment, read the manufacturer's printed information leaflet from inside your pack. The leaflet will give you more information about tolterodine, and a full list of possible side-effects from taking it.
- Take tolterodine exactly as your doctor has told you. If you have been given tablets, you will have been asked to take one tablet twice daily. If you have been given capsules, you will have been asked to take one capsule once daily. Your dose will be on the label of the pack to remind you.
- Try to take your doses at the same times of day each day, as this will help you to remember to take them. You can take them before, during or after your meals.Take them with a drink of water which will help you to swallow them.
- If you have been given prolonged-release capsules (Detrusitol® XL), these have been specially made to release tolterodine evenly over the day, so it is important that you swallow them whole - do not chew or crush them.
- If you forget to take a dose, take it as soon as you remember. If it is almost time to take your next dose, skip the missed dose and take your next dose when it is due. Do not take two doses together to make up for a forgotten dose.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor. This is so your doctor can check on your progress and review your treatment.
- If you buy any medicines, check with a pharmacist that they are suitable to take with tolterodine. This is because some medicines (particularly antihistamines) can increase the chance that you will experience unwanted effects such as a dry mouth, constipation and blurred vision.
- Drinks containing caffeine (for example, tea, coffee, hot chocolate and cola) may make your symptoms worse. This is because caffeine is a natural diuretic and will make you need to pass urine. If you drink a lot of caffeine-containing fluids, consider switching to decaffeinated alternatives.
- Try to maintain a normal life as much as possible with regard to drinking and visiting the toilet. However, drinking late at night may mean your sleep is disturbed by the desire to get up and go to the toilet, so you may want to avoid drinking too much during the evening.
- If you are having an operation or dental treatment, tell the person carrying out the treatment that you are taking tolterodine.
Can tolterodine cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.
|Common tolterodine side-effects - these affect around 1 in 10 people who take this medicine||What can I do if I experience this?|
|Dry mouth||Try chewing sugar-free gum or sucking sugar-free sweets|
|Headache||Ask your pharmacist to recommend a suitable painkiller|
|Blurred vision, feeling drowsy, tired or dizzy||If any of these happen, do not drive or use tools or machines|
|Indigestion, abdominal pain, wind, feeling or being sick||Eat simple meals - avoid rich or spicy foods|
|Constipation||Try to eat a well-balanced diet containing plenty of fibre, and drink several glasses of water each day|
|Diarrhoea||Drink plenty of water to replace lost fluids|
|Chest infections, skin tinglings, vertigo (a feeling of spinning), a fast heartbeat, dry skin, discomfort passing urine, putting on weight, dry eyes||Discuss these with your doctor if any become troublesom|
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.
How to store tolterodine
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Further reading & references
- British National Formulary; 63rd Edition (Mar 2012) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
- Manufacturer's PIL, Detrusitol® 1 mg & 2 mg film-coated tablets; Pharmacia Limited, The electronic Medicines Compendium. Dated May 2012.
- Manufacturer's PIL, Detrusitol XL® 4 mg capsules; Pharmacia Limited, The electronic Medicines Compendium. Dated May 2012.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.
Dr John Cox