Tolterodine Tartrate ER

Last Reviewed: Sep 13, 2024

Warnings

Tolterodine (Detrol LA) Risks, Warnings, and Complications

Tolterodine can cause or worsen health problems in some people. Talk to your doctor or pharmacist about alternative treatment of overactive bladder if you are at an increased risk of adverse reactions from this drug.

SERIOUS ALLERGIC REACTION: Rarely, tolterodine use can cause severe allergic reactions with angioedema (swelling of the face, eyes, lips, tongue, and throat). The swelling can be severe enough to cause throat closing and difficulty breathing. Stop taking tolterodine and seek emergency medical attention if you develop an unusual or allergic reaction with swelling, trouble breathing, low blood pressure, or chest discomfort.
URINARY RETENTION: Tolterodine should be used with caution in people with bladder outflow obstruction due to the risk of urinary retention. Before starting this medicine, tell your doctor if you have a history of bladder problems.
GASTROINTESTINAL DISORDERS: Tolterodine and other antimuscarinic drugs should be used with caution in people with reduced gastrointestinal motility. Before starting this medicine, tell your health care professional if you have any history of any stomach or intestinal conditions.
NARROW-ANGLE GLAUCOMA: Tolterodine should be used with caution in people with uncontrolled narrow-angle glaucoma, an eye condition in which there is increased intraocular pressure.
EFFECTS ON THE CENTRAL NERVOUS SYSTEM: Tolterodine can cause dizziness and sleepiness through its effects on the central nervous system. This is especially likely when you first start treatment and after a dose adjustment. Do not drive or operate machinery until you know how this medicine affects you. Tell your doctor if these side effects are severe. Your doctor may reduce the dose or discontinue treatment.
LIVER DISEASE: The elimination of tolterodine from the body can be reduced in people with liver dysfunction, leading to high drug levels and an increased risk of adverse events. If you have mild to moderate hepatic impairment, your doctor may recommend taking a lower dose (2 mg tolterodine immediate-release daily). Detrol LA (tolterodine extended release) is not recommended for people with severe hepatic impairment.
KIDNEY DISEASE: Tolterodine elimination can be affected in people with renal impairment (reduced kidney function). If you have severe kidney disease, your doctor may recommend taking a lower 2-mg daily dose of Detrol LA. Elderly patients may also need dose adjustment if they have age-related renal impairment.
MYASTHENIA GRAVIS: Tolterodine should be used with caution in people with myasthenia gravis, a condition in which there is muscle weakness due to decreased cholinergic activity at the neuromuscular junction.
LONG QT SYNDROME: Tolterodine can increase the risk of developing a heart rhythm abnormality called QT prolongation. Before starting this medicine, tell your healthcare provider if you have a known history of congenital or acquired QT prolongation or are taking certain other medications that can also cause long QT syndrome.

Precautions Before Starting Tolterodine (Detrol LA)

Tell your doctor if you have ever had allergic reactions to tolterodine, fesoterodine fumarate (Toviaz), any of the active or inactive ingredients in tolterodine immediate-release tablets or extended-release capsules, or any other medicines. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription drugs, over-the-counter medications, vitamins, nutritional supplements, and herbal products. This can help avoid possible interactions between tolterodine and your other medicines.

Give your doctor a complete medical history. Tolterodine may not be safe for people with certain medical conditions such as glaucoma, urinary retention, gastric retention, QT prolongation, bladder problems, stomach or intestinal problems, severe constipation, myasthenia gravis, kidney or liver disease.

Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are breast-feeding.

Precautions During Use of Tolterodine (Detrol LA)

Keep all your medical and lab appointments while on tolterodine. Your doctor may adjust your tolterodine dose based on your response. Continue taking tolterodine even if your symptoms are well controlled. This medicine can help control symptoms of overactive bladder but does not cure the condition.

Tolterodine can cause dizziness, drowsiness, and blurred vision. Do not drive or operate machinery until you know how this medicine affects you.

Tell your doctor if you become pregnant while on tolterodine.

Tell all your healthcare providers you are on tolterodine before any surgery, including dental procedures.

Tolterodine (Detrol LA) Drug Interactions

Taking certain other medicines with tolterodine can affect how the medicines work by increasing or decreasing systemic exposure. Drug interactions can also cause severe adverse effects. Your doctor may adjust the doses of your medications, monitor you carefully for side effects, or switch you to different medicines if there are known interactions between tolterodine and your other drugs. Tolterodine can have interactions with the following drugs:

Antiarrhythmics such as amiodarone (Pacerone, Nexterone), procainamide, sotalol (Betapace, Sotylize, Sorine), and quinidine (in Nuedexta)
Antiviral drugs such as atazanavir (Reyataz, in Evotaz), saquinavir (Invirase), and ritonavir (Norvir, Technivie, Viekira, in Kaletra)
Antifungal agents such as itraconazole (Sporanox. Onmel, Tolsura) and ketoconazole
Antibiotics such as clarithromycin and erythromycin (E.E.S., Ery-Tab, others)
Antihistamines
Immunosuppressants such as cyclosporine (Neoral, Sandimmune, Gengraf)
Medications used to treat Alzheimer’s disease, such as donepezil (Aricept, in Namzaric), rivastigmine (Exelon), and galantamine (Razadyne)
Medications used to treat motion sickness, irritable bowel disease, or Parkinson's disease
Chemotherapy drugs such as vinblastine

The above list may not include all the potential interactions of tolterodine. Give your doctor or pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, nutritional supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use illegal drugs because some of these substances can cause serious health complications when used with prescription medications.

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