Tolterodine is used to treat overactive bladder (bladder function disorder that causes a sudden or frequent urge to urinate).
This medicine calms and relaxes the bladder. It reduces the number of toilet visits and the urge to urinate.
Take Tolterodine exactly as directed by your doctor or according to the instructions on the label. Do not take more or less than instructed by your doctor.
You may take this medicine with or without food. Try to take it at the same time each day.
Tolterodine is available as a conventional tablet and as a modified-release capsule.
If you are taking the modified-release (prolonged-release or extended-release) type of capsule (usually labelled as “PR” or “ER”), swallow it whole. Do not divide, chew, or crush the capsule.
The dose of this medicine will be decided by your doctor. Your doctor will advise you on the treatment timeframe depending on your condition and response to the medication.
Tolterodine must be taken regularly for it to be effective. Continue taking this medicine even when you feel better. Do not stop taking it unless instructed by the doctor.
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal dosing schedule.
DO NOT double a dose under any circumstances.
If you often forget to take your medicine, let your doctor and pharmacist know.
Alert your doctor if you have the following conditions:
- urinary retention (inability to completely empty the bladder when urinating)
- gastric retention (a problem in emptying the contents of the stomach)
- uncontrolled narrow-angle glaucoma (increased pressure in the eyes)
- myasthenia gravis (a muscle weakness disorder)
- severe ulcerative colitis (inflammation of the large intestines)
- toxic megacolon (widening of large intestines caused by complications of infection or inflammation)
as Tolterodine may not be suitable for you.
Inform your doctor if you have the following conditions:
- risk factors for heart rhythm disorder e.g. inherited or acquired abnormally fast heartbeats, slow heartbeat, imbalance of potassium, magnesium or calcium in the body
- pre-existing heart disease e.g. heart failure, irregular or abnormal heartbeat
- obstruction in bladder flow causing difficulty in passing urine or a weak stream of urine
- prostate enlargement
- decreased bowel motility e.g. muscle weakness of the bowel wall
- obstructive bowel problems e.g. pyloric stenosis (narrowing of the stomach outlet)
- controlled or receiving treatment for narrow-angle glaucoma (increased pressure in the eyes)
- Alzheimer’s disease (a progressive disease which destroys memory and other important mental functions)
- autonomic neuropathy (damage of nerves that regulates vital body functions such as heart rate, blood pressure and bowel activities)
- hiatus hernia (a condition when part of the stomach extends through the diaphragm)
- severe kidney disease
- liver disease
Let your doctor know if you are pregnant or breastfeeding.
Be sure to check with your doctor or pharmacist before giving Tolterodine to an elderly.
Individuals who are poor metabolisers of CYP2D6 may experience enhanced side effects of this medicine (e.g. heart rhythm problems). If you know you have this gene type, inform your doctor. Monitor signs and symptoms of heart rhythm problems and let your doctor know immediately.
Why is it important to keep my appointments with the doctor?
Keep your appointments with your doctor. Your doctor needs to monitor your condition and check your response to the medication regularly.
- Routine tests (e.g. liver and kidney function tests) may be done while you are being treated with this medicine.
- Regular monitoring for signs of side effects (e.g. dry mouth, dizziness, constipation) may also be needed.
Your doctor will advise you about how often you need to have these tests.
Tolterodine may cause dizziness, drowsiness, or blurred vision. If affected, do not drive or take part in any activity in which you need to be alert.
Other side effects include any of the following: dry mouth, headache, dry eyes, inflamed airways or sinus, diarrhoea, stomach pain, indigestion, stomach wind, painful or difficulty urinating.
Some side effects may need immediate medical help. Alert your doctor quickly if you experience any of the following:
- rashes, breathlessness, swollen eyes, face, mouth or throat
- chest pain, difficulty breathing, unusual tiredness even at rest, swelling of the ankles or legs
Inform your doctor if any of these side effects do not go away or are severe, or if you experience other side effects.
Inform your doctor and pharmacist if you are taking any of these medicines:
- medicines for irregular heartbeat e.g. quinidine, procainamide, sotalol, amiodarone
- medicines to treat fungal infection e.g. ketoconazole, itraconazole
- certain antibiotics e.g. erythromycin, clarithromycin
- certain medicines for HIV infection e.g. ritonavir
- metoclopramide (medicine for nausea and vomiting)
- cisapride (medicine that affect passage of food)
- fluoxetine (medicine to treat depression)
This list does not include all medicines that may interact with Tolterodine.
Always notify your doctor and pharmacist if you are taking any other medicines, including herbal tonics such as traditional Chinese medicines, supplements and medicines that you buy without a prescription.
Avoid excessive consumption of grapefruit or grapefruit juice (more than 1 litre a day).
Store in a cool, dry place away from the reach of children.
Medicines must not be used past the expiry date.