Trospium chloride


Concise Prescribing Info
Indications/Uses
Overactive bladder.
Dosage/Direction for Use
Adult : PO 20 mg twice daily. Extended release 60 mg/day in the morning.
Dosage Details
Oral
Overactive bladder
Adult: As conventional tab: 20 mg bid; as modified release capsule: 60 mg once daily in the morning.
Elderly: ≥75 yr: as conventional tablet, lower doses of 20 mg once daily may be used.
Renal Impairment
CrClDosage
<30As conventional tablet: 20 mg given daily or on alternate days. As modified released capsule: avoid.
Hepatic Impairment
Severe: Avoid use.
Administration
Should be taken on an empty stomach. Take 1 hr before meals or on an empty stomach.
Contraindications
Urinary retention; gastric retention, toxic megacolon; uncontrolled narrow-angle glaucoma, hypersensitivity; myasthenia gravis; tachyarrhythmia; severe renal or hepatic impairment.
Special Precautions
Urinary flow obstruction, ulcerative colitis, intestinal atony, GI obstructive conditions e.g. pyloric stenosis; conditions where increased heart rate undesirable (e.g. hyperthyroidism, CHF, coronary heart disease); hiatus hernia associated with reflux oesophagitis; mild to moderate hepatic or renal impairment; autonomic neuropathy. May impair ability to drive or operate machinery. Overexposure to heat may increase risk of heat stroke due to decreased production of sweat; adequate hydration is required. Hypersensitivity. Pregnancy; lactation. Elderly: ≥75 yr.
Adverse Reactions
Dry mouth, dry eyes, blurred vision, flatulence, constipation, abdominal pain, nausea, vomiting, dyspepsia, urinary retention, tachycardia.
Overdosage
Symptoms: Increased anticholinergic side effects such as dry mouth, tachycardia; disorders of micturition. Management: Gastric lavage with use of activated charcoal to reduce absorption. Treatment is symptomatic and supportive. Catheterisation may be performed in patients with urinary retention. In cases with severe symptoms, treatment with a parasympathomimetic agent (e.g. neostigmine) may be needed.
Drug Interactions
Competitive elimination between trospium chloride and other compounds eliminated by active renal tubular secretion. Alteration in absorption of other drugs due to alteration in GI motility. Increased side effects with other anticholinergic drugs. Antagonises action of metoclopramide. Additive increase in heart rate with β sympathomimetic agents. Increased drowsiness with alcohol.
Action
Description: Trospium chloride, a quaternary ammonium antimuscarinic, directly antagonises muscarinic acetylcholine receptors located in the cholinergically innervated organs. It also reduces the elastic tension of smooth muscle located in the bladder, thus decreasing the required number of voids, episodes of urge incontinence, severity of urge, improving retention and facilitating increased volume/void.
Pharmacokinetics:
Absorption: Bioavailability: <10% of oral dose; reduced by food, especially food with high fat content. Peak plasma concentration: 4-6 hr.
Distribution: Widely distributed, with apparent volume of distribution >600 L. Protein binding: 50-80%.
Metabolism: Hepatic, via ester hydrolysis with subsequent benzylic acid conjugation resulting in azoniaspironortropanol formation with glucuronic acid.
Excretion: Via urine (as unchanged drug; 10% as metabolite spiroalcohol). Terminal elimination half-life: 10-20 hr.
Storage
Store between 68-77°F (20-25°C).
Disclaimer: This information is independently developed by MIMS based on Trospium chloride from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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