Take one tablet every day. There are two strengths of tablet available: 4 mg and 8 mg. Your doctor will tell you which strength is right for you.
The most common side-effect of fesoterodine is a dry mouth. The tablets can also cause blurred vision and make you feel sleepy or dizzy. If this happens to you, do not drive or use tools or machines while affected.
|Type of medicine||An antimuscarinic medicine|
|Used for||Symptoms of urinary frequency, urgency and incontinence in adults|
|Available as||Prolonged-release tablets|
Fesoterodine is prescribed to treat urinary symptoms such as urgency, frequency and incontinence. Urinary urgency occurs when you have a sudden and urgent need to pass urine. If you need to take more trips to the toilet than normal, this is called urinary frequency. If you leak urine before you go to the toilet, this is called incontinence.
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.
Fesoterodine works by stopping sudden bladder muscle contractions and increasing the volume of urine that your bladder can hold. This helps to control the release of urine and eases your symptoms.
Before taking fesoterodine
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 fesoterodine it is important that your doctor knows:
- If you are pregnant or breast-feeding.
- If you have a heart condition, such as an unusual heart rhythm, problems with the blood vessels in your heart, or heart failure.
- If you have any problems with the way your liver works or with the way your kidneys work.
- If you have any problems with your prostate gland.
- If you have any of the following conditions: increased eye pressure (called glaucoma); hiatus hernia; acid reflux; an overactive thyroid; high blood pressure; a condition causing muscle weakness, called myasthenia gravis.
- If you have a condition which could cause a blockage in your stomach, bowel or urinary tract.
- If you have ever had an allergic reaction to a medicine.
- If you are taking any other medicines. This includes any medicines you are taking which are available to buy without a prescription, such as herbal and complementary medicines.
How to take fesoterodine
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about fesoterodine and will provide you with a full list of the side-effects which you may experience from taking it.
- Take the tablets exactly as your doctor tells you to. The recommended dose is one tablet every day. There are two strengths of tablet available: 4 mg and 8 mg. It is usual to be prescribed the 4 mg strength tablet to begin with, although this may later be increased to the 8 mg strength if needed.
- Try to take the tablet at the same time of day each day, as this will help you to remember to take your doses regularly. You can take fesoterodine either before or after meals. Swallow the tablet with a drink of water. The tablets have been specially made to release fesoterodine evenly over the day, so it is important that you swallow the tablet whole - do not chew or crush it before you swallow.
- If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, leave out the missed dose but make sure you take the dose due on that day. 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. It may take 2-8 weeks before you feel the full benefit from taking the tablets.
- Drinks containing caffeine (for example, tea, coffee, hot chocolate and cola) may make your symptoms worse. This is because caffeine increases urine flow (it is a natural diuretic) and will make you want to pass urine. If you drink a lot of caffeine-containing drinks, 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.
- Your doctor may suggest that you do some pelvic floor exercises to strengthen the muscles around the underside of your bladder. These can help to improve your symptoms.
- If you drink grapefruit juice regularly, please let your doctor know about this. A chemical in grapefruit juice may increase the amount of fesoterodine in your bloodstream. Because of this, your doctor will prescribe only the 4 mg strength of fesoterodine tablets for you.
- If you buy any medicines or herbal remedies, always check with a pharmacist that they are suitable to take with fesoterodine. Some medicines (particularly antihistamines) and some herbal remedies (such as St John's wort) can increase the chance that you will experience unwanted effects such as a dry mouth, constipation and feeling sleepy.
Can fesoterodine cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the common ones associated with fesoterodine. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.
|Very common fesoterodine side-effects (these affect more than 1 in 10 people)||What can I do if I experience this?|
|Dry mouth (or throat)||Try chewing sugar-free gum or sucking sugar-free sweets|
|Common fesoterodine side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Feeling dizzy or sleepy||Do not drive or use tools or machines while affected|
|Headache||Ask your pharmacist to recommend a suitable painkiller|
|Indigestion, feeling sick, tummy (abdominal) pain||Eat simple meals - avoid rich or spicy foods|
|Diarrhoea||Drink plenty of water to replace lost fluids|
|Constipation||Try to eat a well-balanced diet and drink several glasses of water each day|
|Difficulties sleeping, dry eyes, discomfort when passing urine||If any of these become troublesome, speak with your doctor|
If you experience any other symptoms which you think may be due to the tablets, please speak with your doctor or pharmacist for further advice.
How to store fesoterodine
- 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
Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.
Further reading & references
- Manufacturer's PIL, Toviaz® 4 mg prolonged-release tablets and Toviaz® 8 mg prolonged-release tablets; Pfizer Limited, The electronic Medicines Compendium. Dated June 2015.
- British National Formulary; 69th Edition (Mar 2015) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
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 Adrian Bonsall