Tolterodine will help to ease urinary symptoms such as urge, frequency and incontinence.
The most common side-effects are a dry mouth and headache. It can also affect your vision or cause you to feel tired. If this happens to you, do not drive or use tools or machines while you are affected.
|Type of medicine||An antimuscarinic medicine|
|Used for||Urinary symptoms such as frequency, urgency and incontinence|
|Also called||Detrusitol®; Blerone® XL; Efflosomyl® XL; Inconex® XL; Mariosea® XL; Neditol® XL; Preblacon® XL; Santizor® XL|
|Available as||Tablets and prolonged-release capsules|
Tolterodine is prescribed for people who have difficulty controlling their bladders. It is given to treat 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, including weakened pelvic floor muscles and problems causing your bladder muscles to contract too much or too early. Sometimes the cause of the symptoms is unknown.
Tolterodine 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.
In addition to these uses, tolterodine can also be prescribed on the advice of a specialist for older children (over 5 years of age) to help reduce bedwetting caused by an overactive bladder. If your child has been prescribed it for this reason, please ask your child's specialist if you require any further information about the medicine.
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 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; 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 tolterodine
- Before you start the treatment, read the manufacturer's printed information leaflet from inside the pack. It will give you more information about tolterodine and will provide you with a full list of the side-effects which you may experience from taking it.
- Take tolterodine exactly as your doctor tells you to. Your dose will be printed on the label of the pack to remind you about what the doctor said to you.
- If you have been given tablets, you will be asked to take one tablet twice daily. There are two strengths of tablet: 1 mg and 2 mg. It is usual to start by taking the 2 mg strength tablet. Your doctor may recommend the lower 1 mg strength tablet for you if side-effects become troublesome.
- If you have been given capsules, you will be asked to take one capsule daily. There are two strengths of capsule available: 2 mg and 4 mg. It is usual to take the 4 mg strength capsule. The capsules have been specially made to release tolterodine evenly over the day, so it is important that you swallow the capsule whole - do not chew it before you swallow.
- You can take tolterodine either before or after meals. Swallow your doses with a drink of water.
- Try to take your doses at the same times of day each day, as this will help you to remember to take them regularly. If you do forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose, in which case leave out the missed dose. 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.
- 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 buy any medicines or herbal remedies, always check with a pharmacist that they are suitable to take with tolterodine. Some medicines (particularly antihistamines) can increase the chance that you will experience unwanted effects such as a dry mouth, constipation and feeling sleepy.
Can tolterodine 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 tolterodine. 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 tolterodine side-effects (these affect more than 1 in 10 people)
||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|
|Common tolterodine side-effects (these affect less than 1 in 10 people)||What can I do if I experience this?|
|Blurred vision, feeling sleepy, tired or dizzy||Do not drive or use tools or machines|
|Indigestion, tummy (abdominal) pain, feeling sick||Eat simple meals - avoid rich or spicy foods|
|Constipation||Try to eat a well-balanced diet and drink several glasses of water each day|
|Diarrhoea||Drink plenty of water to replace the lost fluids|
|Chest infections, skin tinglings, a fast heartbeat, dry skin, discomfort passing urine, putting on weight, dry eyes||Discuss these with your doctor if any become troublesome|
If you experience any other symptoms which you think may be due to tolterodine, please speak with your doctor or pharmacist for further advice.
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
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, Detrusitol® 1 mg and 2 mg film-coated tablets; Pfizer Limited, The electronic Medicines Compendium. Dated May 2012.
- Manufacturer's PIL, Detrusitol XL® 4 mg capsules; Pfizer Limited, The electronic Medicines Compendium. Dated May 2012.
- 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 John Cox