Detrusin-LA
Generic Name
Tolterodine Tartrate (Extended Release)
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| detrusin la 2 mg capsule | ৳ 8.00 | ৳ 40.00 |
Description
Overview of the medicine
Detrusin-LA 2 mg capsule contains tolterodine tartrate, an antimuscarinic agent used to treat symptoms of overactive bladder (OAB) with symptoms of urge urinary incontinence, urgency, and frequency. The extended-release formulation allows for once-daily dosing.
Uses & Indications
Dosage
Adults
Recommended dose is one 2 mg extended-release capsule once daily. The dose may be reduced to 1 mg extended-release capsule once daily based on individual response and tolerability.
Elderly
No dose adjustment is typically required, but caution is advised in elderly patients with hepatic or renal impairment.
Renal_impairment
For patients with severely reduced renal function (creatinine clearance <30 mL/min), the recommended dose is 1 mg extended-release capsule once daily.
How to Take
Swallow the capsule whole with a glass of water. Do not chew, crush, or break the capsule. Can be taken with or without food.
Mechanism of Action
Tolterodine is a competitive muscarinic receptor antagonist. It acts on muscarinic receptors in the bladder, inhibiting bladder contraction, thereby reducing urinary frequency, urgency, and urge incontinence associated with overactive bladder.
Pharmacokinetics
Onset
Clinical effects typically observed within 1-2 weeks of treatment, with full effect potentially taking 4 weeks.
Excretion
Mainly excreted in urine (approximately 77% as metabolites) and a small amount in feces.
Half life
Approximately 3.5 hours for tolterodine and 6.7 hours for the 5-hydroxymethyl metabolite (for extended-release).
Absorption
Well absorbed after oral administration. Peak plasma concentrations of the active metabolite (5-hydroxymethyl derivative) are reached in approximately 2-6 hours for extended-release capsules. Bioavailability is about 77%.
Metabolism
Primarily metabolized in the liver by CYP2D6 to the pharmacologically active 5-hydroxymethyl derivative. Further metabolism by CYP3A4 to inactive metabolites.
Side Effects
Contraindications
- Urinary retention
- Gastric retention
- Uncontrolled narrow-angle glaucoma
- Myasthenia gravis
- Severe ulcerative colitis
- Toxic megacolon
- Hypersensitivity to tolterodine or any excipients
Drug Interactions
Anticholinergic agents
Additive anticholinergic effects; avoid concomitant use.
Prokinetic agents (e.g., metoclopramide)
May antagonize the effects of prokinetic agents.
CYP2D6 inhibitors (e.g., quinidine, fluoxetine, paroxetine)
May increase plasma concentrations of tolterodine in poor metabolizers.
CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, erythromycin, clarithromycin, ritonavir)
May increase plasma concentrations of tolterodine, requiring dose reduction.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe anticholinergic effects (e.g., severe central anticholinergic effects like hallucinations, severe excitation; peripheral anticholinergic symptoms like dilated pupils, dry mouth, urinary retention, tachycardia). Treatment is symptomatic and supportive; physostigmine can be considered for severe central anticholinergic effects.
Pregnancy & Lactation
Pregnancy Category C. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is unknown if tolterodine is excreted in human milk; caution advised during breastfeeding.
Side Effects
Contraindications
- Urinary retention
- Gastric retention
- Uncontrolled narrow-angle glaucoma
- Myasthenia gravis
- Severe ulcerative colitis
- Toxic megacolon
- Hypersensitivity to tolterodine or any excipients
Drug Interactions
Anticholinergic agents
Additive anticholinergic effects; avoid concomitant use.
Prokinetic agents (e.g., metoclopramide)
May antagonize the effects of prokinetic agents.
CYP2D6 inhibitors (e.g., quinidine, fluoxetine, paroxetine)
May increase plasma concentrations of tolterodine in poor metabolizers.
CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, erythromycin, clarithromycin, ritonavir)
May increase plasma concentrations of tolterodine, requiring dose reduction.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe anticholinergic effects (e.g., severe central anticholinergic effects like hallucinations, severe excitation; peripheral anticholinergic symptoms like dilated pupils, dry mouth, urinary retention, tachycardia). Treatment is symptomatic and supportive; physostigmine can be considered for severe central anticholinergic effects.
Pregnancy & Lactation
Pregnancy Category C. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is unknown if tolterodine is excreted in human milk; caution advised during breastfeeding.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacturing date.
Availability
Pharmacies, hospitals, clinics
Approval Status
Approved by regulatory authorities (e.g., FDA, DGDA)
Patent Status
Generic versions available, original patent expired
Clinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of tolterodine extended-release in reducing symptoms of overactive bladder. Key trials typically focus on improvements in micturition frequency, urgency episodes, and urge incontinence episodes over placebo.
Lab Monitoring
- Liver function tests (in patients with hepatic impairment)
- Renal function tests (in patients with renal impairment)
- Monitor for anticholinergic effects such as urinary retention.
Doctor Notes
- Counsel patients on potential for anticholinergic side effects, particularly dry mouth and constipation.
- Assess for risk factors for urinary retention or narrow-angle glaucoma before initiating therapy.
- Consider dose adjustment in patients with significant hepatic or renal impairment or those taking potent CYP3A4 inhibitors.
Patient Guidelines
- Take as directed by your doctor.
- Do not crush or chew the capsule.
- Inform your doctor about all other medications you are taking.
- Report any severe side effects immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
This medicine may cause dizziness or blurred vision. If you experience these effects, avoid driving or operating machinery.
Lifestyle Advice
- Maintain adequate fluid intake.
- Avoid excessive caffeine or alcohol consumption, which can irritate the bladder.
- Practice bladder training techniques as advised by your healthcare provider.
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