Detrusin-LA
Generic Name
Tolterodine tartrate extended-release capsule
Manufacturer
Leading Pharmaceutical Company
Country
Global
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| detrusin la 4 mg capsule | ৳ 15.00 | ৳ 75.00 |
Description
Overview of the medicine
Detrusin-LA 4 mg capsule is an extended-release medication used to treat symptoms of overactive bladder, such as urge urinary incontinence, urgency, and frequent urination. It contains tolterodine tartrate, an anticholinergic agent that relaxes the bladder muscle.
Uses & Indications
Dosage
Adults
The recommended dose is one Detrusin-LA 4 mg extended-release capsule once daily.
Elderly
No dosage adjustment is routinely required based on age, but caution is advised in elderly patients due to potential decreased renal and hepatic function.
Renal_impairment
For patients with severely reduced renal function (creatinine clearance <30 mL/min), the recommended dose is 2 mg once daily. For moderate impairment, start with 2 mg and consider increasing to 4 mg based on tolerance.
How to Take
Detrusin-LA capsules should be swallowed whole with liquid and must not be chewed, divided, or crushed. It can be taken with or without food.
Mechanism of Action
Tolterodine is a competitive muscarinic receptor antagonist. It works by blocking the action of acetylcholine at muscarinic receptors in the bladder, thereby inhibiting bladder contractions and reducing urinary urgency and frequency. Its selectivity for the bladder over salivary glands may contribute to a lower incidence of dry mouth compared to non-selective anticholinergics.
Pharmacokinetics
Onset
Clinical effects may be observed within a few hours, but full therapeutic effect may take several weeks.
Excretion
Approximately 77% of a dose is excreted in the urine and 17% in the feces, predominantly as metabolites.
Half life
Approximately 2-4 hours for the active metabolite (5-hydroxymethyl derivative). The parent drug has a shorter half-life.
Absorption
Well absorbed after oral administration, with peak plasma concentrations achieved in 2-6 hours for the extended-release formulation. Food increases exposure.
Metabolism
Extensive hepatic metabolism, primarily via CYP2D6 to the active 5-hydroxymethyl metabolite, and to a lesser extent via 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 component of the formulation
Drug Interactions
Prokinetic agents (e.g., metoclopramide)
May antagonize the effects of prokinetic agents due to decreased gastrointestinal motility.
Potent CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, clarithromycin)
May increase plasma concentrations of tolterodine, especially in poor CYP2D6 metabolizers. A lower dose (2 mg daily) of tolterodine may be necessary.
Drugs with anticholinergic properties (e.g., tricyclic antidepressants, phenothiazines)
May potentiate anticholinergic effects (e.g., dry mouth, constipation, urinary retention).
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, excitation; severe mydriasis; dry mucous membranes; tachycardia; urinary retention). Treatment should be symptomatic and supportive; physostigmine can be used for severe central anticholinergic effects.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is unknown whether tolterodine is excreted in human milk; caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Urinary retention
- Gastric retention
- Uncontrolled narrow-angle glaucoma
- Myasthenia gravis
- Severe ulcerative colitis
- Toxic megacolon
- Hypersensitivity to tolterodine or any component of the formulation
Drug Interactions
Prokinetic agents (e.g., metoclopramide)
May antagonize the effects of prokinetic agents due to decreased gastrointestinal motility.
Potent CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, clarithromycin)
May increase plasma concentrations of tolterodine, especially in poor CYP2D6 metabolizers. A lower dose (2 mg daily) of tolterodine may be necessary.
Drugs with anticholinergic properties (e.g., tricyclic antidepressants, phenothiazines)
May potentiate anticholinergic effects (e.g., dry mouth, constipation, urinary retention).
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, excitation; severe mydriasis; dry mucous membranes; tachycardia; urinary retention). Treatment should be symptomatic and supportive; physostigmine can be used for severe central anticholinergic effects.
Pregnancy & Lactation
Pregnancy Category C. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is unknown whether tolterodine is excreted in human milk; caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from manufacturing date
Availability
Pharmacies, hospitals
Approval Status
Approved by regulatory authorities (e.g., FDA, DGDA)
Patent Status
Generic versions available
Clinical Trials
Extensive clinical trials have demonstrated the efficacy and safety of tolterodine extended-release in reducing symptoms of overactive bladder compared to placebo.
Lab Monitoring
- Monitoring of renal and hepatic function may be considered in patients with pre-existing impairment. Regular eye examinations are recommended for patients with glaucoma.
Doctor Notes
- Emphasize patient education on proper administration and potential side effects.
- Assess for pre-existing conditions like urinary retention or uncontrolled glaucoma before prescribing.
- Consider starting with a lower dose (2 mg) in patients with severe renal or hepatic impairment, or those on potent CYP3A4 inhibitors.
Patient Guidelines
- Take the capsule whole; do not chew, crush, or divide it.
- This medication may cause dizziness or blurred vision; avoid driving or operating machinery until you know how it affects you.
- Report any severe constipation, difficulty urinating, or worsening of symptoms to your doctor.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Detrusin-LA may cause dizziness, somnolence, or blurred vision. Patients should be cautioned about engaging in activities requiring mental alertness, such as driving a motor vehicle or operating heavy machinery, until they know how the drug affects them.
Lifestyle Advice
- Maintain adequate fluid intake.
- Avoid caffeine and alcohol, as they can irritate the bladder.
- Practice bladder training techniques as advised by your healthcare provider.
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