Toltrex 2

Indications for Toltrex

Toltrex is indicated for the treatment of an overactive bladder, providing relief from symptoms such as:

• Urge urinary incontinence
• Urgency
• Frequent urination

Important: Always consult a registered healthcare provider before starting any medication.

Pharmacology of Toltrex

Tolterodine is a specific muscarinic receptor antagonist with a high selectivity for the urinary bladder over other tissues such as the salivary glands. It works by inhibiting overactive bladder contractions, leading to reduced urgency and frequency of urination. In extensive metabolizers, the active metabolite (5-hydroxymethyl derivative) contributes significantly to the therapeutic effect. Patients typically start to feel the benefits of treatment within 4 weeks.

Dosage & Administration

• Extended-release capsule: The usual dose of Tolterodine Tartrate is 4 mg once daily. Depending on individual response and tolerance, the dose can be reduced to 2 mg per day. For those with liver or kidney impairment, or those on potent CYP3A4 inhibitors, the recommended dose is 2 mg daily.
• Film-coated tablet: The recommended dose for Tolterodine Tartrate is 2 mg twice daily, except for patients with liver or severe kidney dysfunction (GFR <30 ml/min), in which case the dose should be 1 mg twice daily. If side effects are troublesome, the dose may be reduced to 1 mg twice daily. Re-evaluation of the treatment effect should occur after 2-3 months.
• Pediatric use: The safety and effectiveness of Tolterodine for children have not been established.
• Geriatric use: No significant safety differences have been observed between older and younger patients.

Important: Always follow the dosage recommendations provided by a healthcare professional.

Drug Interactions

• Ketoconazole, a potent inhibitor of CYP3A4, significantly increases Toltrex plasma concentrations in poor metabolizers. If using Ketoconazole or other potent CYP3A4 inhibitors (such as Itraconazole, Miconazole, or Macrolide antibiotics like Erythromycin), the recommended dose of Toltrex is 2 mg daily.

Contraindications

Tolterodine Tartrate should not be used in patients with:

• Urinary retention
• Gastric retention
• Uncontrolled narrow-angle glaucoma
• Known hypersensitivity to any component of the medication.

Side Effects

Common side effects associated with Toltrex include:

• Dry mouth (most frequent)
• Headache
• Constipation
• Abdominal pain

Other potential side effects include blurred vision, urinary retention, and dry eyes, which are typical of antimuscarinic agents. If side effects persist or worsen, consult your healthcare provider.

Pregnancy & Lactation

• Pregnancy: There are no studies on the use of Tolterodine in pregnant women. It should only be used if the potential benefits justify the risks to the fetus.
• Breastfeeding: It is not known if Tolterodine is excreted in human milk, so it is not recommended for nursing mothers. A decision should be made to either discontinue nursing or discontinue the medication.

Precautions & Warnings

Toltrex should be used with caution in patients with:

• Clinically significant bladder outflow obstruction (risk of urinary retention)
• Gastrointestinal obstructive disorders, such as pyloric stenosis (risk of gastric retention)
• Narrow-angle glaucoma

For patients with reduced liver or kidney function, the dose should be reduced to 2 mg daily. In patients with a history of QT prolongation or those on antiarrhythmic medications (Class IA or III), Toltrex should be prescribed with caution.

Patients should be aware that Toltrex may cause blurred vision, dizziness, or drowsiness.

Overdose Effects

Overdose of Toltrex may result in severe central anticholinergic effects. Immediate treatment is required, and ECG monitoring is recommended in the event of an overdose.

Therapeutic Class

• BPH (Benign Prostatic Hyperplasia)
• Urinary Retention
• Urinary Incontinence

Storage Conditions

Store Toltrex in a cool, dry place away from light and moisture. Keep out of the reach of children.