Detrol LA is the long-acting capsule formulation of tolteradine tartrate. It is an antimuscarinic agent, and it works by blocking the parasympathetic nerve response in order to diminish symptoms of urge incontinence, urinary frequency and urgency. Patients suffering from overactive bladder (OAB) may benefit from this drug. Extended release oxybutynin is a similar drug for OAB symptoms, and appears to have similar efficacy and tolerability. All antimuscarinic drugs have side effects and drug interactions that may limit the ability to tolerate them for long-term use in some patients.
Pre-existing Conditions
Detrol LA can worsen certain pre-existing medical conditions. Patients with an obstructed bladder outlet could develop urinary retention if they take Detrol LA. Patients who have decreased gastrointestinal motility might develop bowel blockage with Detrol LA use. Narrow angle glaucoma, myasthenia gravis and and certain cardiac arhythmias could be worsened by Detrol LA. For that reason, it is important to use extra care with Detrol LA in these patients and to discuss other options for OAB treatment.
Drug Interactions
Some drugs can interfere with the metabolism of Detrol LA, causing more of the drug to remain in the body over time. These drugs can increase the level of Detrol LA in the blood and may require decreased dosages of Detrol LA. Fluoxetine (an antidepressant), itraconazole and ketoconazole (antifungals), and clarithromycin (an antibiotic) are examples of drugs that may interfere with Detrol LA. Tell your doctor if you are taking any of these medications.
Dry Mouth
The most common side effect of Detrol LA is dry mouth. This symptom can be very bothersome to some patients, and it is the most common reason for discontinuation of the drug. Almost one quarter of patients taking Detrol LA will have some dry-mouth symptoms. Chewing sugar-free gum, taking sips of water and avoiding excessive caffeine can help with this problem.
Other Side Effects
The sympathetic and parasympathetic nervous systems control many automatic functions in the body, such as peristalsis of the gut, dilation of pupils, and heart rate. Detrol LA can have side effects related to these functions. Dryness of the eyes and trouble with pupil function have been reported with Detrol LA. Both constipation and diarrhea have been reported as well. Some people taking Detrol LA have complained of palpitations. Elderly patients, particularly those with dementia, are more prone to confusion and memory impairment.
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