Formulary
Tolterodine tartrate: Indications, Dosing, Side Effects and Interactions
Tolterodine tartrate clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Tolterodine tartrate: Indications, Dosing, Side Effects and Interactions
Tolterodine tartrate clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Urinary frequency,Urinary urgency,Urinary incontinence**
- **Adult** (By Mouth Using Immediate-Release Medicines): 2 mg twice daily, reduced if not tolerated to 1 mg twice daily.
- **Adult** (By Mouth Using Modified-Release Capsules): 4 mg once daily.
**Urinary frequency, Urinary urgency, Urinary incontinence for tolterodine tartrate**
- **Child 2-17 years** (By mouth using immediate-release medicines): 1 mg once daily, then increased if necessary up to 2 mg twice daily, adjusted according to response.
- **Child 2-17 years** (By mouth using modified-release capsules): 4 mg once daily.
**Nocturnal enuresis associated with overactive bladder for tolterodine tartrate**
- **Child 5-17 years** (By mouth using immediate-release medicines): 1 mg once daily, dose to be taken at bedtime, then increased if necessary up to 2 mg twice daily, adjusted according to response.
Cautions
For all antimuscarinics (systemic) Acute myocardial infarction; arrhythmias (may be worsened); autonomic neuropathy; cardiac insufficiency (due to association with tachycardia); cardiac surgery (due to association with tachycardia); conditions characterised by tachycardia; congestive heart failure (may be worsened); coronary artery disease (may be worsened); diarrhoea; elderly (especially if frail); gastro-oesophageal reflux disease; hiatus hernia with reflux oesophagitis; hypertension; hyperthyroidism (due to association with tachycardia); individuals susceptible to angle-closure glaucoma; prostatic hyperplasia; pyrexia; ulcerative colitis Cautions, further information Elderly Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria to aid medication reviews (see Prescribing in the elderly for information). Potentially inappropriate: if treating extrapyramidal side-effects of antipsychotic medications (risk of antimuscarinic toxicity) with delirium or dementia (risk of exacerbation of cognitive impairment), angle-closure glaucoma (contra-indicated; risk of acute exacerbation of glaucoma), or chronic prostatism (risk of urinary retention) if two or more antimuscarinic drugs prescribed concomitantly (risk of increased antimuscarinic toxicity) Cautions For tolterodine tartrate History of QT-interval prolongation
Contraindications
For all antimuscarinics (systemic) Angle-closure glaucoma; gastro-intestinal obstruction; intestinal atony; myasthenia gravis (but some antimuscarinics may be used to decrease muscarinic side-effects of anticholinesterases); paralytic ileus; pyloric stenosis; severe ulcerative colitis; significant bladder outflow obstruction; toxic megacolon; urinary retention
Side effects
For all antimuscarinics (systemic) Common or very common Constipation; dizziness; drowsiness; dry mouth; dyspepsia; flushing; headache; nausea; palpitations; skin reactions; tachycardia; urinary disorders; vision disorders; vomiting Rare or very rare Angioedema; confusion (more common in elderly) Side-effects For tolterodine tartrate Common or very common Abdominal pain; bronchitis; chest pain; diarrhoea; dry eye; fatigue; gastrointestinal disorders; paraesthesia; peripheral oedema; vertigo; weight increased Uncommon Arrhythmia; heart failure; memory loss; nervousness Frequency not known Hallucination
Interactions
**Severe interactions:**
- Concomitant treatment with fluoxetine (a potent CYP2D6 inhibitor) does not result in a clinically significant interaction since tolterodine and its CYP2D6-dependent metabolite, 5-hydroxymethyl...
**Other interactions (2):**
- Concomitant systemic medication with potent CYP3A4 inhibitors such as macrolide antibiotics (erythromycin and clarithromycin), antifungal agents (e.g.
- Drug interaction studies have shown no interactions with warfarin or combined oral contraceptives (ethinyl estradiol/levonorgestrel).
Pregnancy
Manufacturer advises avoid-toxicity in animal studies.
Breast feeding
Manufacturer advises avoid-no information available.
Hepatic impairment
Manufacturer advises caution (risk of increased exposure). Dose adjustments For immediate-release medicines , manufacturer advises dose reduction to 1 mg twice daily. For modified-release capsules , manufacturer advises dose reduction to 2 mg once daily.
Renal impairment
Manufacturer advises caution (risk of increased exposure). Dose adjustments See Prescribing in renal impairment . For immediate-release medicines , manufacturer advises dose reduction to 1 mg twice daily if eGFR less than or equal to 30 mL/minute/1.73 m 2 . For modified-release capsules , manufacturer advises dose reduction to 2 mg once daily if eGFR less than or equal to 30 mL/minute/1.73 m 2 .
Medicinal forms
Solution,Tablet,Capsule
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
Inside MedNext for this topic
- 411 MedNext-authored chapters
- 80,000+ MCQ bank
- 15 study modes
- Growing visual cheat sheets
Study modes
- Notes
- MCQ
- Audio
- Video
- Visual
- 3D Anatomy
- Trace
- Flashcards
- Mnemonics
- Image Bank
- Clinical
- Microscopy
- Audio QBank
- Cadaver
- Book Match
Continue reading
Subject HubPharmacology Hub
All pharmacology resources in one place.
Drug SchedulesIndian Drug Schedules
Schedule H, H1, X and G classifications.
FormularyBrowse all drugs
Search 1,850+ drug profiles.
Study Tolterodine tartrate in the MedNext app
Challenge yourself with targeted pharmacology MCQs on this drug class. Every explanation links back to the chapter that teaches the concept.
Start drug challengeExplore the full formulary

