Formulary
Trospium chloride: Indications, Dosing, Side Effects and Interactions
Trospium chloride clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Trospium chloride: Indications, Dosing, Side Effects and Interactions
Trospium chloride clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Urinary frequency,Urinary urgency,Urge incontinence**
- **Adult** (By Mouth Using Immediate-Release Medicines): 20 mg twice daily, to be taken before food.
- **Adult** (By Mouth Using Modified-Release Medicines): 60 mg once daily.
**Urinary frequency, Urinary urgency, Urge incontinence for trospium chloride**
- **Child 12-17 years** (By mouth using immediate-release medicines): 20 mg twice daily, to be taken before food.
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)
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 trospium chloride Common or very common Abdominal pain Uncommon Chest pain; diarrhoea; flatulence Rare or very rare Arthralgia; asthenia; dyspnoea; myalgia Frequency not known Agitation; anaphylactic reaction; hallucination; severe cutaneous adverse reactions (SCARs)
Interactions
**Other interactions (3):**
- Pharmacodynamic interactions: The following potential pharmacodynamic interactions may occur: Potentiation of the effect of drugs with anticholinergic action (such as amantadine, tricyclic...
- Pharmacokinetic interactions: An inhibition of the absorption of trospium chloride with drugs like guar, colestyramine and colestipol cannot be excluded.
- Though trospium chloride was shown not to affect pharmacokinetics of digoxin, an interaction with other active substances eliminated by active tubular secretion cannot be excluded.
Pregnancy
Manufacturer advises caution.
Breast feeding
Manufacturer advises caution.
Hepatic impairment
Manufacturer advises caution in mild to moderate impairment; avoid in severe impairment (no information available).
Renal impairment
Use with caution. Avoid Regurin XL . Dose adjustments Reduce dose to 20 mg once daily or 20 mg on alternate days if eGFR 10-30 mL/minute/1.73m 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.
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