Dosing & Uses
Dosing Forms & Strength
tablet, extended release
Indicated for overactive bladder with symptoms of urge incontinence, urgency, and frequency
Initial: 7.5 mg PO qDay
May be increased to 15 mg based on patient response as early as 2 weeks later
Do not increase dose if taking concomitant CYP3A4 inhibitors
Moderate: Do not exceed initial dose of 7.5 mg/day
Severe: Not recommended
Swallow with water, do not crush, chew or cut
Safety and efficacy not established
Serious - Use Alternative
Significant - Monitor Closely
Dry mouth (19-35%)
Abdominal pain (2-4%)
Dry eyes (2%)
Back pain (>1%)
Abnormal vision (>2%)
Weight gain (>1%)
Flu-like syndrome (1-3%)
Peripheral edema (>1%)
Dermatologic: Erythema multiforme, interstitial granuloma annulare
General: Hypersensitivity reactions, including angioedema with airway obstruction and anaphylactic reaction; hallucinations
Uncontrolled narrow-angle glaucoma
Severe hepatic impairment
GI or Gu obstruction
Bladder outflow obstruction, controlled narrow-angle glaucoma, decreased GI motility, renal/hepatic impairment
Angioedema of the face, lips, tongue, and/or larynx have been reported, in some cases angioedema occurred after the first dose
CNS anticholinergic effects reported including headache, confusion, hallucinations, and somnolence
Heat prostration may occur in the presence of increased environmental temperature
Use caution in patients with decreased GI motility, hiatal hernia, reflux esophagitis, and ulcerative colitis
Use caution in patients with controlled narrow-angle glaucoma and patients with hepatic impairment, or myesthenia gravis
Pregnancy & Lactation
Pregnancy Category: C
Lactation: Excretion in milk unknown; use caution
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Mechanism of Action
Competitive muscarinic receptor antagonist of the M3 muscarinic receptor; receptor blocking limits bladder contractions, and reduce symptoms of bladder irritability/overactivity
Protein Bound: 98%
Vd: 163 L
Peak plasma time: 7 hr
Liver, by CYP3A4 and CYP2D6
Half-Life: 13-19 hr
Excretion: 60% urine; 40% feces
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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.
|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
|2||This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.|
|3||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.|
|4||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|5||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|6||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|NC||NOT COVERED – Drugs that are not covered by the plan.|
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.