Dosing & Uses
Dosage Forms & Strengths
tablet
- 20mg
capsule, extended release
- 60mg
Overactive Bladder
Immediate release: 20 mg PO twice daily
Extended Release: 60 mg PO qDay
Renal Impairment
CrCl <30 mL/min: 20 mg immediate release PO qHS; extended-release not recommended
CrCl≥30 mL/min: Dose adjustment not provided by manufacturer; monitor for increased adverse effects
Hepatic Impairment
Use with caution; dose adjustment not provided by manufacturer
Safety and efficacy not established
>75 years
Immediate release: May titrate down to 20 mg immediated release qDay based on tolerability
Extended release: 60 mg PO qDay
Interactions
Interaction Checker
No Results
Contraindicated
Serious
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious (5)
- glycopyrronium tosylate topical
glycopyrronium tosylate topical, trospium chloride. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.
- pramlintide
pramlintide, trospium chloride. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- revefenacin
revefenacin and trospium chloride both decrease cholinergic effects/transmission. Avoid or Use Alternate Drug. Coadministration may cause additive anticholinergic effects.
- secretin
trospium chloride decreases effects of secretin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Concomitant use of anticholinergic drugs may cause a hyporesponse to stimulation testing with secretin. Discontinue anticholinergic drugs at least 5 half-lives before administering secretin.
- sofpironium topical
sofpironium topical and trospium chloride both increase pharmacodynamic synergism. Avoid or Use Alternate Drug. Additive anticholinergic adverse effects may occur.
Monitor Closely (107)
- abobotulinumtoxinA
trospium chloride increases effects of abobotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Drugs with anticholinergic effects may potentiate botulinum toxin effects, which may result in excessive neuromuscular weakness and heighten systemic anticholinergic effects.
- aclidinium
aclidinium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- amantadine
trospium chloride, amantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Potential for increased anticholinergic adverse effects.
- amitriptyline
trospium chloride and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- amoxapine
trospium chloride and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- anticholinergic/sedative combos
anticholinergic/sedative combos and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- aripiprazole
trospium chloride decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.
aripiprazole increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - atracurium
atracurium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- atropine
atropine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- atropine IV/IM
atropine IV/IM and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- belladonna alkaloids
belladonna alkaloids and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- belladonna and opium
belladonna and opium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- benperidol
trospium chloride decreases levels of benperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of benperidol by pharmacodynamic antagonism. Use Caution/Monitor.
benperidol increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - benzgalantamine
benzgalantamine, trospium chloride. Either decreases effects of the other by pharmacodynamic antagonism. Use Caution/Monitor. Galantamine, an acetylcholinesterase inhibitor, enhances cholinergic effects. Coadministration with drugs that elicit anticholinergic effects may antagonize one another.
- benztropine
benztropine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.
- bethanechol
bethanechol increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carbachol
carbachol increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- cevimeline
cevimeline increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- chlorpromazine
trospium chloride decreases levels of chlorpromazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of chlorpromazine by pharmacodynamic antagonism. Use Caution/Monitor.
chlorpromazine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - cisatracurium
cisatracurium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- clomipramine
trospium chloride and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- clozapine
trospium chloride decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor.
clozapine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - cyclizine
cyclizine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- cyclobenzaprine
cyclobenzaprine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- darifenacin
darifenacin and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- daxibotulinumtoxinA
trospium chloride increases effects of daxibotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Drugs with anticholinergic effects may potentiate botulinum toxin effects, which may result in excessive neuromuscular weakness and heighten systemic anticholinergic effects.
- desipramine
trospium chloride and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- dicyclomine
dicyclomine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- digoxin
digoxin, trospium chloride. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
- diphenhydramine
diphenhydramine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- donepezil
donepezil increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- donepezil transdermal
donepezil transdermal, trospium chloride. Either decreases effects of the other by pharmacodynamic antagonism. Use Caution/Monitor.
- dosulepin
trospium chloride and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor.
- doxepin
trospium chloride and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.
- droperidol
trospium chloride decreases levels of droperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of droperidol by pharmacodynamic antagonism. Use Caution/Monitor.
droperidol increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - echothiophate iodide
echothiophate iodide increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fesoterodine
fesoterodine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- flavoxate
flavoxate and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- fluphenazine
trospium chloride decreases levels of fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor.
fluphenazine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - galantamine
galantamine decreases effects of trospium chloride by pharmacodynamic antagonism. Use Caution/Monitor. Galantamine may interfere with anticholinergic medication activity.
- glycopyrrolate
glycopyrrolate and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- glycopyrrolate inhaled
glycopyrrolate inhaled and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- haloperidol
trospium chloride decreases levels of haloperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of haloperidol by pharmacodynamic antagonism. Use Caution/Monitor.
haloperidol increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - henbane
henbane and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- homatropine
homatropine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- huperzine A
huperzine A increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- hyoscyamine
hyoscyamine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- hyoscyamine spray
hyoscyamine spray and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- iloperidone
trospium chloride decreases levels of iloperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of iloperidone by pharmacodynamic antagonism. Use Caution/Monitor.
iloperidone increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - imipramine
trospium chloride and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- incobotulinumtoxinA
trospium chloride increases effects of incobotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Drugs with anticholinergic effects may potentiate botulinum toxin effects, which may result in excessive neuromuscular weakness and heighten systemic anticholinergic effects.
- ipratropium
ipratropium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.
- letibotulinumtoxinA
trospium chloride increases effects of letibotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Drugs with anticholinergic effects may potentiate botulinum toxin effects, which may result in excessive neuromuscular weakness and heighten systemic anticholinergic effects.
- lofepramine
trospium chloride and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- loxapine
trospium chloride decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.
loxapine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - loxapine inhaled
loxapine inhaled increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.
trospium chloride decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor. - maprotiline
trospium chloride and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- meclizine
meclizine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- metformin
metformin will decrease the level or effect of trospium chloride by increasing renal clearance. Use Caution/Monitor. Coadministration reduced steady state trospium systemic exposure (decreased AUC and Cmax) by competing for renal tubular secretion
- methscopolamine
methscopolamine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- morphine
morphine, trospium chloride. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
- neostigmine
neostigmine increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nortriptyline
trospium chloride and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- olanzapine
trospium chloride decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.
olanzapine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - olanzapine/samidorphan
trospium chloride, olanzapine/samidorphan. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of olanzapine and other drugs with anticholinergic (antimuiscarinic) activity can increase risk for severe gastrointestinal adverse reactions related to hypomotility. .
- oliceridine
trospium chloride increases toxicity of oliceridine by Other (see comment). Use Caution/Monitor. Comment: Anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. Monitor for signs of urinary retention or reduced gastric motility if oliceridine is coadministered with anticholinergics.
- onabotulinumtoxinA
trospium chloride increases effects of onabotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Drugs with anticholinergic effects may potentiate botulinum toxin effects, which may result in excessive neuromuscular weakness and heighten systemic anticholinergic effects.
- orphenadrine
trospium chloride and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin
oxybutynin and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin topical
oxybutynin topical and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- oxybutynin transdermal
oxybutynin transdermal and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- paliperidone
trospium chloride decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.
paliperidone increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - pancuronium
pancuronium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
pancuronium, trospium chloride. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor. - perphenazine
trospium chloride decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.
perphenazine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - physostigmine
physostigmine increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pilocarpine
pilocarpine increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pimozide
trospium chloride decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor.
pimozide increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - prabotulinumtoxinA
trospium chloride increases effects of prabotulinumtoxinA by pharmacodynamic synergism. Use Caution/Monitor. Drugs with anticholinergic effects may potentiate botulinum toxin effects, which may result in excessive neuromuscular weakness and heighten systemic anticholinergic effects.
- pralidoxime
pralidoxime and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- procainamide
procainamide, trospium chloride. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
- prochlorperazine
trospium chloride decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor.
prochlorperazine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - promethazine
trospium chloride decreases levels of promethazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of promethazine by pharmacodynamic antagonism. Use Caution/Monitor.
promethazine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - propantheline
propantheline and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- protriptyline
trospium chloride and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.
- pyridostigmine
pyridostigmine increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- quetiapine
trospium chloride decreases levels of quetiapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of quetiapine by pharmacodynamic antagonism. Use Caution/Monitor.
quetiapine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - rapacuronium
rapacuronium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- rimabotulinumtoxinB
trospium chloride increases effects of rimabotulinumtoxinB by pharmacodynamic synergism. Use Caution/Monitor. Drugs with anticholinergic effects may potentiate botulinum toxin effects, which may result in excessive neuromuscular weakness and heighten systemic anticholinergic effects.
- risperidone
trospium chloride decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.
risperidone increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - rivastigmine
trospium chloride decreases effects of rivastigmine by cholinergic effects/transmission. Use Caution/Monitor.
- rocuronium
rocuronium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- scopolamine
scopolamine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- solifenacin
solifenacin and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- succinylcholine
succinylcholine increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- tenofovir DF
tenofovir DF, trospium chloride. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
- thioridazine
trospium chloride decreases levels of thioridazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of thioridazine by pharmacodynamic antagonism. Use Caution/Monitor.
thioridazine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - thiothixene
trospium chloride decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.
thiothixene increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - tiotropium
tiotropium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- tolterodine
tolterodine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.
- trazodone
trospium chloride and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.
- trifluoperazine
trospium chloride decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.
trifluoperazine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - trihexyphenidyl
trihexyphenidyl and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.
- trimipramine
trospium chloride and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.
- vancomycin
vancomycin, trospium chloride. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.
- vecuronium
trospium chloride and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.
- ziprasidone
trospium chloride decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor.
ziprasidone increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. - zotepine
trospium chloride decreases levels of zotepine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
trospium chloride decreases levels of zotepine by pharmacodynamic antagonism. Use Caution/Monitor.
Minor (3)
- dimenhydrinate
dimenhydrinate increases toxicity of trospium chloride by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.
- donepezil
donepezil decreases effects of trospium chloride by pharmacodynamic antagonism. Minor/Significance Unknown.
- levodopa
trospium chloride, levodopa. Other (see comment). Minor/Significance Unknown. Comment: Anticholinergic agents may enhance the therapeutic effects of levodopa; however, anticholinergic agents can exacerbate tardive dyskinesia. In high dosage, anticholinergics may decrease the effects of levodopa by delaying its GI absorption. .
Adverse Effects
>10%
Dry mouth (20.1%)
1-10%
Constipation (9.6%)
Tachycardia (<2%)
Headache (4.2%)
Fatigue (1.9%)
Rash (<2%)
Dyspepsia (1-2%)
Abdominal pain (1-3%)
Abdominal distention (<2%)
Constipation (9-10%)
Dry eyes (1-2%)
Dyspepsia (1-2%)
Flatulence (1-2%)
Urinary retention (<1%)
Urinary tract infection (1-7%)
Nasopharyngitis (3%)
Nasal dryness (1%)
Postmarketing Reports
Gastrointestinal: Gastritis
Cardiovascular: Palpitations, supraventricular tachycardia, chest pain, syncope, hypertensive crisis
Immunological: Stevens-Johnson syndrome, anaphylactic reaction, angioedema
Nervous system: Dizziness, confusion, vision abnormal, hallucinations, somnolence and delirium
Skeletal system: Musculoskeletal: Rhabdomyolysis
Dermatology: Rash
Warnings
Contraindications
Urinary/gastric retention
Uncontrolled narrow-angle glaucoma
Hypersensitivity
Cautions
Use caution in renal impairment, geriatric patients, moderate or severe hepatic dysfunction
Angioedema of the face, lips, tongue and/or larynx reported (including with 1st dose); if involvement of the tongue, hypopharynx, or larynx occurs promptly discontinue; promptly provide appropriate therapy and/or measures necessary to ensure a patent airway function
Administer with caution to patients with clinically significant bladder outflow obstruction or gastrointestinal obstructive disorders due to risk of urinary or gastric retention; use with caution in patients with conditions such as ulcerative colitis, intestinal atony, and myasthenia gravis
To administer, must carefully monitor patients with controlled narrow-angle glaucoma; benefits should outweigh risks
Somnolence reported; advise patients not to drive or operate heavy machinery until they know how therapy affects them
Drug substantially excreted by kidney; effects of moderate renal impairment on systemic exposure are not known but systemic exposure is likely increased; risk of anticholinergic adverse reactions (including dry mouth, constipation, dyspepsia, urinary tract infection, and urinary retention) is expected to be greater in patients with moderate renal impairment
Pregnancy & Lactation
Pregnancy Category: C
Lactation: Excretion in mikl unknown; use with caution
Pregnancy Categories
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.Pharmacology
Mechanism of Action
Reduces the smooth muscle tone of the bladder by antagonizing the effects of acetyl choline on muscarinic receptors.
Pharmacokinetics
Absorption: <10%; reduced when administered with high-fat meal
Half-life: 20 hr (immediate release)
Peak plasma time: 5-6 hr
Protein bound: 45-85%
Metabolism: Not fully elucidated; major pathway is thought to be ester hydrolysis followed by glucuronide conjugation of benzylic acid
Renal clearance: 29.07 L/hr
Excretion: Feces (85.2%); urine (5.8% with 60% unchanged drug)
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Formulary
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