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
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 - Use Alternative
Significant - Monitor Closely
Minor
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
Controlled narrow-angle glaucoma
Renal impairment
Decreased GI motility
CNS anticholinergic effects reported including dizziness, confusion, hallucinations and somnolence
Geriatric patients
Pregnancy/lactation
Caution with moderate or severe hepatic dysfunction
Angioedema of the face, lips, tongue and/or larynx reported (including with 1st dose)
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)
Images
Patient Handout
Formulary
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