Tolterodine Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Urinary Incontinence

Initial dose:
Tablets: 2 mg orally twice a day
Extended release capsules: 4 mg orally once a day

Maintenance dose:
Tablets: 1 to 2 mg orally twice a day, depending on the patient's response and tolerability
Extended release capsules: 2 to 4 mg orally once a day, depending on the patient's response and tolerability

Usual Adult Dose for Urinary Frequency

Initial dose:
Tablets: 2 mg orally twice a day
Extended release capsules: 4 mg orally once a day

Maintenance dose:
Tablets: 1 to 2 mg orally twice a day, depending on the patient's response and tolerability
Extended release capsules: 2 to 4 mg orally once a day, depending on the patient's response and tolerability

Renal Dose Adjustments

Significantly reduced renal function:
Tablets: 1 mg orally twice a day
Extended release capsules: 2 mg orally once a day

Liver Dose Adjustments

Significantly reduced hepatic function:
Tablets: 1 mg orally twice a day
Extended release capsules: 2 mg orally once a day

Dose Adjustments

Concomitant use of potent CYP450 3A4 inhibitors:
Tablets: 1 mg orally twice a day
Extended release capsules: 2 mg orally once a day

Precautions

Tolterodine is contraindicated in patients with urinary retention, gastric retention, or uncontrolled narrow-angle glaucoma. Therapy with tolterodine should be administered cautiously in patients with significant bladder outflow obstruction, decreased gastrointestinal motility, or gastrointestinal obstruction (e.g., pyloric stenosis) because of the risk of urinary and gastric retention.

Tolterodine should be used with caution in patients with myasthenia gravis.

Tolterodine may exacerbate narrow-angle glaucoma and should be used cautiously in patients treated for this condition.

Caution should be used when administering tolterodine to patients with congenital or acquired QT prolongation or patients who are taking Class IA antiarrhythmic medications. In studies using the immediate release tablets, the effect of tolterodine on the QT interval appeared greater for 8 mg/day (twice the therapeutic dose) compared to 4 mg/day and was more pronounced in CYP450 2D6 poor metabolizers than extensive metabolizers.

Safety and efficacy have not been established in pediatric patients (less than 18 years of age).

Dialysis

Data not available

Other Comments

Spontaneous postmarketing adverse events reported in association with the use of tolterodine in clinical practice have included: anaphylactoid reactions, tachycardia, and peripheral edema.

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