Can you take Flutamide with Tolterodine?
1 drug interaction and 12 additional warnings found for the following 2 drugs:
- flutamide
- tolterodine
Drug interactions
Moderate drug interactions
Moderate:
flutamide tolterodine
Applies to: flutamide and tolterodine
Using flutamide together with tolterodine can increase the risk of an irregular heart rhythm that may be serious and potentially life-threatening, although it is a relatively rare side effect.
You may be more susceptible if you have:
- a heart condition called congenital long QT syndrome
- other cardiac diseases
- conduction abnormalities
- electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting)
Talk to your doctor if you have any questions or concerns. Your doctor may already be aware of the risks, but has determined that this is the best course of treatment for you and has taken appropriate precautions and is monitoring you closely for any potential complications.
You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications, whether together or alone.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Food/lifestyle interactions
Moderate food/lifestyle interactions
Moderate:
flutamide Nicotine
Applies to: flutamide
As you stop smoking during treatment with nicotine, your dosage requirement of flutamide may need to be changed. Talk to your doctor if you have any questions or concerns.
Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications.
It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.
Disease interactions
11 potential interactions Applies to: 10 conditions, including Myasthenia Gravis, Dementia, Urinary Retention, Liver Disease, and Long QT Syndrome.
Central Nervous System Disorders
Moderate:
tolterodine
Tolterodine has a moderate potential interaction with Central Nervous System Disorders.
Tolterodine is associated with anticholinergic central nervous system (CNS) effects. If a patient experiences anticholinergic CNS effects, dose reduction or drug discontinuation should be considered. Tolterodine should be used with caution in patients with Parkinson's disease and in patients with preexisting dementia treated with cholinesterase inhibitors due to the risk of aggravation of symptoms.
Dementia
Moderate:
tolterodine
Tolterodine has a moderate potential interaction with Dementia.
Tolterodine is associated with anticholinergic central nervous system (CNS) effects. If a patient experiences anticholinergic CNS effects, dose reduction or drug discontinuation should be considered. Tolterodine should be used with caution in patients with Parkinson's disease and in patients with preexisting dementia treated with cholinesterase inhibitors due to the risk of aggravation of symptoms.
Gastrointestinal Obstruction
Major:
tolterodine
Tolterodine has a major potential interaction with Gastrointestinal Obstruction.
The use of tolterodine is contraindicated in patients with GI obstruction, ileus, or obstructive uropathy. Tolterodine exerts anticholinergic activity by competitive antagonism of muscarinic receptors.
Glaucoma/Intraocular Hypertension
Major:
tolterodine
Tolterodine has a major potential interaction with Glaucoma/Intraocular Hypertension.
The use of tolterodine is contraindicated in patients with uncontrolled angle-closure (narrow angle) glaucoma. Tolterodine exerts anticholinergic activity and can result in increased intraocular pressure and loss of accommodation.
Hemolytic Anemia
Moderate:
flutamide
Flutamide has a moderate potential interaction with Hemolytic Anemia.
Toxicity consistent with aniline exposure such as methemoglobinemia, hemolytic anemia, and cholestatic jaundice has been reported during flutamide therapy. Therapy with flutamide should be administered cautiously in patients with glucose-6-phosphate deficiency, hemoglobin M disease, and patients who smoke. Clinical monitoring of methemoglobin levels in susceptible individuals is recommended,
Liver Disease
Major:
flutamide
Flutamide has a major potential interaction with Liver Disease.
There have been postmarketing reports of hospitalization and rarely death due to liver failure in patients taking flutamide. Signs of hepatic injury included elevated serum transaminase levels, jaundice, hepatic encephalopathy and death related to acute hepatic failure. The hepatic injury was reversible after discontinuation of therapy in some patients. Approximately half of the reported cases occurred within the initial 3 months of treatment. Serum transaminase levels should be measured prior to starting treatment with flutamide. Flutamide is not recommended in patients whose ALT values exceed twice the upper limit of normal. Serum transaminase levels should then be measured monthly for the first 4 months of therapy, and periodically thereafter. Liver function tests also should be obtained at the first signs and symptoms suggestive of liver dysfunction, e.g., nausea, vomiting, abdominal pain, fatigue, anorexia, "flu-like" symptoms, hyperbilirubinuria, jaundice or right upper quadrant tenderness. If at any time, a patient has jaundice, or their ALT rises above 2 times the upper limit of normal, flutamide should be immediately discontinued with close follow-up of liver function tests. Flutamide should be administered with extreme caution in patients with or predisposed to compromised hepatic function, and it is contraindicated in patients with severe hepatic impairment.
Moderate:
tolterodine
Tolterodine has a moderate potential interaction with Liver Disease.
Tolterodine undergoes biotransformation in the liver of extensive metabolizers to an active metabolite. Poor metabolizers have a greater concentration of active parent and less active metabolite, however the net activity of tolterodine is expected to be the same. The pharmacokinetic disposition of tolterodine can be significantly altered in patients with hepatic dysfunction. Therapy with tolterodine should be administered cautiously in patients with severe hepatic impairment and dosage should be reduced to no greater than 1 mg twice daily.
Long QT Syndrome
Moderate:
tolterodine
Tolterodine has a moderate potential interaction with Long QT Syndrome.
Tolterodine has been associated with QT prolongation. The effect on QT interval correlates with plasma concentration of tolterodine. Caution is recommended when prescribing this agent to patients with a known history of QT prolongation or to patients who are taking Class IA (e.g., quinidine, procainamide) or Class III (e.g., amiodarone, sotalol) antiarrhythmic medications.
Myasthenia Gravis
Moderate:
tolterodine
Tolterodine has a moderate potential interaction with Myasthenia Gravis.
Tolterodine acts as a competitive antagonist of acetylcholine at postganglionic muscarinic receptors. Caution is recommended when using this agent in patients with myasthenia gravis, a disease characterized by decreased cholinergic activity at the neuromuscular junction.
Renal Dysfunction
Moderate:
tolterodine
Tolterodine has a moderate potential interaction with Renal Dysfunction.
The renal elimination of tolterodine and active metabolite is limited and a prolonged half-life is not anticipated in patients with renal impairment. However, the pharmacokinetic disposition of tolterodine has not been evaluated in patients with renal impairment and it is recommended that tolterodine be administered cautiously in patients with compromised renal function.
Urinary Retention
Major:
tolterodine
Tolterodine has a major potential interaction with Urinary Retention.
The use of tolterodine is contraindicated in patients with GI obstruction, ileus, or obstructive uropathy. Tolterodine exerts anticholinergic activity by competitive antagonism of muscarinic receptors.
More resources
flutamide
A total of 351 drugs are known to interact with flutamide.
- Flutamide is in the following drug classes: antiandrogens, hormones/antineoplastics.
-
Flutamide is used to treat the following conditions:
- Hirsutism (off-label)
- Prostate Cancer
tolterodine
A total of 670 drugs are known to interact with tolterodine.
- Tolterodine is in the drug class urinary antispasmodics.
- Tolterodine is used to treat the following conditions:
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.