Tolterodine (Detrusitol)

Tolterodine, sold under several brand names including Detrusitol, is a medicine used to help alleviate symptoms of urinary incontinence, such as stress incontinence or urge incontinence, and overactive bladder syndrome.

It works by relaxing the muscles that surround the bladder, which helps to increase the amount of urine your bladder can hold and reduces the risk of urine leaks.

One of the main causes of incontinence is overactive bladder muscles. Some of the main muscles involved are the detrusor muscles.

In healthy bladders, these muscles relax to allow the bladder to fill and contract to release urine. However, in incontinence, these muscles contract too often, which causes frequent and intense urges to urinate followed by leakage.

Tolterodine works by calming these muscles and reducing symptoms. It belongs to a class of medicines called antimuscarinics, sometimes known as anticholinergics or antispasmodics. It specifically works by blocking receptors in the detrusor muscle cells, preventing the chemical reaction which causes the muscles to contract.

When taken over several weeks, Tolterodine will work gradually to reduce urges and sudden leaking.

Detrusitol is suitable for most adults who struggle with urinary incontinence symptoms. However, if you have a certain medical condition, it may not be safe for you to take, such as if you:

• are allergic to tolterodine or any of the other ingredients
• are pregnant or breastfeeding
• are unable to pass urine (urinary retention)
• have uncontrolled glaucoma
• have myasthenia gravis (muscle weakness)
• have severe ulcerative colitis
• have a toxic megacolon

You should also consult your doctor if you have any of the following, as they will want to check it’s suitable for you to take:

• any gastrointestinal problems
• kidney or liver problems
• difficulty passing urine
• heart problems
• low levels of potassium, calcium or magnesium in your blood
• a hiatus hernia
• autonomic neuropathy - condition that affects autonomic bodily functions

For a full list of precautions, please refer to the patient information leaflet.

Detrusitol is available as both immediate and prolonged-release tablets. Immediate release tablets are available in two different dosages: 1mg and 2mg. Prolonged-release tablets, or slow/modified-release tablets, are available as 2mg and 4mg dosages.

The typical dosage is 4mg daily. Those with certain conditions that could make them more sensitive to Detrusitol, may need the lower dosage, which is 2mg a day.

Tablets must be swallowed whole, do not crush or chew them. You can take them before, after or during a meal.

If you take more Detrusitol than you’re supposed to, consult your doctor or pharmacist. If you miss a dose, take it as soon as you remember. If it’s nearly time for your next dose however, skip the missed dose and continue from your next scheduled dose.

How long does it take for Tolterodine (Detrusitol) to work?

Detrusitol starts to work within 3 - 8 hours. However, it may take up to 4 weeks to see overall improvements in your symptoms. If you haven’t seen any improvements after 2 - 3 months, you should consult your doctor for alternative treatment options.

As with all medications, there is a slight risk of side effects. However, the most common side effects are typically mild and go away on their own.

Some of the most common side effects include:

Rarer side effects may include heart problems, such as irregular heart rate, heart failure, and chest pain. If any of these symptoms are sudden, persistent or severe, seek medical advice.

If you experience any signs of an allergic reaction (e.g. any swelling or skin reaction), stop using Detrusitol and speak to your doctor.

If you are taking other medicines, it’s important you let your prescriber know. This includes any over-the-counter, herbal or prescription medicines.

You should not take Detrusitol with any of the following medicines:

• certain antibiotics (e.g. erythromycin and clarithromycin)
• antifungal medicines (e.g. ketoconazole and itraconazole)
• medicines used to treat HIV

There are other medicines that may react, so should be used with caution, such as:

• medicines that help with digestion (e.g. metoclopramide and cisapride)
• medicines for an irregular heartbeat (e.g. amiodarone)
• other antimuscarinic medicines
• medicines to have the opposite effect to Detrusitol

If you’re not sure, consult your doctor or healthcare provider for more details on the medicines you already take.

You can buy Detrusitol online here at euroClinix for urinary incontinence. All you have to do is complete an online medical questionnaire that will be reviewed by one of our UK-registered doctors. Once they approve you for treatment, our pharmacy will dispense and dispatch your prescription with free next-day delivery.