Detrusitol (Tolterodine)

Detrusitol contains the active ingredient Tolterodine, and belongs to a class of medicines called antimuscarinics. It is used for the treatment of overactive bladder syndrome. People with overactive bladder syndrome may find that they:

• are unable to control urination (urinary incontinence)
• need to rush to the toilet without warning (urinary urgency)
• need to go to the toilet more often (urinary frequency)

Tolterodine works by relaxing the muscles surrounding the bladder. This helps to increase the amount of urine the bladder can hold and reduces the risk of urine leaks.

Tolterodine is sold under several brand names including Detrusitol. It is available as 1mg, 2mg and 4mg tablets.

This medicine is approved by the European Medicines Agency (EMA) and can be purchased online at euroClinix after completing an online consultation for overactive bladder symptoms.

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 hold urine, and contract to pass urine. However, in incontinence, these muscles contract too often, which causes frequent and intense urges to urinate.

How Tolterodine works

Prevents the action of certain brain signals

Tolterodine helps relax the muscles in the bladder by blocking the signals that activate the muscarinic receptors that tell the bladder to contract

Reduces symptoms

This helps reduce the urge to pee, calms bladder spasms, and increases control by tightening the muscles that keep urine in.

There are many advantages of taking this medicine for an overactive bladder.

Helps with bladder control

Tolterodine reduces frequent urination, urgency, and controls incontinence.

Improves quality of life

Taking Tolterodine helps reduce disruptions during your daily activities, giving you the freedom to go out and even get better sleep, without frequent nighttime bathroom trips.

Non-invasive option

Tolterodine provides a non-surgical alternative to managing overactive bladder symptoms, which is especially helpful before considering more aggressive treatments.

Simple dosing

Tolterodine is usually taken once or twice daily (depending on whether it's the immediate or extended-release version). This means it is easy to fit into your daily routine.

Research shows that Tolterodine is effective in treating symptoms of an overactive bladder.

A study was conducted with 177 patients aged 65 years or older with symptoms of urinary urgency, frequent urination, and/or incontinence. In this study, patients were randomised to receive treatment with Tolterodine 1 mg or 2 mg twice daily, or a placebo, for 4 weeks.

The results reported that:

• Tolterodine significantly reduced how often patients needed to urinate compared to placebo.
• Patients taking the 2 mg twice daily dose experienced fewer episodes of urge incontinence and passed a larger amount of urine when going to the toilet.

A separate study compared Tolterodine to another overactive bladder treatment, Oxybutynin. The results showed that although Oxybutynin works well, it often causes side effects such as dry mouth, resulting in many patients stopping treatment or lowering their dose. In contrast, Tolterodine avoids these problems, offering a safer, longer-lasting treatment.

Detrusitol is suitable for most adults who struggle with overactive bladder symptoms. However, there may be some groups of people this medicine isn’t suitable for.

Who can take this medicine?

This medicine is recommended for adults with symptoms of an overactive bladder. It is a great option for people wanting a non-surgical option for managing bladder symptoms, such as:

• having sudden urges to pee
• needing to pee more often
• not being able to hold in your pee

Who cannot take this medicine?

Do not take Tolterodine If you are allergic to the active ingredient or any of the other ingredients of this medicine. You should also avoid this medicine if you:

• cannot pass urine from the bladder
• have an uncontrolled narrow-angle glaucoma (high pressure in the eyes)
• have myasthenia gravis (excessive muscle weakness)
• have severe ulcerative colitis (ulceration and inflammation of the colon)
• have toxic megacolon (acute dilatation of the colon)

Talk to your doctor or pharmacist before taking this medicine if you have any of the following:

Digestive issues

• gastro-intestinal disease that affects your food passing or being digested
• hiatal hernia (when the upper part of the stomach bulges into the chest cavity)
• less bowel movements or severe constipation

Heart conditions

• abnormal heart tracing (ECG)
• a slow heart rate
• weak heart muscle
• reduced blood flow to the heart
• an irregular heartbeat
• heart failure

Other conditions

• trouble passing urine or have a poor stream of urine
• kidney or liver problems
• conditions that affect your blood pressure, bowel or sexual function
• very low blood levels of potassium, calcium, or magnesium

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

Tolterodine dosages

Detrusitol is available as both immediate and prolonged-release tablets. Immediate release tablets are available in 1mg and 2mg strengths. Prolonged-release tablets, or slow-release tablets, are available as 2mg and 4mg strengths.

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

How and when do I take it?

It’s important to take this medicine exactly as prescribed by your doctor. To take it correctly, follow the instructions below:

1. Take one 2mg tablet twice daily, in the morning and evening.
2. Tablets must be swallowed whole, do not crush or chew them.
3. You can take this medicine before, after or with a meal.

If you take more Detrusitol than you’re supposed to, consult your doctor or pharmacist.

How long do I take it for?

Your doctor will tell you how long your treatment will last. You should not stop your treatment early just because you do not begin to notice the effects right away. Your bladder will take time to get used to the medicine.

Your symptoms will typically be reviewed by your doctor after 2 to 3 months to assess whether the medication is effective. If you haven’t noticed any improvement by then, be sure to let your doctor know.

Dr. Caroline Fontana Lead Prescribing Doctor

What should I do if I miss a dose?

If you miss a dose, take it as soon as you remember. If it’s nearly time for your next dose, skip the missed dose and continue from your next scheduled dose. Do not take a double dose to make up for a missed dose as this can increase the chance of side effects.

This medicine starts to work within 3 to 8 hours. However, it may take 4 weeks or more to see the full effect and experience overall improvements in symptoms.

If you haven’t noticed any improvements after 2 to 3 months, you should consult your doctor for alternative treatment options.

It’s important to make certain lifestyle changes to ensure the overactive bladder treatment​ is effective and to reduce the risk of experiencing side effects.

How to improve an overactive bladder

Limit drinks that bother the bladder

• Some drinks that encourage your body to make more urine include caffeine, carbonated drinks and alcohol. Limit or remove these from your diet.

Keep a blader diary

• Writing down when you make trips to the toilet for a few days can help you understand your body better.
• It may also highlight things that make your symptoms worse.

Try double voiding

• ‘Double voiding’ is when you empty your bladder twice. After you go to the bathroom, wait a few seconds and then try to urinate again.
• This may be helpful for those who have trouble fully emptying their bladder.

Try pelvic floor exercises

• This involves quickly squeezing, holding, then relaxing your pelvic floor muscles over and over again.
• These exercises can strengthen the muscles that control urination and help to prevent incontinence and leaks.

Constipation can put pressure on your bladder and worsen your symptoms. To avoid constipation, add fiber to your diet to improve digestion. Try eating more oatmeal, whole grains, fresh fruits, and vegetables.

Silvia Fonda Nutritionist

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.

Common side effects

Uncommon side effects

If you experience any of the following uncommon but serious side effects, seek immediate medical attention:

• an allergic reaction (symptoms include a swollen face, tongue or throat, difficulty swallowing, hives, difficulty breathing, itching, rash, or hives).
• heart failure (symptoms include chest pain, difficulty breathing, getting tired at rest, difficulty breathing at night, swelling of the legs)

This is not a complete list of the potential side effects. For the full list, please refer to the patient information leaflet.

How can I manage the side effects?

Some common side effects of this medicine can be managed at home. Refer to the table below for helpful advice.

How to manage common side effects of Detrusitol

Headaches

Make sure to rest and consider taking a painkiller such as paracetamol, if recommended by your doctor.

Dry mouth

Chew sugar-free gum, suck on ice chips, or use a saliva substitute if needed.

Nausea or vomiting

Eat simple, bland foods and avoid spicy, rich or processed foods.

Dizziness or vertigo

Stand up gradually from a sitting or lying down position.

If you are taking other medicines, it’s important you let your doctor 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, clarithromycin)
• antifungal medicines (e.g. ketoconazole, itraconazole)
• HIV medicines

Other drug interactions that require caution include:

• medicines that help with digestion (e.g. metoclopramide, cisapride)
• medicines for an irregular heartbeat (e.g. amiodarone, sotalol, quinidine)
• other antimuscarinic medicines
• medicines that 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.

This is not a complete list of possible interactions. For a full list, refer to the BNF interaction checker.

For more information, refer to the safety information table below:

Safety Tips

Pregnancy Avoid

Do not use Detrusitol if you are pregnant. Inform your doctor immediately if you become pregnant during treatment.

Breastfeeding Avoid

Avoid breastfeeding while taking Detrusitol, as it is unknown if the active substance passes into breast milk.

Alcohol Caution

Be cautious when consuming alcohol during Detrusitol treatment, as it may worsen dizziness.

Driving Caution

Detrusitol may cause dizziness or blurred vision. Do not drive or operate machinery until you know how the medication affects you.

How to store

Store this medicine at room temperature, away from sunlight and moisture. Do not store above 25° C. Keep this medicine in its original packaging, out of the sight and reach of children.

Disposal

Do not use this medicine after the expiry date stated on the pack. To throw away any expired or unused medication, take it to your nearest pharmacy. Do not throw away medicines in your household waste or flush them down the toilet, as this may harm the environment.

No. Tolterodine is a prescription-only medicine which you can buy online here at euroClinix. You need a valid prescription from a healthcare professional to purchase it. This ensures the medication is safe and suitable for your needs.

To buy urinary incontinence medication, such as Tolterodine online from euroClinix, follow these simple steps:

1. Complete a quick online consultation to check your eligibility.
2. UK-registered doctors review your responses to ensure the medication is right for you.
3. Upon approval, an e-prescription will be issued.
4. Enjoy free delivery from our licensed pharmacy with tracking details.

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Start your online consultation today to enjoy professional care from the comfort of your home.

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• Experienced doctors manage your consultations and prescriptions.
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The price of Tolterodine at euroClinix includes everything you need:

• Free online consultation with our experienced doctors
• Free prescription, if approved
• Free delivery straight to your door

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If this medicine is not right for you, another alternative available is Vesicare. Find more information about the two in the table below: