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Tolterodine Tartrate ER

Tolterodine Tartrate ER is an extended-release (ER) medication used to treat symptoms of overactive bladder, such as urinary frequency, urgency, and urge incontinence. It belongs to the antimuscarinic or anticholinergic class of drugs, which work by relaxing the bladder muscles to reduce the number of involuntary bladder contractions. This helps improve bladder control and reduce episodes of urinary leakage.



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Frequently Asked Questions

Does Tolterodine help with urinary incontinence?
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Yes, it relaxes the bladder muscle and helps reduce the episodes of urinary incontinence.

Can Tolterodine cause constipation?
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Yes, constipation is a common side effect of Tolterodine.

Can I drink alcohol while taking Tolterodine?
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Alcohol might worsen the side effects of Tolterodine, such as dizziness, so it's best avoided.

What happens if I miss a dose?
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If you miss a dose, take it as soon as you remember. However, if it's almost time for the next dose, skip the missed dose. Never double up on doses.

How long does it take for Tolterodine to start working?
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Tolterodine starts working within a few hours, but it may take several days to achieve the maximum benefit.

Comprehensive Drug Guide

How Does Tolterodine Tartrate ER Work?

Tolterodine Tartrate ER works by blocking muscarinic receptors in the bladder, reducing the contractions of the bladder muscle. This action relaxes the bladder and increases its capacity, which helps to control the urgency and frequency of urination and reduce episodes of incontinence.



Common Dosages

  • 2 mg extended-release capsules
  • 4 mg extended-release capsules

Typical Dosing

  • The typical starting dose for most patients is 4 mg once daily. In individuals who cannot tolerate the full dose, the dosage may be reduced to 2 mg once daily.

Typical Dosing

FDA Approved Indications

  • Overactive bladder with symptoms of urinary frequency, urgency, and urge incontinence.

Pediatric Dosing

Pediatric dosing of tolterodine is generally not recommended as safety and effectiveness in this age group have not been established. Always follow the doctor's instructions.

Who Shouldn't Take Tolterodine Tartrate ER?

  • Urinary retention
  • Gastric retention
  • Uncontrolled narrow-angle glaucoma
  • Known hypersensitivity to tolterodine or any of its components

Advice From The Pharmacist

  • Take Tolterodine Tartrate ER exactly as prescribed, typically once daily. It can be taken with or without food.
  • Do not crush or chew the extended-release capsules, as they are designed to release the medication slowly over time.
  • Stay hydrated, as Tolterodine can cause dry mouth and reduce sweat production.
  • Avoid alcohol while taking Tolterodine, as it may increase drowsiness or dizziness.

Side Effects of Tolterodine Tartrate ER

Common Side Effects

  • Dry mouth
  • Constipation
  • Blurred vision
  • Dizziness
  • Fatigue


Uncommon/Severe Side Effects

  • Urinary retention (inability to urinate)
  • Severe allergic reactions (rash, swelling, difficulty breathing)
  • Increased heart rate
  • Cognitive issues or confusion, particularly in older adults

Risks and Warnings of Tolterodine Tartrate ER

  • Urinary Retention: Tolterodine can cause or worsen urinary retention, particularly in individuals with conditions that affect bladder emptying, such as an enlarged prostate.
  • Cognitive Effects: Older adults may be more susceptible to confusion, memory problems, and other cognitive issues while taking Tolterodine Tartrate ER.
  • Heat Intolerance: This medication may reduce the body's ability to sweat, increasing the risk of overheating during hot weather or physical activity.

Interactions with Tolterodine Tartrate ER

Common Drug Interactions

  • Other anticholinergic medications: Combining Tolterodine with other anticholinergic drugs (e.g., oxybutynin, benztropine) may increase the risk of side effects like dry mouth, constipation, and urinary retention.
  • CYP3A4 inhibitors: Drugs that inhibit the enzyme CYP3A4 (e.g., ketoconazole, erythromycin) may increase the levels of Tolterodine in the body, raising the risk of side effects.
  • Warfarin: Tolterodine may affect the effectiveness of blood thinners like warfarin. Monitoring of clotting times may be necessary.

Common Food Interactions


Alternatives to Tolterodine Tartrate ER

  • Oxybutynin ER: Another antimuscarinic medication used for the treatment of overactive bladder symptoms.
  • Solifenacin (Vesicare): A newer antimuscarinic agent with fewer side effects, particularly dry mouth.
  • Mirabegron (Myrbetriq): A beta-3 adrenergic agonist used for overactive bladder, with a different mechanism of action and a lower risk of dry mouth compared to antimuscarinics.
  • Trospium: Another anticholinergic used to treat urinary incontinence and overactive bladder.