Tolterodine (Detrusitol): Uses, Dosage & Side Effects
Complete guide to tolterodine: understanding overactive bladder treatment, dosage, and side effects.
Tolterodine: Understanding Your Overactive Bladder Treatment
Tolterodine is prescribed for people who have difficulty controlling their bladders and is given to treat symptoms such as urgency, frequency, and incontinence. This medication belongs to a group of medicines called antispasmodics and works by helping to control the release of urine by reducing spasm and relaxing the smooth muscle of the bladder wall. Understanding how tolterodine works and how to use it safely is essential for managing overactive bladder symptoms effectively.
What Tolterodine Treats
Tolterodine addresses three main urinary symptoms related to overactive bladder:
- Urinary urgency: A sudden and urgent need to pass urine that may be difficult to control
- Urinary frequency: Needing to take more trips to the toilet than normal
- Urinary incontinence: Involuntary leakage of urine before reaching the toilet
The medication helps by increasing the storage volume of the bladder and can act on the brain to delay the desire to urinate. Results vary from person to person and often depend on how severe your symptoms were initially. If tolerated, the medication should be taken for a month so your doctor can assess how effective the treatment is for you, with reassessment typically occurring after a few months.
Before Taking Tolterodine
Before you start taking tolterodine, it is important that your doctor knows about any existing health conditions or medications you may be taking. Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken.
Inform your doctor if you have any of the following:
- If you are pregnant or breastfeeding
- Heart conditions, such as an unusual heart rhythm, problems with the blood vessels in your heart, or heart failure
- Problems with the way your liver or kidneys work
- Any problems with your prostate gland
- Increased eye pressure (called glaucoma)
- Hiatus hernia (a part of the stomach protrudes through the diaphragm, causing belching and heartburn)
- An overactive thyroid gland
- High blood pressure
- Myasthenia gravis (a condition causing muscle weakness)
- Severe constipation
- Uncontrolled narrow angle glaucoma
Additionally, tolterodine should be used with caution in patients at risk for urinary retention or decreased gastrointestinal motility. Always check the ingredients to ensure you can take this medicine and are not allergic to tolterodine or any similar medicines.
How to Take Tolterodine
Before you start treatment, read the manufacturer’s printed information leaflet from inside the pack, as it will give you more information about tolterodine and provide a full list of side-effects you may experience. Take tolterodine exactly as your doctor tells you, with your dose printed on the label of the pack.
Tablet Form
If you have been given tablets, you will be asked to take one tablet twice daily. There are two strengths of tablet available:
- 1 mg strength: Recommended if side-effects become troublesome
- 2 mg strength: Usually the initial starting dose
Your doctor may recommend the lower 1 mg strength tablet if you experience side-effects that become problematic.
Prolonged-Release Capsules
If you have been given capsules, you will be asked to take one capsule daily. There are two strengths of capsule available:
- 2 mg strength: Available if needed
- 4 mg strength: The usual strength to take
The capsules have been specially made to release tolterodine evenly over the day, so it is important that you swallow the capsule whole—do not chew it before you swallow.
General Administration Instructions
You can take tolterodine either before or after meals. Swallow your doses with a drink of water and try to take your doses at the same times of day each day, as this will help you remember to take them regularly. If you forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose, in which case leave out the missed dose. Never take two doses together to make up for a forgotten dose.
Continue taking your medicine for as long as your doctor tells you. This medicine helps to control your condition but does not cure it, so it is important to keep taking your medicine even if you feel well. Your doctor should reassess your condition at regular intervals, for example after 6 months, to determine how long you need to keep taking tolterodine.
Common Side-Effects and Management
The most common side-effects are a dry mouth and headache. However, tolterodine can also affect your vision or cause you to feel tired. If this happens to you, do not drive and do not use tools or machines while you are affected.
| Side-Effect | Management Strategies |
|---|---|
| Dry mouth | Try chewing sugar-free gum or sucking sugar-free sweets |
| Headache | Ensure you are drinking the recommended amount of water each day. Ask your pharmacist to recommend a suitable painkiller. If the headaches continue, let your doctor know |
| Blurred vision, feeling sleepy, tired or dizzy | Do not drive and do not use tools or machines |
| Indigestion, tummy (abdominal) pain, feeling sick (nausea) | Eat simple meals—avoid rich or spicy foods |
| Constipation | Try to eat a well-balanced diet and drink several glasses of water each day |
| Diarrhoea | Drink plenty of water to replace the lost fluids |
Other Potential Side-Effects
The following side-effects have been reported and should be discussed with your doctor if any become troublesome:
- Chest infections
- Skin tingling
- A fast heartbeat
- Dry skin
- Discomfort passing urine
- Weight gain
- Dry eyes
- Sinusitis
- Allergic reactions
- Confusion
- Dizziness
- Somnolence (excessive sleepiness)
Tolterodine may occasionally cause urinary retention, meaning that it is difficult to urinate, and your child may have difficulty with constipation (having a difficult bowel movement). If you experience any other symptoms which you think may be due to tolterodine, please speak with your doctor or pharmacist for further advice.
Serious Side-Effects Requiring Immediate Medical Attention
Call your doctor straight away or go to the Emergency Department at your nearest hospital if you notice any of these serious side effects:
- Swelling of the face, lips, mouth, tongue, or throat which may cause difficulty in swallowing or breathing
- Dizziness or confusion
- Fits (seizures)
- Fast heartbeat or palpitations
- Shortness of breath and swelling of the feet or legs
- Blurred vision
- Difficulty or pain in urinating (passing water)
- Hallucinations (seeing, hearing, or feeling things that are not really there)
Important Precautions and When to Stop Taking Tolterodine
You should avoid or stop taking this medication if you experience the following:
- Changes in your vision
- Severe abdominal pain or cramps
- Cannot pass urine or find it difficult to urinate
- Experience a new onset of lower back pain
- Experience palpitations
- Feel dizzy or faint
- Notice changes in your cognitive function or experience increased confusion
A small study in 2018 found that tolterodine may worsen cognitive function in people with multiple sclerosis, in particular affecting processing speed and memory. If you have concerns about how tolterodine is affecting your cognition or overall health, discuss these with your healthcare provider immediately.
Special Considerations for Drug Interactions
If you are taking medications that inhibit CYP3A4 enzymes, the recommended total daily dose of tolterodine may need to be adjusted to 2 mg. Additionally, tolterodine should not be used in capsule form for patients with congenital or documented acquired QT prolongation or those taking Class IA or Class III antiarrhythmic medications such as quinidine, procainamide, amiodarone, or sotalol. Always inform your doctor about all medications and supplements you are taking before starting tolterodine.
Frequently Asked Questions (FAQs)
Q: How long does it take for tolterodine to work?
A: If tolerated, the medication should be taken for a month so your doctor can assess how effective the treatment is for you. You should then be reassessed again after a few months. Results vary from person to person and often depend on how severe your symptoms were initially.
Q: Can I take tolterodine with food?
A: Yes, you can take tolterodine either before or after meals. Swallow your doses with a drink of water and try to take your doses at the same times of day each day.
Q: What should I do if I forget to take a dose?
A: If you do forget to take a dose, take it as soon as you remember unless it is nearly time for your next dose, in which case leave out the missed dose. Do not take two doses together to make up for a forgotten dose.
Q: Can I chew or crush the tolterodine capsules?
A: No, the capsules have been specially made to release tolterodine evenly over the day. It is important that you swallow the capsule whole—do not chew it before you swallow.
Q: Is tolterodine a cure for overactive bladder?
A: No, tolterodine helps to control your condition but does not cure it. It is important to keep taking your medicine even if you feel well, and your doctor should reassess your condition at regular intervals to determine how long you need to keep taking it.
Q: What are the most common side-effects?
A: The most common side-effects are dry mouth and headache. Other side-effects may include blurred vision, feeling sleepy, tired or dizzy, indigestion, constipation, and diarrhoea. Management strategies are available for most common side-effects.
Q: Can I drive if I experience blurred vision or dizziness?
A: No, if you experience blurred vision, feeling sleepy, tired, or dizzy, you should not drive and should not use tools or machines while you are affected by these symptoms.
References
- Tolterodine — Patient.info. Accessed 2026-01-13. https://patient.info/medicine/tolterodine-detrusitol-neditol
- DETRUSITOL SR® — Pfizer Labeling. https://labeling.pfizer.com/ShowLabeling.aspx?id=15274
- DETRUSITOL — NPS MedicineWise. https://www.nps.org.au/medicine-finder/detrusitol-tablets
- Tolterodine (Detrusitol) — MS Trust. https://mstrust.org.uk/a-z/tolterodine-detrusitol
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