Detrol (tolterodine) is an antispasmodic medication used to treat an overactive bladder. This medication is also known as Detrusitol.

In reducing bladder muscle spasms, the medication helps patients regain control of:

• Urgent urination
• Frequent urination
• Incontinence
• Nighttime incontinence
• Waking up to urinate

Detrol generally should not be used in children. Not only can it be very difficult to distinguish between regular wetting and overactive bladder in younger patients, many studies of the medication have shown no benefit when compared to placebo. Seeking doctor advice is strongly encouraged before use in children, and a doctor will likely need to modify dosage.

This page is about the regular Detrol tablets, typically taken twice per day. Patients may also be interested in the extended-release version of Detrol, called Detrol XL, which is taken just once per day.

What to Expect from Detrol

This medication consists of film-coated tablets, which can be taken with or without food according to personal preference. A full glass of fluid is recommended with each dose.

Treatment in the majority of adults is quite similar:

• Take 2 mg twice per day.
• This dose is suitable for the vast majority of patients.
• Dosage may be adjusted, if needed, after a week or two of treatment.

Smaller doses of 1 mg twice per day are good for those who have kidney or liver impairment, or those on certain other medications, most notably those taking potent inhibitors of CYP3A4. These are:

• Antibiotics called clarithromycin or telithromycin;
• An antidepressant called nefazodone;
• Protease inhibitors (antivirals used to treat HIV or Hepatitis C) that end with -avir, such as ritonavir or tipranavir.

Some patients may notice improvements within taking the first few doses, but most will need to take the medication for a week or two to see full benefit. In reducing spasms in the bladder, urination should be less frequent and the urge to do so less severe. Most patients taking Detrol are better able to control urination, with fewer accidents and fewer incidences of waking up to urinate.

The need to continue treatment should be evaluated every three to six months.

Use in Children

In most places this medication is not approved for use in children. Some large studies, involving hundreds of children aged 5 to 10 years, found no difference between those on Detrol and those on placebo. There have been other studies in which Detrol did cause some improvement, but it was only marginally better than placebo.

Use of this product in children under age 16 should be done only with the approval and involvement of a doctor.

Potential Complications

Side effects from Detrol are typically mild, but rarely serious side effects can develop. Certain individuals are at increased risk of experiencing these severe side effects; Detrol should be used with caution in those who have:

• Difficulty or inability to urinate
• Gastrointestinal obstruction
• Kidney or liver impairment
• Hiatus hernia
• Autonomic neuropathy
• Glaucoma
• Decreased gastrointestinal motility
• Prolonged QT interval from any cause

The most common side effects associated with Detrol use are mild and often transient, meaning they stop occurring as the body adjusts to treatment. These side effects include:

• Dry mouth
• Dry eyes
• Blurred vision
• Mild stomach upset
• Joint pain
• Headache
• Constipation or diarrhea
• Mild drowsiness

Rarely more serious side effects develop. Seek medical attention if experiencing:

• Rapid or irregular heartbeat
• Chest pain
• Confusion
• Hallucinations
• Painful urination
• Difficult urination

Don't be afraid to ask a doctor about any concerning side effects, no matter how trivial they may seem.

Effects of Detrol on unborn or nursing babies are unknown; it hasn't been studied. In animal trials the medication did cause harm, however, so use of this medication while pregnant or breastfeeding is discouraged.