Tolterodine dosage

The increases in tolterodine levels were not considered to be clinically relevant, and no routine dosage adjustment of tolterodine dosage was considered necessary when given with duloxetine. Consider also Urinary antimuscarinics Tolterodine + Fluoxetine , p.l290. 

In praetical terms this means that the antimuscarinic (anticholinergic) effects of the tolterodine are only moderately increased, and it seems unlikely that any tolterodine dosage changes are likely to be needed. Consider also Antimuscarinics + Antimuscarinics , p.674. 

The findings are not unexpected dry mouth is by far the most commonly reported adverse effect, with a frequency of about 40% in patients taking 2 mg of the immediate-release formulation bd. The next most common effects are consistently headache, constipation, and abdominal discomfort. Hallucinations and tachycardia have also been reported. It is agreed that higher doses should not be used because of the risk of urinary retention. About 5% of patients stopped taking tolterodine because of adverse effects and in about 10% the dosage was reduced. In one comparison of tolterodine 2 mg twice-daily with 4 mg once-daily in a modified-release formulation the latter produced about a 23% lower incidence of dry mouth, with increased efficacy (7). 

Tolterodine and oxybutynin have been compared (8). The authors concluded that the efficacy of tolterodine 2 mg bd is equivalent to that of oxybutynin 5 mg bd, but that tolterodine causes fewer autonomic adverse effects, less need for dosage reduction, and fewer dropouts because of adverse effects. 

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