Tolterodine extended-release

Sathyan G, Dmochowski RR, AppeU RA, Guo C, Gupta SK. Effect of antacid on the pharmacokinetics of extended-release formulations of tolterodine and oxy-butynin. Clin Pharmacokinet 2004 43 1059-68. 

Appel, R.A., Sand, P., Dmochowski, R., et al., (2000). Prospective randomized controlled trial of extended-release oxybutynin chloride and tolterodine tartrate in the tteatment of overactive bladder results of the Object Study. Mayo Clin Proc 78 358-363. 

Chappie CR et al A comparison of the efficacy and tolerability of solifenacin succinate and extended release tolterodine at treating overactive bladder syndrome Results of the STAR trial. Eur Urol 2005 48 464. [PMID 15990220]... 

In neurodegenerative disorders, patients often experience urinary urgency, which is thought to be caused by spasm of the urinary sphincter or detrusor muscle. Oxybutynin (Ditropan) and tolterodine (Detrol) are effective for urinary urgency. For ALS patients and some PD patients, swallowing tablets may be difficult due to dysphagia. Extended release oxybutynin allows for infrequent daily dosing and oxytrol patches avoids the oral route of administration. 

A total of 1077 patients continued to take extended-release tolterodine 4 mg/day after participating in a randomized trial, about 78% of those who completed the double-bhnd phase of the study (9). Of the patients who took open treatment, 71% were still doing so after 12 months. The only significant adverse effect was a dry mouth in 13%, while 3.3% complained of constipation. There was no serious systemic toxicity of any kind and efficacy was judged to be at least equivalent to that of the immediate-release formulation. 

Kreder K, Mayne C, Jonas U. Long-term safety, tolerability and efficacy of extended-release tolterodine in the treatment of overactive bladder. Eur Urol 2002 41(6) 588-95. 

In a controlled study of 1529 adult outpatients with urinary frequency and UUI, tolterodine LA, an extended-release formulation of tolterodine tartrate, significantly decreased the mean number of weekly incontinence episodes (23% effect rate over placebo and 7% effect rate over tolterodine IR). Patient withdrawal rates did not differ significantly between the two active treatments, but dry mouth was observed significantly less often in patients taking the LA formulation than among those patients receiving the IR formulation. ... 

Diokno AC, Appell RA, Sand PK, et al. Prospective, randomized, doubleblind study of the efficacy and tolerability of the extended-release formulations of oxybutynin and tolterodine for overactive bladder Results of the OPERA trial. Mayo Clin Proc 2003 78 687-695. 

Sussman D, Garely A. Treatment of overactive bladder with once-daily extended-release tolterodine or oxybutynin The Antimuscarinic Clinical Effectiveness Trial (ACET). Curr Med Res Opin 2002 18 177-184. 

Zinner NR, Mattiason A, Stanton SL. Efficacy, safety, and tolerability of extended-release once-daily tolterodine treatment for overactive bladder in older versus younger patients. J Am Geriatr Soc 2002 50 799-807. 

Dmochowski R, Sathyan G, Ye C, et al. The pH effect of drug release from extended-release formulations of oxybutynin and tolterodine. Proceedings of the Second International Consultation on Incontinence. Paris, France, July 2001. 

Overactive urinary bkuMer disease can be successfully treated with muscarinic antagonists, primarily tolterodine and trospium chloride, which lower intravesicular pressure, increase capacity, and reduce the frequency of contractions by antagonizing parasympathetic control of the bladder. Oxybu-tynin is used as a transdermal system (oxytrol) that delivers 3.9 mg/day and is associated with a lower incidence of side effects than the oral immediate- or extended-release formulations. Tolterodine is metabolized by CYP2D6 to a 5-hydroxymethyl metabolite since this metabolite possesses similar activity to the parent drug, variations in CYP2D6 levels do not affect the duration of drug action. Trospium is as effective as oxybutynin, with better tolerability. Solifenacin is newly approved for overactive bladder with a favorable efficacy side effect ratio. Stress urinary incontinence has been treated with some success with duloxetine (YENTREVE), which acts centrally to influence 5-HT and NE levels. 

In an identical study in 23 healthy subjects, Maa/ojc increased the maximum plasma level of a single 4-mg dose of extended-release tolterodine (DetrolLA) by 50%, but did not change any other pharmacokinetic parameter (time to maximum level, elimination half-life, AUC). ... 

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