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fesoterodine (Toviaz)
FDA-approved 2008
Indications:
- lower urinary tract symptoms (LUTS)
- urinary urgency & urinary frequency due to
- urge incontinence, detrussor instability, overactive bladder
Contraindications:
1) severely reduced renal function (caution)
2) urinary retention
3) gastroparesesis (caution)
4) uncontrolled narrow-angle glaucoma
5) severe liver impairment
Dosage:
- 4-8 mg PO QD
- do not exceed 4 mg in patients with renal insufficiency
Tabs: 4, 8 mg
Pharmacokinetics:
- metabolized by cyt P450 3A4
Adverse effects:
1) common: dry mouth, constipation
2) less frequent: dry eyes, urinary retention
3) also see parasympatholytic
Drug interactions:
- levels increased by drugs that inhibit cyt P450 3A4 (ketoconazole)
Mechanism of action:
- anticholinergic, antimuscarinic agent
- relaxes smooth muscle of bladder
- prodrug of tolterodine
Notes:
- improves urge incontinence & sleep quality in industry-sponsored study [2]
Interactions
drug adverse effects of parasympatholytics
General
urinary antispasmodic
References
- FDA News, Nov 2008
- Warsi QA, Huang AJ, Hess R et al.
Association of pharmacologic treatment of urgency urinary
incontinence with sleep quality and daytime sleepiness.
Obstet Gynecol 2018 Feb; 131:204
PMID: 29324595