Detrol XL (tolterodine ER) is a convenient, once-per-day medication that treats overactive bladder. The XL in this product's name stands for extended-release, compared to regular Detrol tablets, which are taken twice per day.

This product is also known as Detrusitol XL or Incont LA.

Detrol XL is not suitable for children under 16 years of age. Studies have found no improvement to marginal improvement in younger patients given this medication when compared to placebo; risks are generally not worth the benefits.

Taking Detrol XL

Detrol XL reduces muscle spasms in the bladder, which in turn reduces the urgency and frequency of urination. It's often used to reduce or eliminate:

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

XL tablets, since they're extended-release, must be swallowed whole; they shouldn't be split, crushed, or chewed. Taking them with food is optional, but a full glass of fluid is recommended with each dose. Treatment is similar in otherwise healthy adults:

• Take 4 mg once per day.
• This dose is suitable for the vast majority of patients.
• Do not exceed 4 mg per day without explicit doctor approval.

Some patients are at increased risk of severe side effects from Detrol XL; these patients will need a half-dose:

• Take 2 mg once per day.

Note that if the appropriate dosage is not available on this page it might be found on the regular Detrol tablets page. Dosage will be reduced and frequency will be increased to twice per day with regular tablets.

It might take a couple of weeks of treatment for patients to see significant improvement, though some individuals notice benefit sooner. The need to continue treatment should be evaluated every three to six months.

Most patients find the medication helps reduce the urgency and frequency of urination, preventing embarrassing accidents, improving sleep, and generally improving quality of life.

Precautions & Side Effects

Side effects from Detrol XL are typically mild, but, rarely, serious side effects can develop. Certain individuals are at increased risk of experiencing these severe side effects; Detrol XL 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 medication can interact with a number of other medications. Of most concern are potent inhibitors of CYP3A4, which 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.

Patients taking the above medications or who have any of the conditions listed before them may not be suitable for Detrol XL use, or will require modified dosage of 2 mg once per day.

Serious side effects which require urgent medical attention include:

• 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 XL 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.