Detrusitol (tolterodine) is an antispasmodic medication that reduces spasms in the bladder muscles, which in turn reduces the frequency and urgency of urination in overactive bladder. This product is also known as Detrol.

While quite good at managing symptoms, Detrusitol is not a cure. Symptoms will likely return if treatment ends unless other measures have been taken.

Effects of Detrusitol in patients under age 16 are marginal, while side effects are increased. For this reason it is not considered worth the risks. Parents trying to address this issue for younger children should discuss alternative options with a doctor.

Overactive Bladder Basics

In most cases overactive bladder is strongly associated with spasms of the bladder itself, a condition known as detrusor overactivity. It's more common in older adults, but does affect some younger individuals as well. Symptoms include:

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

Detrusitol relaxes the muscle walls of the bladder, inhibiting the spasms that cause inconvenient, distressing, and embarrassing symptoms. Most patients find symptoms are minimized or even eliminated for the duration of treatment; however, without other intervention, symptoms will likely return once treatment ends.

Note that bladder spasms are not the only cause of the above; ideally the condition will be diagnosed by a doctor before taking Detrusitol---or any medication---to treat it. Detrusitol will not provide benefit when symptoms are not caused by spasms.

There are many simple exercises patients can do, such as kegel exercises or bladder training (urinating on a schedule regardless of if one needs to or not), that can sometimes fully resolve the problem. Maintaining a healthy weight will also help. Information about these methods, and others, can be found in detail with a simple web search.

If the condition cannot otherwise be addressed, patients may consider surgery. Bladders can be expanded, or even replaced entirely with an artificial bladder. However, surgery is invasive, costly, and carries serious risks of its own; many patients prefer to buy Detrusitol indefinitely rather than put themselves through surgery.

Taking Detrusitol

Detrusitol comes in tablets, in the majority of cases taken twice per day. Food is optional, but a full glass of fluid is recommended with each dose.

In otherwise healthy adults:

• 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.

Usually dosage is adjusted down, not up, and usually it's because other medical conditions or other medications put the patient at increased risk of side effects. In these cases treatment is typically:

• Take 1 mg twice per day.

Some patients may notice improvements within taking the first few doses, but most will need to take Detrusitol 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 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, especially if bladder retraining, pelvic floor therapy, or other methods to address the underlying issue are being utilized.

Precautions

Detrusitol should be used with caution in patients who have a history of:

• 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

And in those who are taking 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 who have or are taking any of the above may not be good candidates for Detrusitol, or will require modified dosage of 1 mg twice per day.

Serious side effects, though rare when Detrusitol is used as directed, do require urgent medical attention:

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

Effects of Detrusitol 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.