Detrusitol XL (tolterodine ER) is the extended-release version of an antispasmodic medication that alleviates the urgency and frequency of urination in overactive bladder. While the regular version of this medication is taken twice per day, Detrusitol XL is taken just once per day.

Detrusitol XL should not be administered to patients under 16 years old; benefit is marginal while the risk of side effects is worse. A doctor can recommend a more suitable alternative for young patients.

What to Expect from Detrusitol XL

In the majority of overactive bladder patients---which tend to be older adults---the conditions is very often associated with detrusor overactivity, which is a fancy way of saying bladder spasms. The detrusor muscle undergoes abnormal contractions, which can produce distressing and embarrassing symptoms:

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

Note that detrusor overactivity is commonly found in overactive bladder patients, but it is not the only possible cause of the above symptoms. Ideally patients will have the condition diagnosed by a doctor prior to starting treatment with Detrusitol XL.

If the condition is caused by spasms, odds are good that Detrusitol XL can help. The medication relaxes the bladder wall, minimizing spasms and therefor reducing urgency, frequency, and incontinence. Relaxed bladders can also often hold more urine without producing the urge to urinate, further reducing symptoms. Some patients find symptoms are eliminated entirely.

Also note, however, that Detrusitol XL is not a cure. If other methods to control the underlying condition are not taken, symptoms will likely return if treatment ends.

Dosage & Administration

Detrusitol XL comes in tablets; as with the majority of extended-release tablets, they must be swallowed whole and not be split, crushed, chewed, or otherwise damaged. Doing so will destroy its extended-release properties.

Food is optional with each dose, though a full glass of fluid is recommended.

Treatment is very similar for the majority of patients:

• 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.

Dosage is sometimes adjusted down when other medical conditions or other medications put the patient at increased risk of side effects. In these cases patients may wish to change to regular-acting tablets rather than extended-release versions.

Some patients may notice improvements within taking the first few doses, but most will need to take the medication 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 who take Detrusitol XL 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 other corrective measures have been employed in the interim.

Other Methods

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 an overactive bladder. Maintaining a healthy weight will also help. Information about these methods, and numerous 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 XL indefinitely rather than put themselves through surgery.

Before Taking Detrusitol XL

Side effects from Detrusitol XL are typically mild, but, rarely, serious side effects can develop. Certain individuals are at increased risk of experiencing these severe side effects; Detrusitol 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 Detrusitol XL use, or will require modified dosage.

Serious side effects are rare, but do require urgent medical attention:

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

Effects of this product on unborn babies has not been studied and are ultimately unknown. However, the medication did cause fetal harm in animal studies, so use while pregnant is not advisable.