Terol LA (tolterodine) is an antispasmodic medication used to help patients manage symptoms of an overactive bladder. It is suitable for patients age 16 and up.

Though effective at managing overactive bladder symptoms, Terol LA is not a cure. When treatment ends, unless other measures were taken, symptoms will likely return.

The LA in this product indicates it is a long-acting formula, taken less frequently than regular tablets.

How it Works

The majority of overactive bladder sufferers experience abnormal contractions or spasms of the bladder wall; this is a condition referred to as detrusor overactivity. Most patients who experience this are older, but the condition does affect some younger patients. It produces symptoms such as:

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

Terol LA relaxes the muscle walls of the bladder, inhibiting the spasms that cause the above conditions. Many patients find the above symptoms are minimized or even eliminated for the duration of treatment; however, without other intervention, symptoms will likely return once treatment ends.

As the medication inhibits the contractions or spasms of the bladder wall, patients experiencing urgency or incontinence from other causes will find Terol LA provides little to no benefit. Consult a doctor about alternative therapies more suited to the particular condition.

Those who do take Terol LA are often encouraged to practice other methods that can improve the condition, such as pelvic floor therapy, in which the pelvic muscles are strengthened, or bladder retraining, in which urination takes place on a schedule whether one needs to urinate or not. Both methods can significantly reduce incontinence and frequency of urination, and others may also help.

Surgery is also an option for some; bladder extensions or even bladder replacements may be viable. However, such surgeries are both invasive and costly, and may lead to serious side effects. Many patients prefer to take Terol LA over the long term than resort to surgery.

Taking Terol LA

Terol LA comes in tablets, which must be swallowed whole and not crushed, split, dissolved, or otherwise damaged. Patients who have difficulties swallowing whole tablets may want to consider regular, fast-acting versions of this medication, many of which can be split or crushed.

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

Treatment is easy in otherwise healthy 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.

Sometimes dosage adjustments are needed, but it's usually 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 2 mg once per day.

Most patients who take Terol LA are better able to control urination, with fewer accidents and fewer incidences of waking up to urinate, leading to improved sleep quality.

Some improvement is often seen within the first week of treatment, but it will probably take two weeks to a month for full benefit to be seen. Give the medication at least two weeks, preferably a month, before passing judgement.

Treatment can last as long as needed, which in some cases will be indefinite. However, patients should periodically stop treatment to see if it's still needed, especially if other measures to correct the problem have been taken in the meantime.

Precautions

Terol LA is not the best choice for all patients; other medical conditions and medications increase risk of side effects. Conditions of concern include:

• 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 medications of concern are largely 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 the above may not be good candidates for Terol LA, or will require modified dosage of 2 mg once per day, rather than the usual 4 mg.

Effects of Terol LA on unborn babies are unclear. As a general rule this medication should not be used during pregnancy unless absolutely necessary. Discuss potential risks with a doctor.