Generic
Trospium Chloride
1 brands available in the market
At a glance
Trospium Chloride is indicated for the symptomatic treatment of urge incontinence and/or increased urinary frequency and urgency as may occur in patients with overactive bladder.
Description
Trospium is a muscarinic antagonist. Trospium chloride antagonizes the effect of acetylcholine on muscarinic receptors in cholinergically innervated organs including the bladder. Its parasympatholytic action reduces the tonus of smooth muscle in the bladder.
Indications
- Overactive bladder (OAB)
- Urge incontinence
- Urgency
- Increased urinary frequency
Therapeutic class
Other genito-urinary preparations
Pharmacological class
Antimuscarinic
Pharmacology
Trospium is a muscarinic antagonist. It antagonizes the effect of acetylcholine on muscarinic receptors in cholinergically innervated organs including the bladder. Its parasympatholytic action reduces the tonus of smooth muscle in the bladder. Receptor assays showed negligible affinity for nicotinic receptors as compared to muscarinic receptors at therapeutic concentrations.
Mechanism of action
Antagonizes muscarinic receptors, reducing the tonus of smooth muscle in the bladder.
Dosage
Adult Dose (Oral):
- 20 mg tablet twice daily
- Severe renal impairment (CrCl<30 mL/min): 20 mg once daily at bedtime
- Geriatric patients ≥75 years: dose may be titrated down to 20 mg once daily
- Reassess need for continued treatment at regular intervals of 3-6 months
Administration
- Swallow whole with a glass of water before meals on an empty stomach
- Do not chew or crush the tablet
Missed dose
If you miss a dose, take it as soon as you remember; if almost time for next dose, skip it; do not double the dose.
Side effects
Common Side Effects:
- Dry mouth
- Constipation
- Headache
- Abdominal pain
- Dyspepsia
- Nausea
- Gastritis
- Palpitations
- Supraventricular tachycardia
- Chest pain
- Syncope
- Hypertensive crisis
- Dizziness
- Confusion
- Hallucinations
- Somnolence
- Delirium
- Rash
Precautions & warnings
- Obstructive conditions of the gastrointestinal tract (pyloric stenosis)
- Obstruction of urinary flow (risk of urinary retention)
- Autonomic neuropathy
- Hiatus hernia associated with reflux oesophagitis
- Fast heart rates undesirable (hyperthyroidism, coronary artery disease, congestive heart failure)
- Caution in mild to moderate hepatic impairment
- Caution in mild to moderate renal impairment
- Exclude organic causes of urinary frequency, urgency, and urge incontinence before commencing therapy
Contraindications
- Urinary retention
- Severe gastro-intestinal condition (including toxic megacolon)
- Myasthenia gravis
- Narrow-angle glaucoma
- Tachyarrhythmia
- Hypersensitivity to active substance or any excipients
Drug interactions
- Drugs with anticholinergic action (amantadine, tricyclic antidepressants): potentiation of effect
- β-sympathomimetics: enhancement of tachycardic action
- Pro-kinetic agents (metoclopramide): decrease in efficacy
- Guar, cholestyramine, colestipol: inhibition of absorption cannot be excluded; simultaneous administration not recommended
- Digoxin: does not affect pharmacokinetics, but interaction with drugs eliminated by active tubular secretion cannot be excluded
- No influence on P450 enzyme metabolic activities; no metabolic interactions expected
Food interactions
Food interactions are not significant.
Use in pregnancy
Use in Pregnancy: Animal studies do not indicate direct or indirect harmful effects; no clinical data; prescribe with caution.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Placental transfer and passage into maternal milk occurs in rats; no clinical data; prescribe with caution.
Pediatric use
Safety and efficacy not established in children under 12 years
Geriatric use
Dose may be titrated down to 20 mg once daily in patients ≥75 years
Renal / hepatic impairment
Renal Impairment: Severe (CrCl<30 mL/min): 20 mg once daily at bedtime; mild to moderate: caution
Hepatic Impairment: Severe: not recommended; mild to moderate: caution
Overdose effects
Symptoms: Dry mouth, tachycardia, disorders of micturition.
Treatment: Gastric lavage, activated charcoal; pilocarpine (glaucoma); catheterisation (urinary retention); neostigmine (severe symptoms); beta blockers (tachycardia/circulatory instability).
Storage conditions
Store below 30°C in a dry place, protected from light.