trospium chloride (Rx)

Brand and Other Names:Sanctura, Sanctura XR
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 20mg

capsule, extended release

  • 60mg

Overactive Bladder

Immediate release: 20 mg PO twice daily

Extended Release: 60 mg PO qDay

Renal Impairment

CrCl <30 mL/min: 20 mg immediate release PO qHS; extended-release not recommended

CrCl≥30 mL/min: Dose adjustment not provided by manufacturer; monitor for increased adverse effects

Hepatic Impairment

Use with caution; dose adjustment not provided by manufacturer

Safety and efficacy not established

>75 years

Immediate release: May titrate down to 20 mg immediated release qDay based on tolerability

Extended release: 60 mg PO qDay

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Interactions

Interaction Checker

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              Serious - Use Alternative (4)

              • glycopyrronium tosylate topical

                glycopyrronium tosylate topical, trospium chloride. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.

              • pramlintide

                pramlintide, trospium chloride. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.

              • revefenacin

                revefenacin and trospium chloride both decrease cholinergic effects/transmission. Avoid or Use Alternate Drug. Coadministration may cause additive anticholinergic effects.

              • secretin

                trospium chloride decreases effects of secretin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Concomitant use of anticholinergic drugs may cause a hyporesponse to stimulation testing with secretin. Discontinue anticholinergic drugs at least 5 half-lives before administering secretin.

              Monitor Closely (101)

              • abobotulinumtoxinA

                abobotulinumtoxinA increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects. .

              • aclidinium

                aclidinium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • amantadine

                trospium chloride, amantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Potential for increased anticholinergic adverse effects.

              • amitriptyline

                trospium chloride and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • amoxapine

                trospium chloride and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • anticholinergic/sedative combos

                anticholinergic/sedative combos and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • aripiprazole

                trospium chloride decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.

                aripiprazole increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • atracurium

                atracurium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • atropine

                atropine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • atropine IV/IM

                atropine IV/IM and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • belladonna alkaloids

                belladonna alkaloids and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • belladonna and opium

                belladonna and opium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • benperidol

                trospium chloride decreases levels of benperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of benperidol by pharmacodynamic antagonism. Use Caution/Monitor.

                benperidol increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • benztropine

                benztropine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • bethanechol

                bethanechol increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • carbachol

                carbachol increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • cevimeline

                cevimeline increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • chlorpromazine

                trospium chloride decreases levels of chlorpromazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of chlorpromazine by pharmacodynamic antagonism. Use Caution/Monitor.

                chlorpromazine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • cisatracurium

                cisatracurium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • clomipramine

                trospium chloride and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • clozapine

                trospium chloride decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor.

                clozapine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • cyclizine

                cyclizine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • cyclobenzaprine

                cyclobenzaprine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • darifenacin

                darifenacin and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • desipramine

                trospium chloride and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • dicyclomine

                dicyclomine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • digoxin

                digoxin, trospium chloride. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

              • diphenhydramine

                diphenhydramine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • donepezil

                donepezil increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • dosulepin

                trospium chloride and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • doxepin

                trospium chloride and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • droperidol

                trospium chloride decreases levels of droperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of droperidol by pharmacodynamic antagonism. Use Caution/Monitor.

                droperidol increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • echothiophate iodide

                echothiophate iodide increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • fesoterodine

                fesoterodine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • flavoxate

                flavoxate and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • fluphenazine

                trospium chloride decreases levels of fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor.

                fluphenazine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • galantamine

                galantamine increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • glycopyrrolate

                glycopyrrolate and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • glycopyrrolate inhaled

                glycopyrrolate inhaled and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • haloperidol

                trospium chloride decreases levels of haloperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of haloperidol by pharmacodynamic antagonism. Use Caution/Monitor.

                haloperidol increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • henbane

                henbane and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • homatropine

                homatropine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • huperzine A

                huperzine A increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • hyoscyamine

                hyoscyamine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • hyoscyamine spray

                hyoscyamine spray and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • iloperidone

                trospium chloride decreases levels of iloperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of iloperidone by pharmacodynamic antagonism. Use Caution/Monitor.

                iloperidone increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • imipramine

                trospium chloride and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • ipratropium

                ipratropium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.

              • lofepramine

                trospium chloride and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • loxapine

                trospium chloride decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.

                loxapine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • loxapine inhaled

                loxapine inhaled increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                trospium chloride decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.

              • maprotiline

                trospium chloride and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • meclizine

                meclizine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • metformin

                metformin will decrease the level or effect of trospium chloride by increasing renal clearance. Use Caution/Monitor. Coadministration reduced steady state trospium systemic exposure (decreased AUC and Cmax) by competing for renal tubular secretion

              • methscopolamine

                methscopolamine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • morphine

                morphine, trospium chloride. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

              • neostigmine

                neostigmine increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • nortriptyline

                trospium chloride and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • olanzapine

                trospium chloride decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.

                olanzapine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • oliceridine

                trospium chloride increases toxicity of oliceridine by Other (see comment). Use Caution/Monitor. Comment: Anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. Monitor for signs of urinary retention or reduced gastric motility if oliceridine is coadministered with anticholinergics.

              • onabotulinumtoxinA

                onabotulinumtoxinA and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • orphenadrine

                trospium chloride and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • oxybutynin

                oxybutynin and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • oxybutynin topical

                oxybutynin topical and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • oxybutynin transdermal

                oxybutynin transdermal and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • paliperidone

                trospium chloride decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.

                paliperidone increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • pancuronium

                pancuronium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

                pancuronium, trospium chloride. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

              • perphenazine

                trospium chloride decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.

                perphenazine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • physostigmine

                physostigmine increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • pilocarpine

                pilocarpine increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • pilocarpine ophthalmic

                pilocarpine ophthalmic increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • pimozide

                trospium chloride decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor.

                pimozide increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • prabotulinumtoxinA

                trospium chloride, prabotulinumtoxinA. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects.

              • pralidoxime

                pralidoxime and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • procainamide

                procainamide, trospium chloride. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

              • prochlorperazine

                trospium chloride decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor.

                prochlorperazine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • promethazine

                trospium chloride decreases levels of promethazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of promethazine by pharmacodynamic antagonism. Use Caution/Monitor.

                promethazine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • propantheline

                propantheline and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • protriptyline

                trospium chloride and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • pyridostigmine

                pyridostigmine increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • quetiapine

                trospium chloride decreases levels of quetiapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of quetiapine by pharmacodynamic antagonism. Use Caution/Monitor.

                quetiapine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • rapacuronium

                rapacuronium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • risperidone

                trospium chloride decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.

                risperidone increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • rivastigmine

                trospium chloride decreases effects of rivastigmine by cholinergic effects/transmission. Use Caution/Monitor.

              • rocuronium

                rocuronium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • scopolamine

                scopolamine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • solifenacin

                solifenacin and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • succinylcholine

                succinylcholine increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • tenofovir DF

                tenofovir DF, trospium chloride. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

              • thioridazine

                trospium chloride decreases levels of thioridazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of thioridazine by pharmacodynamic antagonism. Use Caution/Monitor.

                thioridazine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • thiothixene

                trospium chloride decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • tiotropium

                tiotropium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • tolterodine

                tolterodine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • trazodone

                trospium chloride and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • trifluoperazine

                trospium chloride decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

                trifluoperazine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • trihexyphenidyl

                trihexyphenidyl and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.

              • trimipramine

                trospium chloride and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • vancomycin

                vancomycin, trospium chloride. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.

              • vecuronium

                trospium chloride and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • ziprasidone

                trospium chloride decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor.

                ziprasidone increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • zotepine

                trospium chloride decreases levels of zotepine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                trospium chloride decreases levels of zotepine by pharmacodynamic antagonism. Use Caution/Monitor.

              Minor (4)

              • dimenhydrinate

                dimenhydrinate increases toxicity of trospium chloride by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

              • donepezil

                donepezil decreases effects of trospium chloride by pharmacodynamic antagonism. Minor/Significance Unknown.

              • galantamine

                galantamine decreases effects of trospium chloride by pharmacodynamic antagonism. Minor/Significance Unknown.

              • levodopa

                trospium chloride, levodopa. Other (see comment). Minor/Significance Unknown. Comment: Anticholinergic agents may enhance the therapeutic effects of levodopa; however, anticholinergic agents can exacerbate tardive dyskinesia. In high dosage, anticholinergics may decrease the effects of levodopa by delaying its GI absorption. .

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              Adverse Effects

              >10%

              Dry mouth (20.1%)

              1-10%

              Constipation (9.6%)

              Tachycardia (<2%)

              Headache (4.2%)

              Fatigue (1.9%)

              Rash (<2%)

              Dyspepsia (1-2%)

              Abdominal pain (1-3%)

              Abdominal distention (<2%)

              Constipation (9-10%)

              Dry eyes (1-2%)

              Dyspepsia (1-2%)

              Flatulence (1-2%)

              Urinary retention (<1%)

              Urinary tract infection (1-7%)

              Nasopharyngitis (3%)

              Nasal dryness (1%)

              Postmarketing Reports

              Gastrointestinal: Gastritis

              Cardiovascular: Palpitations, supraventricular tachycardia, chest pain, syncope, hypertensive crisis

              Immunological: Stevens-Johnson syndrome, anaphylactic reaction, angioedema

              Nervous system: Dizziness, confusion, vision abnormal, hallucinations, somnolence and delirium

              Skeletal system: Musculoskeletal: Rhabdomyolysis

              Dermatology: Rash

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              Warnings

              Contraindications

              Urinary/gastric retention

              Uncontrolled narrow-angle glaucoma

              Hypersensitivity

              Cautions

              Use caution in renal impairment, geriatric patients, moderate or severe hepatic dysfunction

              Angioedema of the face, lips, tongue and/or larynx reported (including with 1st dose); if involvement of the tongue, hypopharynx, or larynx occurs promptly discontinue; promptly provide appropriate therapy and/or measures necessary to ensure a patent airway function

              Administer with caution to patients with clinically significant bladder outflow obstruction or gastrointestinal obstructive disorders due to risk of urinary or gastric retention; use with caution in patients with conditions such as ulcerative colitis, intestinal atony, and myasthenia gravis

              To administer, must carefully monitor patients with controlled narrow-angle glaucoma; benefits should outweigh risks

              Somnolence reported; advise patients not to drive or operate heavy machinery until they know how therapy affects them

              Drug substantially excreted by kidney; effects of moderate renal impairment on systemic exposure are not known but systemic exposure is likely increased; risk of anticholinergic adverse reactions (including dry mouth, constipation, dyspepsia, urinary tract infection, and urinary retention) is expected to be greater in patients with moderate renal impairment

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              Pregnancy & Lactation

              Pregnancy Category: C

              Lactation: Excretion in mikl unknown; use with caution

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Reduces the smooth muscle tone of the bladder by antagonizing the effects of acetyl choline on muscarinic receptors.

              Pharmacokinetics

              Absorption: <10%; reduced when administered with high-fat meal

              Half-life: 20 hr (immediate release)

              Peak plasma time: 5-6 hr

              Protein bound: 45-85%

              Metabolism: Not fully elucidated; major pathway is thought to be ester hydrolysis followed by glucuronide conjugation of benzylic acid

              Renal clearance: 29.07 L/hr

              Excretion: Feces (85.2%); urine (5.8% with 60% unchanged drug)

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              trospium oral
              -
              20 mg tablet
              trospium oral
              -
              60 mg capsule
              trospium oral
              -
              20 mg tablet
              trospium oral
              -
              20 mg tablet
              trospium oral
              -
              20 mg tablet
              trospium oral
              -
              60 mg capsule
              trospium oral
              -
              20 mg tablet

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              trospium oral

              TROSPIUM EXTENDED-RELEASE - ORAL

              (TROW-spee-um)

              COMMON BRAND NAME(S): Sanctura XR

              USES: This medication is used to treat an overactive bladder. By relaxing the muscles in the bladder, trospium improves your ability to control your urination. It helps to reduce leaking of urine, feelings of needing to urinate right away, and frequent trips to the bathroom. Trospium belongs to a class of drugs known as antispasmodics. It is also known as an antimuscarinic.

              HOW TO USE: Read the Patient Information Leaflet provided by your pharmacist before you start using trospium and each time you get a refill. If you have any questions, consult your doctor or pharmacist.Take this medication by mouth on an empty stomach at least 1 hour before a meal, usually once daily or as directed by your doctor.Swallow the capsule whole. Do not crush or chew the capsule. Also avoid drinking alcohol or taking any product containing alcohol for 2 hours before and after taking this medication. Alcohol can destroy the long action of the drug and may increase side effects.If you cannot swallow the capsule, you may open the capsule and place the beads in a small amount of water or directly onto the tongue. Do not crush or chew the beads because doing so may cause the drug to be released too quickly, increasing side effects. Swallow all of the beads right away.Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day. Dosage is based on your medical condition and response to treatment.Tell your doctor if your condition does not improve or if it worsens.

              SIDE EFFECTS: Dry mouth, constipation, stomach upset, dry eyes, dry nose, dizziness, blurred vision, or drowsiness may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if any of these unlikely but serious side effects occur: eye pain, difficulty urinating, fast heartbeat, mental/mood changes (such as hallucinations, confusion).A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking trospium, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: glaucoma, kidney disease, liver disease, stomach/intestinal problems (such as blockage, constipation, ulcerative colitis), myasthenia gravis, inability to urinate (urinary retention).This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).This medication may make you sweat less, making you more likely to get heat stroke. Avoid doing things that may cause you to overheat, such as hard work or exercise in hot weather, or using hot tubs. When the weather is hot, drink a lot of fluids and dress lightly. If you overheat, quickly look for a place to cool down and rest. Get medical help right away if you have a fever that does not go away, mental/mood changes, headache, or dizziness.Older adults may be more sensitive to the side effects of this drug, especially constipation, dry mouth, drowsiness, confusion, or trouble urinating. Drowsiness and confusion can increase the risk of falling.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: other drugs that are also removed by the kidneys (such as metformin, tenofovir, vancomycin), certain anti-Parkinson's drugs (such as trihexyphenidyl), other antimuscarinic drugs (such as dicyclomine, oxybutynin, scopolamine, tolterodine), potassium tablets/capsules, pramlintide.Tell your doctor or pharmacist if you are taking other products that cause drowsiness, including alcohol, marijuana (cannabis), certain antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.This document does not contain all possible interactions. Before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: fast heartbeat, widened pupils.

              NOTES: Do not share this medication with others.

              MISSED DOSE: If you miss a dose, take it as soon as you remember, at least 2 hours after a meal or 1 hour before your next meal. If it is near the time of your next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Do not store in the bathroom. Keep all medicines away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

              Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.