Tolterodine, Tolterodine ER

Introduction

Written by Melanie Sangobowale, PharmD
Medically reviewed by Patricia Weiser, PharmD
Updated on July 28, 2023

Tolterodine (tole TER oh deen) is a generic medication prescribed for the treatment of overactive bladder in adults. Tolterodine belongs to a group of drugs called anticholinergics.

This article doesn’t provide coupons for all forms of tolterodine. To find coupons for tolterodine extended-release oral capsule, see this article. (With extended release, the drug is slowly released into your body over time.)

Side effects of tolterodine

Tolterodine may cause mild or serious side effects. More common mild side effects of tolterodine and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about tolterodine’s side effects, ask your doctor or pharmacist. You can also refer to the prescribing information for tolterodine listed in the “Resources” section.

Mild side effects

More common mild side effects reported with some forms of tolterodine are listed below. These side effects may differ based on the form of tolterodine you take.

This article doesn’t include all possible mild side effects of the drug. To learn more about tolterodine’s side effects based on the form, refer to the prescribing information for tolterodine listed in the “Resources” section.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Mild side effects of tolterodine oral tablet and extended-release oral capsule† include:

• dry mouth
• headache
• constipation
• abdominal pain
• dizziness
• mild allergic reaction*

* For details about this side effect, see the “Interactions and warnings for tolterodine” section.
† With extended release, the drug is slowly released into your body over time.

Serious side effects

A serious side effect of tolterodine is listed below. Side effects may differ based on the form of tolterodine you take.

This article doesn’t include all possible serious side effects of the drug. To learn more about tolterodine’s side effects based on the form, refer to the prescribing information for tolterodine listed in the “Resources” section.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

In general, tolterodine’s serious side effect is severe allergic reaction. For details about this side effect, see the “Interactions and warnings for tolterodine” section.

Common questions about tolterodine

Below you’ll find answers to a few commonly asked questions about tolterodine.

What is tolterodine’s mechanism of action? How does the drug work?

Tolterodine belongs to a group of drugs called anticholinergics. Anticholinergics work by blocking a chemical in your body called acetylcholine. Acetylcholine tells your bladder muscles to contract. By blocking this chemical, your bladder relaxes, and you won’t have the urge to urinate so often. This helps reduce symptoms of overactive bladder.

Tolterodine starts working in the body within 5–6 hours after you take your first dose. Most people experience relief within the first few days of starting tolterodine treatment. It can take up to 4 weeks for the drug to reach its full effect.

If you’d like to know more about this, talk with your doctor or pharmacist.

Is there a best time of day to take tolterodine?

There isn’t a best time to take tolterodine, but you should take your medication at the same time each day.

Tolterodine oral tablet is usually taken twice per day. Tolterodine extended-release (ER) capsule should be taken once per day with liquid. (With ER drugs, the medication is slowly released into your body over time.) Swallow the ER capsule whole. Do not split, crush, or chew it.

You can take tolterodine with or without food.

If you have questions about when to take tolterodine, talk with your doctor or pharmacist.  

How does tolterodine compare with oxybutynin?

Similar to tolterodine, oxybutynin is an anticholinergic medication prescribed to treat overactive bladder. These two drugs have similar effects.

Studies have shown that tolterodine is better tolerated compared with oxybutynin. Tolterodine has a lower risk of certain side effects, such as dry mouth, compared with oxybutynin.  

Talk with your doctor if you have questions about how tolterodine compares with oxybutynin.

Interactions and warnings for tolterodine

Below, you’ll find information about tolterodine’s possible interactions and warnings.

Interactions of tolterodine

Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you take tolterodine, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription or over-the-counter drugs
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for tolterodine” section below.

Warnings for tolterodine

Tolterodine should not be taken by certain people.

Tolterodine could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether tolterodine is a safe option for you. These warnings may differ based on the form of tolterodine you take.

Ask your doctor about specific warnings for tolterodine, and be sure to tell your doctor about your:

• current health conditions, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Tolterodine can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to tolterodine or any of its ingredients, your doctor will likely not prescribe tolterodine. Your doctor can tell you about medications that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your eyelids, lips, hands, or feet
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to tolterodine, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Overdose of tolterodine

If you take tolterodine by mouth, you should not take more than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.

If you think you’ve taken too much tolterodine, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.

Pregnancy or breastfeeding and tolterodine

Information about tolterodine and pregnancy and breastfeeding is described below.

Tolterodine and pregnancy

It’s not known whether tolterodine should be taken during pregnancy. Currently, there’s no data available from studies including pregnant people. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication.

Also talk with your doctor about overactive bladder treatment options during pregnancy. Together, you can discuss the risks and benefits of your treatment options and decide whether you should take tolterodine during pregnancy.

Tolterodine and breastfeeding

It’s not known whether tolterodine should be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication.

If you’re planning to breastfeed, talk with your doctor about overactive bladder treatment options. Together, you can discuss the risks and benefits of your treatment options and decide whether you should take tolterodine during this time. Your doctor may recommend other healthy ways to feed your child.

Uses of tolterodine

The Food and Drug Administration (FDA) approves prescription drugs such as tolterodine for certain conditions. An approved use for tolterodine is described below.

Use for overactive bladder

Doctors may prescribe tolterodine oral tablet or extended-release oral capsule* for treating overactive bladder. It’s prescribed for this purpose in adults. It’s usually prescribed as a short-term treatment along with lifestyle changes. These include weight loss, bladder training, pelvic floor exercises, and others.

Overactive bladder is a condition caused by uncontrolled bladder muscle contractions. When the bladder muscle contracts too often or not at all, you may experience symptoms of overactive bladder.

Symptoms of overactive bladder may include:

• having a strong urge to urinate
• urinating more often
• difficulty managing your bladder  

Be sure to speak with your doctor and pharmacist for recommendations to help you manage your condition.

* With extended release, the drug is slowly released into your body over time.

What to ask your doctor

Let your doctor know if you have questions about tolterodine or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• Do I have to take this medication every day?
• Will I have to take this medication for a long time?
• What should I do if I miss a dose of my medication?

Resources

• Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
• Harvey MA, et al. (2001). Tolterodine versus oxybutynin in the treatment of urge urinary incontinence: A meta-analysis. https://pubmed.ncbi.nlm.nih.gov/11483904/
• Tolterodine tartrate extended-release capsules. (2022). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/da9423b5-00ab-46fc-8959-3db3c0a0bc6d/spl-doc
• Tolterodine tartrate tablets. (2022). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/3f2291c3-7e3c-41be-afa6-ef73ce896e30/spl-doc

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.