Drug information of Trospium

Trospium

Drug group:

Trospium is an antispasmodic agent used to treat the symptoms of overactive bladder, a condition that causes the bladder muscles to contract uncontrollably.

Mechanism of effect

Trospium antagonizes the effect of acetylcholine on muscarinic receptors in cholinergically innervated organs. Its parasympatholytic action reduces the tonus of smooth muscle in the bladder.

Pharmacodynamic

Trospium is an antispasmodic, antimuscarinic agent indicated for the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and urinary frequency. According to receptor assays, it displays higher affinity towards muscarininc receptors compared to nicotinic receptors at therapeutic concentrations.

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)

Drug indications

overactive bladder

Dosage

Adult

Overactive Bladder

Immediate release: 20 mg PO twice daily

Extended Release: 60 mg PO qDay

Pediatric

Safety and efficacy not established

Alerts

Controlled narrow-angle glaucoma

Renal impairment

Decreased GI motility

CNS anticholinergic effects reported including dizziness, confusion, hallucinations and somnolence

Geriatric patients

Pregnancy/lactation

Caution with moderate or severe hepatic dysfunction

Angioedema of the face, lips, tongue and/or larynx reported (including with 1st dose)

Points of recommendation

  • Tell all of your health care providers that you take this medicine . This includes your doctors, nurses, pharmacists, and dentists.
  • Avoid driving and doing other tasks or actions that call for you to be alert or have clear eyesight until you see how this medicine affects you.
  • Be careful in hot weather or while being active. Drink lots of fluids to stop fluid loss.
  • Talk with your doctor before you drink alcohol or use other drugs and natural products that slow your actions.
  • A very bad reaction called angioedema has happened with this medicine. Sometimes, this may be life-threatening. Signs may include swelling of the hands, face, lips, eyes, tongue, or throat; trouble breathing; trouble swallowing; or unusual hoarseness. Get medical help right away if you have any of these signs.
  • Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using this medicine  while you are pregnant.
  • Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.
  • Take on an empty stomach or at least 1 hour before a meal.
  • Take with a full glass of water.
  • To gain the most benefit, do not miss doses.
  • Take a missed dose as soon as you think about it.
  • If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
  • Do not take 2 doses at the same time or extra doses.

Pregnancy level

Group c - Not adequate studies in pregnant women


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