Tolterodine

About tolterodine

Tolterodine is a medicine used to treat symptoms of an overactive bladder. These can include:

It's also used to treat bedwetting in children (nocturnal enuresis).

Tolterodine works by relaxing the muscles around your bladder. This means your bladder can hold more liquid and you do not need to pee as often or as urgently.

Tolterodine is only available on prescription.

It comes as standard tablets and slow-release capsules (also called prolonged release or XL). This means the capsules release tolterodine slowly and evenly throughout the day.

Key facts

Who can and cannot take tolterodine

Tolterodine can be taken by most adults. It can also be taken by children aged 2 years and over, on the advice of their specialist.

Tolterodine is not suitable for some people. To make sure it's safe for you, tell your doctor or pharmacist before starting tolterodine if you:

How and when to take tolterodine

Dosage for tolterodine tablets

Always read the information that comes with your medicine.

Tolterodine capsules release the medicine evenly during the day. This means you do not need to take them as often as the standard tablets.

Swallow the tablets or capsules whole with a drink of water. Do not chew the capsules. You can take the tablets or capsules with or without food.

Adults will usually take 2mg in the morning and 2mg in the evening. Leave a gap of 12 hours between doses.

Children will usually take between 1mg and 4mg a day.

If you are giving tolterodine to a child to stop bedwetting, the usual dose is 1mg taken at bedtime. The dose can be increased up to a maximum of 2mg twice a day, depending on response.

If you have kidney or liver disease, or you're affected by side effects, your doctor may reduce your dose to 1mg twice a day.

Dosage for tolterodine slow-release capsules

The usual dose for adults taking slow-release tolterodine capsules is 4mg once a day.

Children will usually take between 1mg and 4mg a day.

If you have kidney or liver disease, or you're affected by side effects, your doctor may reduce your dose to 2mg once a day taken as tablets.

Take the capsule at the same time each day. This will help you to remember to take them.

What if I forget to take it?

If you forget to take a dose, take it as soon as you remember, unless it's nearly time for your next dose. In this case, just skip the missed dose and take your next dose as normal.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you. You could ask your pharmacist for advice on other ways to remember your medicines.

What if I take too much?

Taking 1 extra dose of tolterodine is unlikely to harm you.

However, you may get more side effects, such as a dry mouth or headache.

The amount of tolterodine that can lead to an overdose varies from person to person, and too much tolterodine can be dangerous.

Call 999 or go to A&E if:

You've taken more than your usual dose of tolterodine and you have:

  • a fast heartbeat
  • breathing problems

If you need to go to hospital, do not drive yourself. Get someone else to drive you, or to call you an ambulance.

Take the tolterodine packet with you, or the leaflet inside it, plus any remaining medicine.

Contact 111 for advice now if:

You've taken 2 or more extra doses of tolterodine and you:

  • have hallucinations
  • feel very restless or excited
  • have dilated pupils in your eyes
  • are not able to pee

Call 111 or go to 111.nhs.uk

If you need advice for a child under the age of 5 years, call 111.

Side effects

Common side effects

Like all medicines, tolterodine can cause side effects, but not everyone gets them.

Keep taking tolterodine, but talk to your doctor or pharmacist if these side effects bother you or do not go away, or if you notice any other possible side effects.

Common side effects that may affect up to 1 in 10 people include:

Serious side effects

Serious side effects are rare.

Tell your doctor straight away if you have:

Call 999 or go to A&E if:

  • you have chest pain – this can be a sign of heart rhythm problems (cardiac arrhythmia)

Serious allergic reaction

If you need to go to hospital, do not drive yourself. Get someone else to drive you, or to call you an ambulance.

In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to tolterodine.

These are not all the side effects of tolterodine. For a full list, see the leaflet inside your medicine packet.

How to cope with side effects of tolterodine

What to do about:

Pregnancy and breastfeeding

Tolterodine and pregnancy

Tolterodine is not usually recommended in pregnancy because there's not enough information available to say it's safe for you and your baby.

If you're trying to get pregnant or you're already pregnant, talk to your doctor about whether taking tolterodine is right for you.

Tolterodine and breastfeeding

Tolterodine is not usually recommended while breastfeeding. However, some breastfeeding mothers may still need it.

It is not known how much tolterodine gets into breast milk, but this is likely to be small.

If your doctor says it's OK for you to keep taking tolterodine, monitor your baby for possible side effects, such as constipation, peeing less and colic.

Talk to your doctor, midwife, or health visitor if you have any concerns about your baby while you're breastfeeding, including if you do not think your baby is putting on enough weight.

For more information about treating bladder problems (urinary incontinence) during pregnancy, read this leaflet on the Best Use of Medicines in Pregnancy (BUMPs) website.

Cautions with other medicines

Mixing tolterodine with herbal remedies and supplements

Some medicines and tolterodine can affect each other. This can increase the chance of side effects.

Tell your doctor if you're taking:

There might be a problem using herbal remedies and supplements while taking tolterodine.

Some herbal medicines can make you feel sleepy, cause a dry mouth, or make it difficult to pee. Their effect is similar to tolterodine. This can increase your risk of getting side effects or make your side effects worse.

Common questions about tolterodine

How does tolterodine work? How long does it take to work? How long will I take it for? Is it safe to take for a long time? Is it safe to take with painkillers? Can I stop taking it? Are there other medicines for urinary incontinence and overactive bladder? Can I drink alcohol with it? Is there any food or drink I need to avoid? Will I gain or lose weight? Will it affect my contraception? Will it affect my fertility? Can I drive or ride a bike? Are there lifestyle changes that can help overactive bladder?