Detrol
Detrol (Tolterodine)Pharmacological action
The preparation reducing a tonus of smooth muscles of urinary ways. As Detrol (Tolterodine) does not render essential influence on other receptors.
In the doses exceeding therapeutic, causes enlarges quantity of a residual urine.
The therapeutic Detrol (Tolterodine) effect is reached in 4 weeks.
Indications
- A hyperreflexia (hyperactivity, instability) a bladder, shown by frequent, imperative desires to an emiction, increase of an emiction and-or an urine incontience.
Dosage regimen
The preparation is prescribed in a daily dose by of 4 mg: the tablets covered with a cover, - on 2 mg 2 times/sut, capsules of the prolonged action - on 4 mg of 1 times/days
At disturbances of function of a liver and-or kidneys, and also at simultaneous application with other strong inhibitors CYP3A4 the recommended daily dose makes 2 mg: the tablets covered with a cover, - on 1 mg 2 times/24h, capsules of the prolonged action - on 2 mg of 1 times/days
Side effect
The by-effects bound to anticholinergic action: often (more than 10 %) - dryness in a mouth; accommodation disturbances; seldom (less than 1 %) - an emiction delay.
From the alimentary system: sometimes (1-10 %) - a dyspepsia, a constipation, abdominal pains, a meteorism, vomiting; seldom (less than 1 %).
From party TSNS and peripheric nervous system: sometimes (1-10 %) - a headache, giddiness, delicacy, drowsiness, weariness, nervousness, sight disturbances; seldom (less than 1 %) - confusion of consciousness, hallucination.
From cardiovascular system: seldom (less than 1 %) - blood "inflow" to a face skin, a tachycardia, sensation of strong palpitation, peripheric edemas.
Allergic reactions: seldom (less than 1 %) - anaphylactic reactions, including a Quincke's disease.
The by-effects caused by reception of a preparation in tablets: sometimes (1-10 %) - a stethalgia, a xeroderma, a bronchitis, augmentation of mass of a body.
The by-effects caused by reception of a preparation in capsules of prolonged action: sometimes (1-10 %) - a sinusitis.
Contraindications
- An emiction delay;
- An angle-closure glaucoma;
- A myasthenia resistant to treatment;
- A serious ulcerative colitis;
- A megacolon;
- A hypersensibility to Detrol and to other components of a preparation.
With care prescribe a preparation at the expressed obstruction of the bottom urinary ways because of risk of a delay of an emiction, at the raised risk of depression of a peristalsis GASTROINTESTINAL TRACT, at obstructive diseases GASTROINTESTINAL TRACT (for example, the pyloric stenosis), at renal or hepatic insufficiency, a neuropathy, a hernia of an esophageal aperture of a diaphragm, and also to children and teenagers is elderly till 18 years.
Pregnancy and lactemia
Adequate and controllable researches of safety of application of a preparation at pregnancy it was not spent, therefore Detrol application at pregnancy is possible only in case the prospective advantage of therapy for mother surpasses potential risk for a foetus.
As data onDetrol deducing with thoracal milk are absent, it is necessary to avoid application of a preparation in a lactemia.
Women of genital age should apply reliable methods of contraception during Detrol therapy.
Special indicatings
Before the treatment beginning it is necessary to exclude the organic reasons of frequent and imperative desires on an emiction.
At simultaneous application with inhibitors CYP3A4, such as antibiotics of group of macroleads or antimicotic agents, it is necessary to lower the general daily dose to 2 mg.
Use in pediatrics
Detrol do not recommend to prescribe to children as now safety and efficiency of application of a preparation at this category of patients is not studied.
Influence on ability to driving of the car and to management of mechanisms
As Detrol can cause disturbances of accommodation and reduce rate of psychomotor reactions, in treatment it is necessary to abstain from driving of motor transport and employment by potentially dangerous kinds of the activity demanding raised concentration of attention and speed of psychomotor reactions.
Overdosage
The most important symptoms: disturbances of accommodation and the complicated emiction, and also are possible hallucinations, strong excitation, cramps, breath disturbance, a tachycardia, an emiction delay, expansion of pupils.
Treatment: a gastric lavage, appointment of the activated coal, symptomatic therapy: at development of hallucinations - Physostigminum, at cramps or the expressed excitation - benzodiazepine structure, at the developed respiratory insufficiency - artificial breath; at a tachycardia - beta adrenoblockers; at an emiction delay - a bladder catheterization; at a mydriasis - Pilocarpinum in eye drops and-or transfer of the patient in a dark premise.
Conditions and periods of storage
B.Preparat's list should be stored in protected from light, a place inaccessible to children at temperature not above 25 C. The Period of validity of the tablets covered with a cover, - 3 years; capsules of the prolonged action - 2 years.
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