Fesoterodine: Uses, Dosage, Side Effects & Overactive Bladder Relief

Summary of Key Points

Fesoterodine is a prescription medication used to manage symptoms of overactive bladder, such as urinary urgency, frequency, and incontinence. It works by relaxing the muscles of the bladder, helping to reduce sudden urges and prevent leaks. Fesoterodine is typically taken once daily in the form of an extended-release tablet. Always consult your healthcare provider before starting or adjusting your dose. You can also connect with one of our providers through telemedicine for personalized advice.

Names of Medication

US Brand Name: Toviaz (Fesoterodine)

The generic name refers to the active ingredient, while the brand name is assigned by the manufacturer. In this case, Fesoterodine is the generic name.

Pharmacologic Category

Antimuscarinic

Anticholinergic

Fesoterodine Dosage

Fesoterodine is prescribed for various bladder-related conditions in adults. The dosage may vary depending on the specific condition being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your dose. You can also schedule a telemedicine appointment with one of our providers for further guidance.

Overactive Bladder

The typical starting dose is 4 mg once daily. Based on your response and tolerance, the dose may be increased to 8 mg once daily. Treatment is usually long-term but should be regularly reviewed by your healthcare provider.

Urinary Incontinence

The initial dose is 4 mg once daily, with the option to increase to 8 mg once daily depending on symptom control and side effects. Treatment is ongoing, but regular follow-up with your doctor is recommended.

Urinary Urgency and Frequency

Start with 4 mg once daily. If needed, your doctor may increase the dose to 8 mg once daily. The duration of treatment varies based on individual response.

Bladder Dysfunction (Including Neurogenic Bladder and Detrusor Overactivity)

The usual dose is 4 mg once daily, with the possibility of increasing to 8 mg once daily. Treatment is typically long-term, but regular check-ins with your healthcare provider are important.

Urge Incontinence and Bladder Hyperactivity

Begin with 4 mg once daily, and your doctor may adjust the dose to 8 mg once daily depending on your response. Treatment is often ongoing.

Nocturia (Frequent Nighttime Urination)

The recommended dose is 4 mg once daily, with the option to increase to 8 mg once daily if necessary. Treatment duration is individualized.

Dosage Forms and Strengths

Extended-release tablets: 4 mg, 8 mg

Administration Instructions for Fesoterodine

Fesoterodine should be taken once daily, with or without food. Swallow the tablet whole; do not crush, chew, or break it. Take the medication at the same time each day to maintain consistent levels in your body. If you miss a dose, take it as soon as you remember unless it’s almost time for your next dose. Do not double up on doses. Always follow your doctor’s instructions, and consult one of our telemedicine providers if you have any questions about how to take your medication.

Fesoterodine Side Effects and Adverse Reactions

Like all medications, Fesoterodine can cause side effects. Most are mild, but some may be more serious. If you experience any concerning symptoms, contact your healthcare provider immediately.

Common Side Effects (Occurring in More Than 1 in 10 Patients)

1. Dry mouth: A common side effect that may cause discomfort or difficulty swallowing.
2. Constipation: Some patients may experience difficulty with bowel movements.

Less Common Side Effects (Occurring in 1 in 100 to 1 in 10 Patients)

1. Dry eyes: You may notice a decrease in tear production, leading to eye irritation.
2. Blurred vision: Some patients report temporary vision changes.
3. Drowsiness: You may feel unusually sleepy or fatigued.

Rare Side Effects (Occurring in Fewer Than 1 in 1,000 Patients)

1. Urinary retention: Difficulty emptying the bladder completely.
2. Severe allergic reactions: This may include swelling of the face, lips, or throat, and difficulty breathing. Seek immediate medical attention if this occurs.

Contraindications for Fesoterodine

A contraindication is a specific situation or condition where a medication should not be used because it may cause harm. If you have any of the following conditions, Fesoterodine may not be safe for you. Always consult with your healthcare provider before starting any new medication, and if you have concerns, you can speak to one of our providers through telemedicine.

Urinary Retention

Fesoterodine can make it harder to urinate, so it is not recommended for people who have difficulty emptying their bladder.

Gastric Retention

If you have a condition that causes slow stomach emptying, such as gastroparesis, Fesoterodine can worsen this condition.

Uncontrolled Narrow-Angle Glaucoma

Fesoterodine can increase pressure in the eye, which is dangerous for people with this type of glaucoma.

Severe Liver Disease

Fesoterodine is processed by the liver, and if your liver is not functioning well, the medication may build up in your body, leading to harmful effects.

Severe Kidney Disease

Similar to liver disease, if your kidneys are not working properly, Fesoterodine may not be cleared from your body efficiently, increasing the risk of side effects.

Allergy to Fesoterodine or Its Ingredients

If you have had an allergic reaction to Fesoterodine or any of its components, you should not take this medication.

Drug to Drug Interactions

Fesoterodine may interact with other medications, potentially increasing the risk of side effects or reducing the effectiveness of either Fesoterodine or the other drugs. It’s important to inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements. Below are some medications that may interact with Fesoterodine:

1. Ketoconazole (Nizoral): This antifungal can raise Fesoterodine levels, increasing the likelihood of side effects.
2. Ritonavir (Norvir): Used to treat HIV, Ritonavir can also elevate Fesoterodine concentrations in your system, heightening the risk of adverse effects.
3. Clarithromycin (Biaxin): This antibiotic may increase Fesoterodine levels, which could lead to more pronounced side effects.
4. Carbamazepine (Tegretol): This seizure medication can reduce Fesoterodine’s effectiveness by speeding up its breakdown in the body.
5. Phenytoin (Dilantin): Another seizure medication that can lower Fesoterodine’s effectiveness by accelerating its metabolism.
6. St. John’s Wort: This herbal supplement may decrease Fesoterodine’s effectiveness by increasing its breakdown in the liver.

Fesoterodine in Pregnancy

Is it safe to take Fesoterodine during pregnancy?

There is limited information on the safety of Fesoterodine during pregnancy. Animal studies suggest there may be some risk to the fetus, but no well-controlled studies have been conducted in humans. Fesoterodine should only be used during pregnancy if the potential benefits outweigh the risks. If you are pregnant or planning to become pregnant, it’s essential to discuss your options with your healthcare provider. You can also consult one of our telemedicine providers for personalized advice.

Fesoterodine while Breastfeeding

Is it safe to take Fesoterodine while breastfeeding?

It is unclear whether Fesoterodine passes into breast milk. Due to the potential for serious side effects in a nursing infant, it is generally recommended to avoid Fesoterodine while breastfeeding. If you are breastfeeding or planning to breastfeed, talk to your healthcare provider about alternative treatments. Our telemedicine providers can help you make the best decision for both you and your baby.

Estimated Cost of Fesoterodine

The cost of a 30-day supply of Fesoterodine (4 mg or 8 mg tablets) without insurance can vary depending on the pharmacy. However, with a GoodRX coupon, the price typically ranges from $300 to $400 for a 30-day supply. Be sure to check with your pharmacy for the most accurate pricing, and consider using a coupon to help reduce costs.

Possible Alternatives to Fesoterodine

If Fesoterodine is not suitable for you, there are other treatments and lifestyle changes that may help manage your condition. Always discuss any changes to your treatment plan with your healthcare provider. You can also consult our telemedicine providers for further guidance.

1. Overactive Bladder: Alternatives include other anticholinergic medications like Oxybutynin (Ditropan) or Tolterodine (Detrol). Behavioral therapies, such as bladder training and pelvic floor exercises, can also be effective.
2. Urinary Incontinence: In addition to medications like Mirabegron (Myrbetriq), lifestyle changes such as weight loss, reducing caffeine intake, and pelvic floor exercises may help improve symptoms.
3. Urinary Urgency: Bladder training and timed voiding can help reduce urgency. Medications like Solifenacin (Vesicare) may also be prescribed.
4. Urinary Frequency: Limiting fluid intake, especially before bedtime, and avoiding bladder irritants like caffeine and alcohol may help. Medications like Trospium (Sanctura) are also options.
5. Bladder Dysfunction: Depending on the cause, treatments may include medications, physical therapy, or surgery. Consult your healthcare provider for a personalized treatment plan.
6. Neurogenic Bladder: This condition often requires a combination of medications, catheterization, and sometimes surgery. Medications like Bethanechol (Urecholine) may improve bladder function.
7. Detrusor Overactivity: Medications like Darifenacin (Enablex) or Botox injections into the bladder muscle can help manage symptoms.
8. Urge Incontinence: In addition to medications, pelvic floor exercises and bladder training are common treatments. Electrical stimulation of the pelvic floor muscles may also be an option.
9. Bladder Hyperactivity: Similar to overactive bladder, treatment options include medications, lifestyle changes, and bladder training.
10. Nocturia: Reducing fluid intake in the evening, avoiding diuretics, and medications like Desmopressin (Noctiva) can help manage nighttime urination.

Recent Updates on Fesoterodine Research

Recent studies on Fesoterodine have focused on its long-term safety and effectiveness in managing overactive bladder and related conditions. A 2022 study found that Fesoterodine remains effective in reducing overactive bladder symptoms over a 12-month period, with manageable side effects. Another ongoing study is exploring the use of Fesoterodine in combination with therapies like pelvic floor exercises to enhance treatment outcomes. Always discuss new research findings with your healthcare provider to determine how they may apply to your treatment plan. Our telemedicine providers are available to help you stay informed about the latest treatment options.

James Kingsley

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