PROCTOLAR-CENTER Price

Overview

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This medicine contains an important and useful components, as it consists of
Bismuth subgallate, Fluocinolone acetonide, Lidocaine, Mentholis available in the market in concentration

Name

Tolterodine Tartrate

Precaution

Before using **Tolterodine Tartrate**, it is important to consult a healthcare provider, particularly if the following conditions apply: - **Allergic Reactions**: Individuals who have a known **allergy** to **Tolterodine** or any of its components should avoid using this medication. Symptoms of an allergic reaction may include **rash**, **itching**, **swelling**, or **difficulty breathing**. Immediate medical attention should be sought if these symptoms occur. - **Urinary Retention**: **Tolterodine** may exacerbate symptoms of **urinary retention** in patients with conditions such as **benign prostatic hyperplasia (BPH)** or other bladder obstruction issues. It should be used cautiously in these patients. - **Liver Impairment**: **Tolterodine** is metabolized by the liver, so individuals with **liver disease** (especially **severe liver dysfunction**) may require a lower dose or closer monitoring. - **Kidney Impairment**: In patients with **renal impairment**, dosage adjustments may be necessary, as **Tolterodine** can accumulate in the body due to reduced clearance. - **Pregnancy and Breastfeeding**: **Tolterodine** is classified as **Pregnancy Category C**, meaning its safety during pregnancy has not been established. It should only be used during pregnancy if the potential benefit justifies the potential risk. **Tolterodine** passes into breast milk, so breastfeeding women should use this medication with caution, or an alternative treatment may be recommended. - **Cognitive Effects**: **Tolterodine** can cause **drowsiness**, **dry mouth**, or **blurred vision**. Patients should be cautious when performing tasks requiring alertness, such as driving or operating heavy machinery.

Indication

**Tolterodine Tartrate** is primarily indicated for the treatment of **overactive bladder** (OAB), characterized by symptoms such as: - **Urgency**: A strong, often uncontrollable need to urinate. - **Frequency**: Increased frequency of urination, typically more than 8 times per day. - **Incontinence**: The unintentional loss of urine. The drug is also used to reduce the symptoms of **bladder spasms** associated with neurological disorders (such as **spinal cord injury** or **multiple sclerosis**) or **post-surgical bladder conditions**. By acting on the **muscarinic receptors** in the bladder, **Tolterodine** helps to relax the bladder muscles and decrease the frequency of spasms and the urgency to urinate.

Contra indication

**Tolterodine Tartrate** is contraindicated in the following cases: - **Hypersensitivity**: **Tolterodine** should not be used by individuals who are allergic to the drug or any of its ingredients. Severe allergic reactions may include symptoms like **rash**, **swelling**, and **breathing difficulties**. - **Urinary Retention**: **Tolterodine** is contraindicated in patients with a history of **urinary retention** or any condition that can cause **bladder obstruction**, including **benign prostatic hyperplasia (BPH)**. This drug may worsen symptoms of retention. - **Uncontrolled Narrow-Angle Glaucoma**: Patients with **narrow-angle glaucoma** (where the drainage of fluid in the eye is obstructed) should avoid **Tolterodine**, as it can increase the intraocular pressure and worsen glaucoma symptoms. - **Severe Liver Disease**: In patients with severe **liver dysfunction** (Child-Pugh class C), **Tolterodine** is contraindicated, as the medication may not be metabolized properly, leading to increased concentrations in the blood. - **Severe Gastrointestinal Conditions**: Patients with **severe gastrointestinal conditions** such as **intestinal obstruction**, **ileus**, or **severe constipation** should avoid using **Tolterodine** as it may worsen these conditions.

Side Effect

Common side effects of **Tolterodine Tartrate** include: - **Dry Mouth**: A very common side effect of **Tolterodine** is **dry mouth**, which can be uncomfortable and lead to **difficulty swallowing**, **altered taste**, or **increased dental issues**. - **Constipation**: **Tolterodine** may cause **constipation**, which can be severe in some individuals. - **Blurred Vision**: Some patients may experience **blurred vision**, which is a common side effect of **anticholinergic drugs**. - **Dizziness**: A feeling of **dizziness** or lightheadedness can occur, particularly when standing up quickly. - **Urinary Retention**: Though **Tolterodine** is used to treat overactive bladder, it may also cause **urinary retention** in some individuals. - **Fatigue**: Patients may feel **tired** or fatigued, especially in the early stages of treatment. Less common but more serious side effects include: - **Severe Allergic Reactions**: **Swelling** of the **face**, **lips**, **throat**, or **difficulty breathing** may occur and requires immediate medical attention. - **Confusion or Memory Issues**: **Tolterodine** can, in rare cases, lead to cognitive side effects like **memory problems**, **confusion**, or **difficulty concentrating**. - **Tachycardia**: An increase in heart rate (tachycardia) may occur, which can be concerning for those with heart conditions. If any severe side effects occur, the patient should seek immediate medical attention.

Pregnancy Category ID

3

Mode of Action

**Tolterodine Tartrate** is an **antimuscarinic agent**. It works by blocking the effects of acetylcholine on **muscarinic receptors** in the **bladder**. Acetylcholine normally stimulates the bladder muscles to contract, which leads to the feeling of urgency and frequent urination. By inhibiting these receptors, **Tolterodine** reduces the frequency and urgency of urination and helps prevent **bladder spasms**. This mechanism helps improve symptoms associated with **overactive bladder** and conditions that cause excessive urinary urgency and frequency.

Interaction

**Tolterodine Tartrate** may interact with several other medications, which could affect its efficacy or increase the risk of side effects: - **CYP3A4 Inhibitors**: Drugs that inhibit the **CYP3A4 enzyme**, such as **ketoconazole**, **itraconazole**, **ritonavir**, or **clarithromycin**, can increase the concentration of **Tolterodine** in the blood, potentially leading to increased side effects such as **dry mouth**, **constipation**, or **urinary retention**. - **CYP2D6 Inhibitors**: Medications like **fluoxetine**, **paroxetine**, and **bupropion**, which inhibit the **CYP2D6 enzyme**, can also increase the levels of **Tolterodine**, which may require a dose adjustment. - **Anticholinergic Drugs**: When taken with other **anticholinergic medications**, such as **antihistamines** or **tricyclic antidepressants**, the **sedative** and **drying effects** (e.g., dry mouth, blurred vision, constipation) may be exacerbated. - **Other Urinary Antispasmodics**: Using **Tolterodine** with other urinary antispasmodic medications may increase the risk of **adverse effects** like **urinary retention** or **constipation**. - **Antifungal and Antiviral Medications**: Certain **antifungal** and **antiviral drugs** (e.g., **voriconazole**, **nelfinavir**) can increase **Tolterodine** levels due to their effects on metabolic enzymes.

Pregnancy Category Note

Information not available

Adult Dose

For adults, the typical dosing of **Tolterodine Tartrate** is: - **Immediate-release tablets**: - Initial dose: **2 mg twice daily**. - If needed, the dose may be increased to a maximum of **4 mg** per day (2 mg twice daily). - **Extended-release tablets**: - Initial dose: **4 mg once daily**. - For some patients, the dose may be increased to **8 mg once daily**, depending on tolerance and therapeutic response. It is essential to follow the prescribed dosing schedule and consult a healthcare provider if any changes or side effects occur.

Child Dose

**Tolterodine Tartrate** is typically not recommended for **pediatric patients**, as its safety and efficacy in children have not been well established. However, in some specific cases, healthcare providers may prescribe **Tolterodine** for children, particularly those over the age of **5 years** who have urinary incontinence or overactive bladder. The dose and regimen for pediatric use should be carefully determined by a healthcare provider based on the child’s specific condition and response. As always, it is critical to **consult a healthcare provider** before using **Tolterodine** in children to ensure the appropriate dosing and monitoring.

Renal Dose

In patients with **renal impairment**, the dose of **Tolterodine** should be reduced due to slower elimination. Specifically: - For **moderate renal impairment** (CrCl 10-30 mL/min), the dose of **Tolterodine** should be reduced to **2 mg once daily** (immediate-release) or **4 mg once daily** (extended-release). - **Severe renal impairment** (CrCl <10 mL/min) may require even further dose adjustments, and close monitoring is advised.

Administration

Information not available