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What is Trospium
Trospium is a non-specific antimuscarinic agent used orally in the treatment of overactive bladder.
Trospium decreases the frequency of bladder contractions, resulting in a reduction in urinary frequency, urgency and incontinence.
Trospium is effective in patients with idiopathic or neurogenic detrusor overactivity, with symptoms of overactive bladder improving as early as one week following drug initiation.
In addition, the safety and efficacy of trospium for the treatment of overactive bladder has been demonstrated for up to 52 weeks.
While not FDA-approved, limited data indicate that trospium may be effective in treating overactive bladder in pediatric patients.
The most commonly reported adverse effects of trospium are dry mouth and constipation, both of which are expected effects of antimuscarinic drugs. Trospium has been shown to be as effective as oxybutynin, but with better tolerability in clinical trials (e.g., less xerostomia).
Trospium is a quaternary amine and does not cross the blood-brain barrier or conjunctiva like oxybutynin, a tertiary amine.
Therefore, CNS related side effects such as dizziness, drowsiness, nervousness, and EEG changes are expected to be less common with trospium (see Adverse Reactions).
The incidence of xerophthalmia is low. In contrast to tolterodine, trospium is not a substrate or inhibitor of cytochrome P-450 enzymes; interactions involving drug metabolism are not expected with trospium. Preliminary data indicate that trospium may be effective when instilled intravesically.
Unlike intravesical oxybutynin, trospium has the potential advantage for minimal systemic absorption.
However, more clinical data is needed before this route of administration can be routinely recommended.
Trospium has been available in Europe for greater than 20 years.
Trospium (Sanctura®) was US FDA approved in May 2004; an extended-release capsule (Sanctura® XR) was approved in August 2007.
Brand Name
Sanctura | Sanctura XR
Indications
- enuresis
- neurogenic bladder
- overactive bladder (OAB)
- urinary incontinence
For the treatment of overactive bladder (OAB) with symptoms of urgency, frequency, and urge urinary incontinence (includes neurogenic bladder)
Side Effects
- abdominal pain
- anaphylactoid reactions
- angioedema
- blurred vision
- chest pain (unspecified)
- confusion
- constipation
- cystitis
- delirium
- dizziness
- drowsiness
- dysgeusia
- dyspepsia
- fatigue
- flatulence
- gastritis
- hallucinations
- headache
- hypertension
- hypertensive crisis
- nausea
- palpitations
- rash
- rhabdomyolysis
- sinus tachycardia
- ST-T wave changes
- Stevens-Johnson syndrome
- supraventricular tachycardia (SVT)
- syncope
- urinary retention
- visual impairment
- vomiting
- xerophthalmia
- xerosis
- xerostomia
Monitoring Parameters
- serum creatinine
Contraindications
- anticholinergic medications
- autonomic neuropathy
- breast-feeding
- children
- closed-angle glaucoma
- contact lenses
- driving or operating machinery
- ethanol ingestion
- gastroesophageal reflux disease (GERD)
- gastroparesis
- geriatric
- GI obstruction
- hepatic disease
- ileus
- myasthenia gravis
- pregnancy
- prostatic hypertrophy
- pyloric stenosis
- renal disease
- renal failure
- renal impairment
- toxic megacolon
- ulcerative colitis
- urinary retention
- urinary tract obstruction
Interactions
- Abacavir; Dolutegravir; Lamivudine
- Abacavir; Lamivudine, 3TC
- Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
- Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
- Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Diphenhydramine
- Acetaminophen; Pentazocine
- Acetaminophen; Tramadol
- Acrivastine; Pseudoephedrine
- Adefovir
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Aliskiren; Hydrochlorothiazide, HCTZ
- Alogliptin; Metformin
- Alosetron
- Amantadine
- Amiloride
- Amiloride; Hydrochlorothiazide, HCTZ
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amoxapine
- Antacids
- Anticholinergics
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Citric Acid; Sodium Bicarbonate
- Atenolol; Chlorthalidone
- Azilsartan; Chlorthalidone
- Benazepril; Hydrochlorothiazide, HCTZ
- Bendroflumethiazide; Nadolol
- Benzhydrocodone; Acetaminophen
- Bisoprolol; Hydrochlorothiazide, HCTZ
- Botulinum Toxins
- Brompheniramine
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Dextromethorphan; Guaifenesin
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Bumetanide
- Buprenorphine
- Buprenorphine; Naloxone
- Bupropion
- Bupropion; Naltrexone
- Butorphanol
- Caffeine
- Canagliflozin; Metformin
- Candesartan; Hydrochlorothiazide, HCTZ
- Captopril; Hydrochlorothiazide, HCTZ
- Carbetapentane; Chlorpheniramine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pseudoephedrine
- Carbetapentane; Pyrilamine
- Carbinoxamine
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carbinoxamine; Phenylephrine
- Carbinoxamine; Pseudoephedrine
- Cetirizine
- Cetirizine; Pseudoephedrine
- Chlophedianol; Dexbrompheniramine
- Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
- Chlorcyclizine
- Chlorothiazide
- Chlorpheniramine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Chlorpromazine
- Chlorthalidone
- Chlorthalidone; Clonidine
- Cholinergic agonists
- Cimetidine
- Cisapride
- Clemastine
- Clozapine
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Cyclizine
- Cyclobenzaprine
- Cyproheptadine
- Dapagliflozin; Metformin
- Dexchlorpheniramine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Digoxin
- Dimenhydrinate
- Diphenhydramine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Diphenhydramine; Phenylephrine
- Disopyramide
- Dofetilide
- Dolutegravir; Lamivudine
- Donepezil
- Donepezil; Memantine
- Doravirine; Lamivudine; Tenofovir disoproxil fumarate
- Doxylamine
- Doxylamine; Pyridoxine
- Dronabinol
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Empagliflozin; Linagliptin; Metformin
- Empagliflozin; Metformin
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Emtricitabine; Tenofovir disoproxil fumarate
- Enalapril; Hydrochlorothiazide, HCTZ
- Entecavir
- Eprosartan; Hydrochlorothiazide, HCTZ
- Ertugliflozin; Metformin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Ethacrynic Acid
- Ethanol
- Fluoxetine; Olanzapine
- Fluphenazine
- food
- Fosinopril; Hydrochlorothiazide, HCTZ
- Furosemide
- Galantamine
- Glipizide; Metformin
- Glyburide; Metformin
- Glycopyrronium
- Green Tea
- Hydralazine; Hydrochlorothiazide, HCTZ
- Hydrochlorothiazide, HCTZ
- Hydrochlorothiazide, HCTZ; Irbesartan
- Hydrochlorothiazide, HCTZ; Lisinopril
- Hydrochlorothiazide, HCTZ; Losartan
- Hydrochlorothiazide, HCTZ; Methyldopa
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Moexipril
- Hydrochlorothiazide, HCTZ; Olmesartan
- Hydrochlorothiazide, HCTZ; Propranolol
- Hydrochlorothiazide, HCTZ; Quinapril
- Hydrochlorothiazide, HCTZ; Spironolactone
- Hydrochlorothiazide, HCTZ; Telmisartan
- Hydrochlorothiazide, HCTZ; Triamterene
- Hydrochlorothiazide, HCTZ; Valsartan
- Hydroxyzine
- Itraconazole
- Ketoconazole
- Lamivudine, 3TC
- Lamivudine, 3TC; Zidovudine, ZDV
- Lamivudine; Tenofovir Disoproxil Fumarate
- Levocetirizine
- Linagliptin; Metformin
- Loop diuretics
- Lurasidone
- Maprotiline
- Meclizine
- Megestrol
- Memantine
- Meperidine; Promethazine
- Mesoridazine
- Metformin
- Metformin; Pioglitazone
- Metformin; Repaglinide
- Metformin; Rosiglitazone
- Metformin; Saxagliptin
- Metformin; Sitagliptin
- Methyclothiazide
- Metolazone
- Midodrine
- Mirtazapine
- Nabilone
- Nalbuphine
- Olanzapine
- Omeprazole; Sodium Bicarbonate
- Opiate Agonists
- Orphenadrine
- Pancuronium
- Pentazocine
- Pentazocine; Naloxone
- Perphenazine
- Perphenazine; Amitriptyline
- Phenothiazines
- Phentermine; Topiramate
- Phenylephrine; Promethazine
- Procainamide
- Prochlorperazine
- Promethazine
- Proton pump inhibitors
- Quetiapine
- Quinidine
- Quinine
- Ranitidine
- Rasagiline
- Rivastigmine
- Secretin
- Sedating H1-blockers
- Sodium Bicarbonate
- Solifenacin
- Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
- Tacrine
- Tapentadol
- Tegaserod
- Tenofovir Alafenamide
- Tenofovir, PMPA
- Thiazide diuretics
- Thiethylperazine
- Thioridazine
- Thiothixene
- Topiramate
- Torsemide
- Tramadol
- Triamterene
- Tricyclic antidepressants
- Trifluoperazine
- Trimethobenzamide
- Trimethoprim
- Triprolidine
- Vancomycin
- Zonisamide