Drug interactions
Dronedarone + Tolterodine
Severity: Major
Dronedarone and Tolterodine: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Dronedarone is a moderate CYP3A4 inhibitor and a CYP2D6 inhibitor, so it can raise tolterodine exposure. Tolterodine and dronedarone can each prolong the QT interval, so higher tolterodine levels may increase arrhythmia risk. Anticholinergic adverse effects are also more likely.
What this interaction means in plain words
Dronedarone and Tolterodine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Dronedarone belongs to Cardiovascular; Tolterodine belongs to Genitourinary.
Why it happens
Dronedarone inhibits CYP3A4 and CYP2D6 metabolism of tolterodine, with additive QT effects.
What to do
Avoid the combination if possible, or use the lowest tolterodine dose and obtain an ECG. Correct potassium and magnesium and watch for palpitations or syncope.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Tolterodine
Other interactions of Dronedarone
- Adagrasib + Dronedarone Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Arsenic trioxide + Dronedarone Contraindicated
- Artemether / lumefantrine + Dronedarone Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Azithromycin + Dronedarone Contraindicated
Frequently asked questions
Can I take Dronedarone with Tolterodine?
MediHelp rates the interaction as major. Dronedarone and Tolterodine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Dronedarone is a moderate CYP3A4 inhibitor and a CYP2D6 inhibitor, so it can raise tolterodine exposure. Tolterodine and dronedarone can each prolong the QT interval, so higher tolterodine levels may increase arrhythmia risk. Anticholinergic adverse effects are also more likely.
How serious is the interaction between Dronedarone and Tolterodine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination if possible, or use the lowest tolterodine dose and obtain an ECG. Correct potassium and magnesium and watch for palpitations or syncope.
What other medicines interact with Tolterodine?
MediHelp also lists interactions of Tolterodine with, for example, Clarithromycin, Clozapine, Cobicistat. The full list is on the Tolterodine page.
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