Drug interactions
Fesoterodine + Physostigmine
Severity: Moderate
Fesoterodine and Physostigmine: moderate 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
Physostigmine inhibits acetylcholinesterase and increases cholinergic activity, which directly opposes the antimuscarinic action of fesoterodine. Efficacy of either drug may be reduced, and physostigmine is actually used to reverse anticholinergic toxicity.
What this interaction means in plain words
Fesoterodine and Physostigmine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Pharmacodynamic antagonism between cholinesterase inhibition and muscarinic receptor blockade.
What to do
Expect reduced effect of fesoterodine; monitor bladder symptoms. When physostigmine is used for anticholinergic toxicity, hold fesoterodine.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Fesoterodine
Frequently asked questions
Can I take Fesoterodine with Physostigmine?
MediHelp rates the interaction as moderate. Fesoterodine and Physostigmine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Physostigmine inhibits acetylcholinesterase and increases cholinergic activity, which directly opposes the antimuscarinic action of fesoterodine. Efficacy of either drug may be reduced, and physostigmine is actually used to reverse anticholinergic toxicity.
How serious is the interaction between Fesoterodine and Physostigmine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Expect reduced effect of fesoterodine; monitor bladder symptoms. When physostigmine is used for anticholinergic toxicity, hold fesoterodine.
What other medicines interact with Fesoterodine?
MediHelp also lists interactions of Fesoterodine with, for example, Bethanechol, Clozapine, Levoketoconazole. The full list is on the Fesoterodine page.
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