Drug interactions
Fesoterodine + Tolterodine
Severity: Major
Fesoterodine 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
Fesoterodine is a prodrug of 5-hydroxymethyl tolterodine, which is the main active metabolite of tolterodine. Taking both gives duplicate antimuscarinic therapy and no added benefit. Anticholinergic adverse effects such as dry mouth, constipation, urinary retention and QT effects become more likely.
What this interaction means in plain words
Fesoterodine 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.
Fesoterodine belongs to Genitourinary; Tolterodine belongs to Genitourinary.
Why it happens
Therapeutic duplication, because both drugs yield the same active antimuscarinic metabolite.
What to do
Do not use the two together. Choose one agent and titrate it, or switch to another class such as a beta-3 agonist if the response is inadequate.
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 Fesoterodine
Frequently asked questions
Can I take Fesoterodine with Tolterodine?
MediHelp rates the interaction as major. Fesoterodine 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. Fesoterodine is a prodrug of 5-hydroxymethyl tolterodine, which is the main active metabolite of tolterodine. Taking both gives duplicate antimuscarinic therapy and no added benefit. Anticholinergic adverse effects such as dry mouth, constipation, urinary retention and QT effects become more likely.
How serious is the interaction between Fesoterodine 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: Do not use the two together. Choose one agent and titrate it, or switch to another class such as a beta-3 agonist if the response is inadequate.
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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