Drug interactions
OnabotulinumtoxinA + Tolterodine
Severity: Moderate
OnabotulinumtoxinA and Tolterodine: 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
Anticholinergic drugs may add to the neuromuscular effects of botulinum toxin and increase systemic anticholinergic effects. Excessive weakness or urinary retention could occur after bladder injection.
What this interaction means in plain words
OnabotulinumtoxinA and Tolterodine 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.
OnabotulinumtoxinA belongs to Musculoskeletal; Tolterodine belongs to Genitourinary.
Why it happens
Additive cholinergic blockade, with botulinum toxin blocking acetylcholine release and tolterodine blocking muscarinic receptors.
What to do
Monitor for muscle weakness, swallowing or breathing difficulty and post-void residual volume after injection. Reassess the need for the antimuscarinic after the injection.
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 Tolterodine
Other interactions of OnabotulinumtoxinA
Frequently asked questions
Can I take OnabotulinumtoxinA with Tolterodine?
MediHelp rates the interaction as moderate. OnabotulinumtoxinA and Tolterodine 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. Anticholinergic drugs may add to the neuromuscular effects of botulinum toxin and increase systemic anticholinergic effects. Excessive weakness or urinary retention could occur after bladder injection.
How serious is the interaction between OnabotulinumtoxinA and Tolterodine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for muscle weakness, swallowing or breathing difficulty and post-void residual volume after injection. Reassess the need for the antimuscarinic after the injection.
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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