How does tolterodine work?
Tolterodine is a type of medicine called an antimuscarinic (or anticholinergic) muscle relaxant.
It works by relaxing the muscle that is found in the wall of the bladder. This helps to increase the volume of pee your bladder can hold and control the release of pee.
When will I feel better?
Tolterodine starts to work within 3 to 8 hours to relax the muscle of your bladder.
However, it may take 4 weeks or longer to work fully and for your symptoms to get better.
If your symptoms do not start to improve after 1 to 2 weeks, talk to your doctor.
Talk to your doctor if your symptoms get worse at any time.
Are there any long-term side effects?
Do not take tolterodine for longer than you need to. Your doctor will check every 6 to 12 months that your treatment is still needed.
There may be an increased risk of confusion and possibly dementia getting worse in people taking tolterodine. If you're worried about this, talk to your doctor.
What will happen if I stop taking it?
If you want to stop taking tolterodine, talk to your doctor first.
If you've been taking it for at least 6 months, your doctor may suggest that you can stop taking it for up to 4 weeks to see how your bladder symptoms change without it.
Some people find that their symptoms are still better after they've stopped taking the medicine.
Are there other medicines for urinary incontinence and overactive bladder?
Tolterodine belongs to a group of medicines called antimuscarinics. There are other antimuscarinics that can be used for overactive bladder, including:
- solifenacin
- oxybutynin
- darifenacin
- fesoterodine
- propiverine
- trospium
They all seem to work just as well as tolterodine. However, if you get side effects with one antimuscarinic a different one may suit you better.
If antimuscarinics are not suitable for you, they have not helped your overactive bladder, or you've had side effects, you may be offered a medicine called mirabegron. This works in a slightly different way but also helps with bladder symptoms.
Will I gain or lose weight?
You may gain weight when you take tolterodine tablets. If you start to have problems with your weight while taking tolterodine, talk to your pharmacist or doctor.
Will it affect my contraception?
Tolterodine does not stop any type of contraception from working, including the combined pill and emergency contraception.
However, if tolterodine makes you sick or you have severe, watery diarrhoea or any diarrhoea that lasts for more than 24 hours, your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.
Find out more:
Can I drive or ride a bike?
Do not drive a car, ride a bike, use tools or operate machinery if tolterodine makes you sleepy, gives you blurred vision, or makes you feel dizzy, clumsy or unable to concentrate or make decisions.
This may be more likely when you first start taking it, but could happen at any time. For example, it could happen when you increase the dose or start another medicine.
It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.
Talk to a doctor or pharmacist if you're not sure whether it's safe for you to drive while taking tolterodine.
GOV.UK has more information on the law on drugs and driving.
Can I drink alcohol while taking tolterodine?
Try to avoid drinking alcohol when you first start taking tolterodine, or if your dose is increased, until you see how the medicine makes you feel. Tolterodine combined with alcohol can make you feel very sleepy.
Drinking alcohol may make you more likely to need to get up in the night to pee.
Is there any food or drink I need to avoid?
You can eat normally while taking tolterodine.
If you have urinary incontinence, it can help to cut down on alcohol and drinks containing caffeine, such as tea, coffee, cola and energy drinks.
Are there lifestyle changes that can help overactive bladder?
There are some lifestyle changes that may help your symptoms. It's a good idea to:
- cut down on drinks that contain caffeine, such as tea, coffee, cola and energy drinks, as caffeine can increase how much you pee
- not drink too much or too little fluid during the day, as this can make incontinence worse
- lose weight if you're overweight or living with obesity, as being overweight can increase your risk of urinary incontinence – calculate your body mass index (BMI) to find out if you're a healthy weight for your height
- try non-surgical treatments for urinary incontinence such as pelvic floor muscle training (Kegel exercises) and bladder training
- discuss other options for urinary incontinence with your doctor, such as surgery and procedures