Details
| Stereochemistry | ABSOLUTE |
| Molecular Formula | C22H31NO.C4H4O4 |
| Molecular Weight | 441.5598 |
| Optical Activity | UNSPECIFIED |
| Defined Stereocenters | 1 / 1 |
| E/Z Centers | 1 |
| Charge | 0 |
SHOW SMILES / InChI
SMILES
OC(=O)\C=C\C(O)=O.CC(C)N(CC[C@H](C1=CC=CC=C1)C2=C(O)C=CC(C)=C2)C(C)C
InChI
InChIKey=HKTZTYRSKPLEIQ-BOQYJDHWSA-N
InChI=1S/C22H31NO.C4H4O4/c1-16(2)23(17(3)4)14-13-20(19-9-7-6-8-10-19)21-15-18(5)11-12-22(21)24;5-3(6)1-2-4(7)8/h6-12,15-17,20,24H,13-14H2,1-5H3;1-2H,(H,5,6)(H,7,8)/b;2-1+/t20-;/m1./s1
| Molecular Formula | C22H31NO |
| Molecular Weight | 325.4876 |
| Charge | 0 |
| Count |
|
| Stereochemistry | ABSOLUTE |
| Additional Stereochemistry | No |
| Defined Stereocenters | 1 / 1 |
| E/Z Centers | 0 |
| Optical Activity | UNSPECIFIED |
| Molecular Formula | C4H4O4 |
| Molecular Weight | 116.0722 |
| Charge | 0 |
| Count |
|
| Stereochemistry | ACHIRAL |
| Additional Stereochemistry | No |
| Defined Stereocenters | 0 / 0 |
| E/Z Centers | 1 |
| Optical Activity | NONE |
Tolterodine is competitive muscarinic receptors M3 and M2 antagonist. It was sold under trade names detrol for the treatment of overactive bladder with symptoms of urge urinary incontinence. Both urinary bladder contraction and salivation are mediated via cholinergic muscarinic receptors. After oral administration, tolterodine is metabolized in the liver, resulting in the formation of the 5-hydroxymethyl derivative, a major pharmacologically active metabolite. The 5-hydroxymethyl metabolite, which exhibits an antimuscarinic activity similar to that of tolterodine, contributes significantly to the therapeutic effect. Both tolterodine and the 5-hydroxymethyl metabolite exhibit a high specificity for muscarinic receptors, since both show negligible activity and affinity for other neurotransmitter receptors and other potential cellular targets, such as calcium channels. Tolterodine has a pronounced effect on bladder function. The main effects of tolterodine at 1 and 5 hours were an increase in residual urine, reflecting an incomplete emptying of the bladder, and a decrease in detrusor pressure. These findings are consistent with an antimuscarinic action on the lower urinary tract.
Approval Year
Targets
| Primary Target | Pharmacology | Condition | Potency |
|---|---|---|---|
Target ID: CHEMBL245 |
|||
Target ID: CHEMBL211 |
Conditions
| Condition | Modality | Targets | Highest Phase | Product |
|---|---|---|---|---|
| Primary | DETROL Approved UseTolterodine tartrate extended-release capsules are indicated for the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and frequency [see CLINICAL STUDIES (14) Launch Date1998 |
Cmax
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
1.8 μg/L |
8 mg single, oral dose: 8 mg route of administration: Oral experiment type: SINGLE co-administered: |
TOLTERODINE plasma | Homo sapiens population: UNKNOWN age: ADULT sex: UNKNOWN food status: HIGH-FAT |
|
2.3 μg/L |
8 mg single, oral dose: 8 mg route of administration: Oral experiment type: SINGLE co-administered: |
TOLTERODINE plasma | Homo sapiens population: UNKNOWN age: ADULT sex: UNKNOWN food status: FASTED |
|
1.6 μg/L |
4 mg single, oral dose: 4 mg route of administration: Oral experiment type: SINGLE co-administered: |
TOLTERODINE plasma | Homo sapiens population: UNKNOWN age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
10 μg/L |
4 mg single, oral dose: 4 mg route of administration: Oral experiment type: SINGLE co-administered: |
TOLTERODINE plasma | Homo sapiens population: UNKNOWN age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
19 μg/L |
4 mg 2 times / day multiple, oral dose: 4 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
TOLTERODINE plasma | Homo sapiens population: UNKNOWN age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
2.6 μg/L |
4 mg 2 times / day multiple, oral dose: 4 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
TOLTERODINE plasma | Homo sapiens population: UNKNOWN age: ADULT sex: UNKNOWN food status: UNKNOWN |
AUC
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
23 μg × h/L |
8 mg single, oral dose: 8 mg route of administration: Oral experiment type: SINGLE co-administered: |
TOLTERODINE plasma | Homo sapiens population: UNKNOWN age: ADULT sex: UNKNOWN food status: HIGH-FAT |
|
27 μg × h/L |
8 mg single, oral dose: 8 mg route of administration: Oral experiment type: SINGLE co-administered: |
TOLTERODINE plasma | Homo sapiens population: UNKNOWN age: ADULT sex: UNKNOWN food status: FASTED |
T1/2
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
8.1 h |
8 mg single, oral dose: 8 mg route of administration: Oral experiment type: SINGLE co-administered: |
TOLTERODINE plasma | Homo sapiens population: UNKNOWN age: ADULT sex: UNKNOWN food status: HIGH-FAT |
|
7.9 h |
8 mg single, oral dose: 8 mg route of administration: Oral experiment type: SINGLE co-administered: |
TOLTERODINE plasma | Homo sapiens population: UNKNOWN age: ADULT sex: UNKNOWN food status: FASTED |
|
2 h |
4 mg single, oral dose: 4 mg route of administration: Oral experiment type: SINGLE co-administered: |
TOLTERODINE plasma | Homo sapiens population: UNKNOWN age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
6.5 h |
4 mg single, oral dose: 4 mg route of administration: Oral experiment type: SINGLE co-administered: |
TOLTERODINE plasma | Homo sapiens population: UNKNOWN age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
9.6 h |
4 mg 2 times / day multiple, oral dose: 4 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
TOLTERODINE plasma | Homo sapiens population: UNKNOWN age: ADULT sex: UNKNOWN food status: UNKNOWN |
|
2.2 h |
4 mg 2 times / day multiple, oral dose: 4 mg route of administration: Oral experiment type: MULTIPLE co-administered: |
TOLTERODINE plasma | Homo sapiens population: UNKNOWN age: ADULT sex: UNKNOWN food status: UNKNOWN |
Doses
| Dose | Population | Adverse events |
|---|---|---|
2 mg 2 times / day multiple, oral Recommended Dose: 2 mg, 2 times / day Route: oral Route: multiple Dose: 2 mg, 2 times / day Sources: Page: p.804 |
unhealthy, 20-93 n = 507 Health Status: unhealthy Condition: Overactive bladder Age Group: 20-93 Sex: M+F Population Size: 507 Sources: Page: p.804 |
Disc. AE: Dry mouth... AEs leading to discontinuation/dose reduction: Dry mouth (2.4%) Sources: Page: p.804 |
4 mg 2 times / day multiple, oral Highest studied dose Dose: 4 mg, 2 times / day Route: oral Route: multiple Dose: 4 mg, 2 times / day Sources: Page: p.997 |
unhealthy, 52 n = 58 Health Status: unhealthy Condition: Overactive bladder Age Group: 52 Sex: M+F Population Size: 58 Sources: Page: p.997 |
Disc. AE: Urinary retention... AEs leading to discontinuation/dose reduction: Urinary retention (6.9%) Sources: Page: p.997 |
2 mg 2 times / day multiple, oral Recommended Dose: 2 mg, 2 times / day Route: oral Route: multiple Dose: 2 mg, 2 times / day Sources: Page: p.11 |
unhealthy n = 986 Health Status: unhealthy Condition: Overactive bladder Sex: M+F Population Size: 986 Sources: Page: p.11 |
Disc. AE: Dry mouth, Dizziness... AEs leading to discontinuation/dose reduction: Dry mouth (1%) Sources: Page: p.11Dizziness (common) Headache (common) |
AEs
| AE | Significance | Dose | Population |
|---|---|---|---|
| Dry mouth | 2.4% Disc. AE |
2 mg 2 times / day multiple, oral Recommended Dose: 2 mg, 2 times / day Route: oral Route: multiple Dose: 2 mg, 2 times / day Sources: Page: p.804 |
unhealthy, 20-93 n = 507 Health Status: unhealthy Condition: Overactive bladder Age Group: 20-93 Sex: M+F Population Size: 507 Sources: Page: p.804 |
| Urinary retention | 6.9% Disc. AE |
4 mg 2 times / day multiple, oral Highest studied dose Dose: 4 mg, 2 times / day Route: oral Route: multiple Dose: 4 mg, 2 times / day Sources: Page: p.997 |
unhealthy, 52 n = 58 Health Status: unhealthy Condition: Overactive bladder Age Group: 52 Sex: M+F Population Size: 58 Sources: Page: p.997 |
| Dry mouth | 1% Disc. AE |
2 mg 2 times / day multiple, oral Recommended Dose: 2 mg, 2 times / day Route: oral Route: multiple Dose: 2 mg, 2 times / day Sources: Page: p.11 |
unhealthy n = 986 Health Status: unhealthy Condition: Overactive bladder Sex: M+F Population Size: 986 Sources: Page: p.11 |
| Dizziness | common Disc. AE |
2 mg 2 times / day multiple, oral Recommended Dose: 2 mg, 2 times / day Route: oral Route: multiple Dose: 2 mg, 2 times / day Sources: Page: p.11 |
unhealthy n = 986 Health Status: unhealthy Condition: Overactive bladder Sex: M+F Population Size: 986 Sources: Page: p.11 |
| Headache | common Disc. AE |
2 mg 2 times / day multiple, oral Recommended Dose: 2 mg, 2 times / day Route: oral Route: multiple Dose: 2 mg, 2 times / day Sources: Page: p.11 |
unhealthy n = 986 Health Status: unhealthy Condition: Overactive bladder Sex: M+F Population Size: 986 Sources: Page: p.11 |
PubMed
| Title | Date | PubMed |
|---|---|---|
| Fluoxetine inhibits the metabolism of tolterodine-pharmacokinetic implications and proposed clinical relevance. | 1999 Oct |
|
| Twelve-month treatment of overactive bladder: efficacy and tolerability of tolterodine. | 2001 |
|
| Multiple dose pharmacokinetics of a new once daily extended release tolterodine formulation versus immediate release tolterodine. | 2001 |
|
| Treatment of overactive bladder: long-term tolerability and efficacy of tolterodine. | 2001 Apr |
|
| Detrol LA and Diropan XL for overactive bladder. | 2001 Apr 2 |
|
| Costs and resources associated with the treatment of overactive bladder using retrospective medical care claims data. | 2001 Aug |
|
| Therapeutic opportunities from muscarinic receptor research. | 2001 Aug |
|
| Cost-Effectiveness of tolterodine for patients with urge incontinence who discontinue initial therapy with oxybutynin: a Canadian perspective. | 2001 Dec |
|
| Pharmacological characterization of muscarinic receptors in dog isolated ciliary and urinary bladder smooth muscle. | 2001 Feb |
|
| Tolterodine versus oxybutynin in the treatment of urge urinary incontinence: a meta-analysis. | 2001 Jul |
|
| Food increases the bioavailability of tolterodine but not effective exposure. | 2001 Mar |
|
| Overactive bladder: optimizing quality of care. | 2001 Mar |
|
| Tolterodine: superior tolerability than and comparable efficacy to oxybutynin in individuals 50 years old or older with overactive bladder: a randomized controlled trial. | 2001 May |
|
| [An example of interactions between SSRI preparations and tolterodine?]. | 2001 May 2 |
|
| The effect of tolterodine on the pharmacokinetics and pharmacodynamics of a combination oral contraceptive containing ethinyl estradiol and levonorgestrel. | 2001 Nov |
|
| Tolterodine: an overview. | 2001 Nov |
|
| Which muscarinic receptor is important in the bladder? | 2001 Nov |
|
| Evidence for the efficacy and safety of tolterodine in the treatment of overactive bladder. | 2001 Oct |
|
| The minor population of M3-receptors mediate contraction of human detrusor muscle in vitro. | 2001 Oct-Dec |
|
| [Continence problems after radical prostatectomy: medical treatment]. | 2001 Sep |
|
| Anticholinergic drugs versus placebo for overactive bladder syndrome in adults. | 2002 |
|
| Advances in drug delivery: improved bioavailability and drug effect. | 2002 Dec |
|
| Methodologic shortcomings inherent in a post-hoc analysis. | 2002 Dec |
|
| Current pharmacotherapeutic strategies for overactive bladder. | 2002 Jul |
|
| Long-term safety, tolerability and efficacy of extended-release tolterodine in the treatment of overactive bladder. | 2002 Jun |
|
| Tolterodine: as effective but better tolerated than oxybutynin in Asian patients with symptoms of overactive bladder. | 2002 May |
|
| Overactive bladder patients and role of the pharmacist. | 2002 May-Jun |
|
| Human variability in polymorphic CYP2D6 metabolism: is the kinetic default uncertainty factor adequate? | 2002 Nov |
|
| The newer antimuscarinic drugs: bladder control with less dry mouth. | 2002 Oct |
|
| The subtypes of muscarinic receptors for neurogenic bladder contraction in rats. | 2002 Oct 4 |
|
| Gateways to Clinical Trials. | 2002 Sep |
|
| A randomized controlled trial of tolterodine and oxybutynin on tolerability and clinical efficacy for treating Chinese women with an overactive bladder. | 2002 Sep |
|
| Effects of ATP-sensitive K+ channel openers and tolterodine on involuntary bladder contractions in a pig model of partial bladder outlet obstruction. | 2003 |
|
| A new once-daily formulation of tolterodine provides superior efficacy and is well tolerated in women with overactive bladder. | 2003 Feb |
Sample Use Guides
The initial recommended dose of DETROL (tolterodine tartrate tablets) is 2 mg twice daily. The dose may be lowered to 1 mg twice daily based on individual response and tolerability. For patients with significantly reduced hepatic or renal function or who are currently taking drugs that are potent inhibitors of CYP3A4, the recommended dose of DETROL is 1 mg twice daily
Route of Administration:
Oral
It was compared the antimuscarinic properties of tolterodine with those of oxybutynin, in vitro and in vivo. Tolterodine effectively inhibited carbachol-induced contractions of isolated strips of urinary bladder from guinea pigs (K(B) 3.0 nM; pA2 8.6; Schild slope 0.97) and humans (K(B) 4.0 nM; pA2 8.4; Schild slope 1.04) in a concentration-dependent, competitive manner. The affinity of tolterodine was similar to that derived for oxybutynin (K(B) 4.4 nM; pA2 8.5; Schild slope 0.89) in the guinea-pig bladder. Radioligand binding data showed that tolterodine bound with high affinity to muscarinic receptors in urinary bladder (K(i) 2.7 nM), heart (K(i) 1.6 nM), cerebral cortex (K(i) 0.75 nM) and parotid gland (K(i) 4.8 nM) from guinea pigs and in urinary bladder from humans (K(i) 3.3 nM). The combined in vitro and in vivo data on tolterodine and oxybutynin may indicate either that muscarinic M3/m3 receptors in glands are more sensitive to blockade than those in bladder smooth muscle, or that muscarinic M2/m2 receptors contribute to bladder contraction.
| Substance Class |
Chemical
Created
by
admin
on
Edited
Sat Dec 16 16:34:11 GMT 2023
by
admin
on
Sat Dec 16 16:34:11 GMT 2023
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| Record UNII |
HH7RXJ4PW1
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| Record Status |
Validated (UNII)
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| Record Version |
|
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HH7RXJ4PW1
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admin on Sat Dec 16 16:34:11 GMT 2023 , Edited by admin on Sat Dec 16 16:34:11 GMT 2023
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