by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. trospium chloride decreases levels of promethazine by pharmacodynamic antagonism. Use Caution/Monitor. promethazine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.propanthelineMonitor Closely (1)propantheline and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.protriptylineMonitor Closely (1)trospium chloride and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.pyridostigmineMonitor Closely (1)pyridostigmine increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.quetiapineMonitor Closely (3)trospium chloride decreases levels of quetiapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. trospium chloride decreases levels of quetiapine by pharmacodynamic antagonism. Use Caution/Monitor. quetiapine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.rapacuroniumMonitor Closely (1)rapacuronium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.revefenacinSerious - Use Alternative (1)revefenacin and trospium chloride both decrease cholinergic effects/transmission. Avoid or Use Alternate Drug. Coadministration may cause additive anticholinergic effects.risperidoneMonitor Closely (3)trospium chloride decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. trospium chloride decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor. risperidone increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.rivastigmineMonitor Closely (1)trospium chloride decreases effects of rivastigmine by cholinergic effects/transmission. Use Caution/Monitor.rocuroniumMonitor Closely (1)rocuronium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.scopolamineMonitor Closely (1)scopolamine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.secretinSerious - Use Alternative (1)trospium chloride decreases effects of secretin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Concomitant use of anticholinergic drugs may cause a hyporesponse to stimulation testing with secretin. Discontinue anticholinergic drugs at least 5 half-lives before administering secretin.solifenacinMonitor Closely (1)solifenacin and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.succinylcholineMonitor Closely (1)succinylcholine increases and trospium chloride decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.tenofovir DFMonitor Closely (1)tenofovir DF, trospium chloride. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.thioridazineMonitor Closely (3)trospium chloride decreases levels of thioridazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. trospium chloride decreases levels of thioridazine by pharmacodynamic antagonism. Use Caution/Monitor. thioridazine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.thiothixeneMonitor Closely (3)trospium chloride decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. trospium chloride decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor. thiothixene increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.tiotropiumMonitor Closely (1)tiotropium and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.tolterodineMonitor Closely (1)tolterodine and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.trazodoneMonitor Closely (1)trospium chloride and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.trifluoperazineMonitor Closely (3)trospium chloride decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. trospium chloride decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor. trifluoperazine increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.trihexyphenidylMonitor Closely (1)trihexyphenidyl and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.trimipramineMonitor Closely (1)trospium chloride and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.vancomycinMonitor Closely (1)vancomycin, trospium chloride. Either increases levels of the other by decreasing renal clearance. Use Caution/Monitor.vecuroniumMonitor Closely (1)trospium chloride and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.ziprasidoneMonitor Closely (3)trospium chloride decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. trospium chloride decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of trospium chloride by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.zotepineMonitor Closely (2)trospium chloride decreases levels of zotepine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. trospium chloride decreases levels of zotepine by pharmacodynamic antagonism. Use Caution/Monitor. >10% Dry mouth (20.1%) 1-10% Constipation (9.6%) Tachycardia (<2%) Headache (4.2%) Fatigue (1.9%) Rash (<2%) Dyspepsia (1-2%) Abdominal pain (1-3%) Abdominal distention (<2%) Constipation (9-10%) Dry eyes (1-2%) Dyspepsia (1-2%) Flatulence (1-2%) Urinary retention (<1%) Urinary tract infection (1-7%) Nasopharyngitis (3%) Nasal dryness (1%) Postmarketing Reports Gastrointestinal: Gastritis Cardiovascular: Palpitations, supraventricular tachycardia, chest pain, syncope, hypertensive crisis Immunological: Stevens-Johnson syndrome, anaphylactic reaction, angioedema Nervous system: Dizziness, confusion, vision abnormal, hallucinations, somnolence and delirium Skeletal system: Musculoskeletal: Rhabdomyolysis Dermatology: Rash Contraindications Urinary/gastric retention Uncontrolled narrow-angle glaucoma Hypersensitivity Cautions Use caution in renal impairment, geriatric patients, moderate or severe hepatic dysfunction Angioedema of the face, lips, tongue and/or larynx reported (including with 1st dose); if involvement of the tongue, hypopharynx, or larynx occurs promptly discontinue; promptly provide appropriate therapy and/or measures necessary to ensure a patent airway function Administer with caution to patients with clinically significant bladder outflow obstruction or gastrointestinal obstructive disorders due to risk of urinary or gastric retention; use with caution in patients with conditions such as ulcerative colitis, intestinal atony, and myasthenia gravis To administer, must carefully monitor patients with controlled narrow-angle glaucoma; benefits should outweigh risks Somnolence reported; advise patients not to drive or operate heavy machinery until they know how therapy affects them Drug substantially excreted by kidney; effects of moderate renal impairment on systemic exposure are not known but systemic exposure is likely increased; risk of anticholinergic adverse reactions (including dry mouth, constipation, dyspepsia, urinary tract infection, and urinary retention) is expected to be greater in patients with moderate renal impairment Pregnancy Category: C Lactation: Excretion in mikl unknown; use with cautionPregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Reduces the smooth muscle tone of the bladder by antagonizing the effects of acetyl choline on muscarinic receptors. Pharmacokinetics Absorption: <10%; reduced when administered with high-fat meal Half-life: 20 hr (immediate release) Peak plasma time: 5-6 hr Protein bound: 45-85% Metabolism: Not fully elucidated; major pathway is thought to be ester hydrolysis followed by glucuronide conjugation of benzylic acid Renal clearance: 29.07 L/hr Excretion: Feces (85.2%); urine (5.8% with 60% unchanged drug) BRAND FORM. UNIT PRICE PILL IMAGE trospium oral- 60 mg capsuletrospium oral- 60 mg capsuletrospium oral- 20 mg tablettrospium oral- 20 mg tablettrospium oral- 20 mg tablettrospium oral- 20 mg tablettrospium oral- 60 mg capsuletrospium oral- 20 mg tabletCopyright © 2010 First DataBank, Inc.Print Patient Educationtrospium oral TROSPIUM - ORAL (TROSE-pee-um) COMMON BRAND NAME(S): Sanctura USES: This medication is used to treat an overactive bladder. By relaxing the muscles in the bladder, trospium improves your ability to control your urination. It helps to reduce leaking of urine, feelings of needing to urinate right away, and frequent trips to the bathroom. Trospium belongs to a class of drugs known as antispasmodics. It is also known as an antimuscarinic. HOW TO USE: Take this medication by mouth, usually twice daily, 1 hour before a meal or on an empty stomach.Use this medication regularly in order to get the most benefit from it. Remember to use it at the same time(s) each day. Dosage is based on your age, medical condition, and response to therapy.Tell your doctor if your condition does not improve or if it worsens. SIDE EFFECTS: Dry mouth, constipation, stomach upset, headache, dry eyes, dizziness, blurred vision, or drowsiness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.To relieve dry mouth, suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water or use a saliva substitute.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: eye pain, difficulty urinating, fast heartbeat, mental/mood changes (such as hallucinations, confusion).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345. PRECAUTIONS: Before taking trospium, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: glaucoma, kidney disease, liver disease, stomach/intestinal problems (such as blockage, constipation, ulcerative colitis), myasthenia gravis, inability to urinate (urinary retention).This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).This medication may make you sweat less, making you more likely to get heat stroke. Avoid doing things that may cause you to overheat, such as hard work or exercise in hot weather, or using hot tubs. When the weather is hot, drink a lot of fluids and dress lightly. If you overheat, quickly look for a place to cool down and rest. Get medical help right away if you have a fever that does not go away, mental/mood changes, headache, or dizziness.Older adults may be more sensitive to the side effects of this drug, especially constipation, dry mouth, drowsiness, confusion, or trouble urinating. Drowsiness and confusion can increase the risk of falling.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding. DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: other drugs that are also removed by the kidneys (such as metformin, tenofovir, vancomycin), certain anti-Parkinson's drugs (such as trihexyphenidyl), other antimuscarinic drugs (such as dicyclomine, oxybutynin, scopolamine, tolterodine), potassium tablets/capsules, pramlintide.Tell your doctor or pharmacist if you are taking other products that cause drowsiness, including alcohol, marijuana (cannabis), certain antihistamines (such as cetirizine, diphenhydramine), drugs for sleep or anxiety (such as alprazolam, diazepam, zolpidem), muscle relaxants, and opioid pain relievers (such as codeine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely. OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: fast heartbeat, widened pupils. NOTES: Do not share this medication with others. MISSED DOSE: If you miss a dose, take it as soon as you remember. Take the missed dose at least 2 hours after a meal or 1 hour before your next meal. If it is near the time of your