Adverse Side Effects of Tolterodine

Introduction to Tolterodine Adverse Effects

• The American College of Physicians recommends that tolterodine has a favorable safety profile with no significant increase in treatment discontinuation due to adverse effects compared to placebo, with high-quality evidence showing no statistically significant difference in discontinuation rates due to adverse effects between tolterodine and placebo (relative risk 1.0, 95% CI 0.6-1.7) 1, 2

Comparative Tolerability

• The American College of Physicians notes that tolterodine is better tolerated than oxybutynin, with discontinuation due to adverse effects being significantly higher with oxybutynin than tolterodine (NNTH 14, CI 7-145) 1
• The American Heart Association guidelines suggest that fesoterodine causes more dry mouth, headache, and UTIs than tolterodine (NNTH 18, CI 11-52), and blurred vision is more common with tolterodine than solifenacin, though dry mouth and constipation are more common with solifenacin 3, 4

Patient Monitoring

• The National Institute on Aging recommends monitoring for anticholinergic effects in patients on polypharmacy (≥7 medications), as they experience more adverse effects 5