trospium
Trospium chloride is an antimuscarinic medication that's used to treat overactive bladder in adults. It's available as an immediate-release tablet that's taken by mouth twice daily and an extended-release capsule that's taken once daily. The most common side effects are dry mouth and constipation. The brand name Sanctura has been discontinued, but generic trospium is still available.
What is Trospium?
What is Trospium used for?
How Trospium works
Trospium is an antimuscarinic medication. It's also often called an anticholinergic. This is because antimuscarinics and anticholinergics work very similarly.
Trospium works by blocking a chemical called acetylcholine from attaching to their receptors in your bladder. This causes your bladder muscles to relax. The medication helps you to go to the bathroom less often and have better control of urination.
Drug Facts
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What are the side effects of Trospium?
Common Side Effects
- Dry mouth (20%)
- Constipation (10%)
- Headache (4%)
- Dry mouth (11%)
- Constipation (9%)
Other Side Effects
- Stomach pain
- Fatigue
- Sleepiness
- Dizziness
- Dry eyes
- Trouble emptying your bladder
- Urinary tract infection
- Overheating
Serious Side Effects
- Angioedema (severe swelling): swelling of the face, lips, tongue, or throat; trouble breathing
Source: DailyMed
More on Trospium side effects
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Bladder pain
bloody or cloudy urine
decrease in the frequency of urination
decrease in urine volume
difficult or burning urination
difficulty in passing urine (dribbling)
frequent urge to urinate
lower back or side pain
Less common
Chills
fast, pounding, or irregular heartbeat or pulse
general feeling of discomfort or illness
headache
joint pain
loss of appetite
muscle aches and pains
shivering
sweating
trouble sleeping
unusual tiredness or weakness
vomiting
Incidence not known
Blistering, peeling, or loosening of the skin
changes in vision
clammy skin
confusion as to time, place, or person
dark-colored urine
difficulty with swallowing
dizziness
enlarged pupils
fainting
fast or slow heartbeat
hallucinations
holding false beliefs that cannot be changed by fact
increased sensitivity of the eyes to light
increased sweating, possibly with fever or cold
muscle cramps or spasms
muscle stiffness
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
red skin lesions, often with a purple center
red, irritated eyes
seeing, hearing, or feeling things that are not there
severe chest pain
severe headache
shortness of breath
skin rash
sores, ulcers, or white spots in the mouth or on the lips
stiff or sore neck
tightness in the chest
unusual excitement, nervousness, or restlessness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Back pain
blurred vision
difficulty having a bowel movement (stool)
sleepiness or unusual drowsiness
Less common
Acid or sour stomach
belching
bloated or full feeling
excess air or gas in the stomach or intestines
indigestion
passing gas
stomach discomfort, upset, or pain
trouble with urinating
unable to have a bowel movement (stool)
upper stomach pain
Incidence not known
Burning feeling in the chest or stomach
change in taste
dry throat
indigestion
loss of taste
swelling of the abdomen or stomach area
tenderness in the stomach area
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Trospium
Pros
Works well to lessen how often you feel the urge to go to the bathroom
Choice of immediate-release tablets taken twice daily or extended-release capsules taken once daily
Available as a lower-cost, generic medication
Cons
Must take on an empty stomach
Only available as a pill (no other formulations for people who have trouble swallowing)
Hasn't been studied in children
Pharmacist tips for Trospium
For immediate-release trospium tablets: Take the immediate-release tablet twice per day with water. Take the medication on an empty stomach or at least 1 hour before a meal.
For extended-release trospium capsules: Take the extended-release capsule once per day in the morning. Take the capsule on an empty stomach, at least 1 hour before a meal.
It's best to avoid alcohol while you're taking trospium because alcohol can worsen side effects like drowsiness. The manufacturer recommends that you wait at least 2 hours after you take the extended-release capsule before you drink any alcohol.
Trospium can affect your ability to think, focus, and react. It can also sometimes cause blurry vision. Don't drive, operate machinery, or do anything that you need to concentrate or see clearly for until you know how this medication affects you.
Make sure to stay hydrated while you're taking trospium. This can help with any dry mouth from the medication (the medication can cause your body to make less saliva).
Drinking water, especially when it's hot, can also prevent your body from overheating easily. Trospium can cause your body to make less sweat and make you thirstier.
Let your healthcare team know what medications you take or plan to take, especially any medications that can make you tired (e.g., benzodiazepines, anxiety medications, muscle relaxants). These medications can make possible side effects of trospium, like sleepiness and confusion, worse and raise your risk for falls.
Let your healthcare team know if you're pregnant or planning to become pregnant. It's not completely known whether trospium can harm your unborn baby.
Tell your primary care provider if you're breastfeeding or planning to nurse. It's not known whether trospium can pass into your breast milk and harm your baby. Your primary care provider can recommend safe options while you're taking trospium.
Frequently asked questions about Trospium
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What are the risks and warnings for Trospium?
Trospium can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Facial swelling and breathing problems
Some people who took trospium have reported experiencing an uncommon, but serious side effect called angioedema. This involves swelling in different parts of the body, including the face, throat, and tongue. Swelling of the tongue or throat area can be potentially life-threatening, since it can make it hard to breathe. Go to the emergency room right away if you suddenly can't breathe or notice swelling around your face or throat.
Nervous system side effects
Trospium can cause sleepiness, dizziness, and hallucinations (seeing or hearing things that aren't real). Don't drive or do any activity that requires a lot of attention until you know how this medication makes you feel. Let your healthcare team know if you're experiencing any of these side effects and if they affect your usual daily activities. You might need to have your trospium dose lowered.
Trouble urinating
Use trospium with caution if you have prostate problems or other blockage in the urinary tract that makes it hard for you to urinate. Trospium can worsen your problems with urinating.
Caution in people with stomach problems
Trospium can slow the gut down to a stop. This can lead to serious problems, like severe inflammation and swelling of the colon. Let your primary care provider know if you have a history of stomach problems like ulcerative colitis. Also tell your care team if you have any nerve problems like myasthenia gravis; these nerve problems can sometimes affect how well your gut works. Discuss your medical history with your primary care provider to see whether trospium is safe for you.
Caution in people with glaucoma
Risk factors: Glaucoma
Trospium can cause vision changes, like blurry vision or worsening of glaucoma symptoms. Before you start taking trospium, tell your primary care provider if you have glaucoma so they can discuss the risks and benefits of this medication. Also let your ophthalmologist know if you're taking trospium. It's recommended that you get regular eye exams done if you have glaucoma and you're taking trospium.
Trospium dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 20mg | 60 tablets | $29.69 | $0.49 |
Typical dosing for Trospium
You should take trospium on an empty stomach or at least 1 hour before a meal.
Immediate-release tablets: The typical dose is 20 mg by mouth twice per day.
Extended-release capsules: The typical dose is 60 mg by mouth once daily in the morning.
Your dose might differ if you have kidney problems or if you're 75 years of age or older.
Interactions between Trospium and other drugs
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Potassium
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Amifampridine
- Bupropion
- Clozapine
- Donepezil
- Glucagon
- Glycopyrrolate
- Glycopyrronium Tosylate
- Methacholine
- Quetiapine
- Revefenacin
- Scopolamine
- Secretin Human
- Tiotropium
How much does Trospium cost?
Trospium contraindications
Uncontrolled narrow-angle glaucoma
Not able to urinate or completely empty your bladder (urinary retention), such as with prostate problems
Stomach or intestinal blockage
What are alternatives to Trospium?
Overactive bladder
Incontinence in children due to a neurologic (brain) condition, such as spina bifida
Overactive bladder (OAB) in adults
Neurogenic detrusor overactivity (NDO) in children ages 3 years and older
What is the latest news about Trospium?
Trospium images
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References
Best studies we foundEpstein, B. J., et al. (2006). Newer agents for the management of overactive bladder. American Family Physician.
Fernandez, J. (2023). Angioedema. Merck Manual Consumer Version.
Glenmark Pharmaceuticals Inc., USA. (2023). Trospium chloride tablet, film coated [package insert]. DailyMed.
Gomelsky, A., et al. (2011). OAB update: Focus on trospium. Clinical Medicine Insights: Urology.
Howland, R. H. (2010). Potential adverse effects of discontinuing psychotropic drugs. Part 1: Adrenergic, cholinergic, and histamine drugs. Journal of Psychosocial Nursing and Mental Health Services.
National Institute of Diabetes and Digestive and Kidney Diseases. (2019). Definition & facts of urinary retention.
Sam, C., et al. (2023). Physiology, acetylcholine. StatPearls.
Slate Run Pharmaceuticals, LLC. (2024). Trospium chloride capsule, extended release [package insert]. DailyMed.
Zinner, N., et al. (2004). Trospium chloride improves overactive bladder symptoms: A multicenter phase III trial. The Journal of Urology.
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