Trospium

Administration

• Type: Anticholinergic
• Dosage Forms: 20 mg
• Routes of Administration: Oral
• Common Trade Names: Trospium Chloride

Adult Dosing

• Overactive bladder: 20 mg twice daily

Pediatric Dosing

• Not defined

Geriatric Dosing

• Elderly ≥75 years: consider initial design 20 mg one daily (based on tolerability)

Special Populations

• Pregnancy Rating: C
• Lactation risk: Not defined

Renal Dosing

• Adult:
  • CrCl ≥30 ml/minute: no dose adjustment required
  • CrCl <30 ml/minute: 20 mg once daily at bedtime
• Pediatric: Not defined

Hepatic Dosing

• Adult: Not defined
• Pediatric: Not defined

Contraindications

• Allergy to class/drug
• Urinary retention
• Gastric retention
• Narrowed-angle glaucoma

Adverse Reactions

Serious

• Tachycardia/SVT (<2%)
• Hypertensive crisis (<1%)
• Rhabdomyolysis (<1%)
• Steven-Johnson Syndrome (<1%)

Common

• Xerostomia
• Headache
• Constipation
• Urinary tract infection

Pharmacology

• Half-life: 20 h
• Metabolism: via hydrolysis and conjugation, forms metabolites
• Excretion: feces (85%), urine (6%)

Mechanism of Action

Antagonize effect of acetylcholine on muscarinic receptors, reduce smooth muscle tone of the bladder