Trospium (Oral)

As an antispasmodic, Trospium relaxes the muscles in the bladder, so the patient may more easily control their urination.

Overview

Trospium is a medication used to treat an overactive bladder. It helps patients to control their urination, especially patients that have feelings of the need to urinate right away, have the inability to control their urination, or who make frequent trips to the bathroom. It relaxes the muscles of the bladder to relieve the patient of these urgent feelings and prevent embarrassing or inconvenient episodes.

It is important for the patient to consider their previous medical history and their current medications and talk with their doctor to determine if using trospium is the right choice. Trospium is available in extended-release capsules or tablets, and is taken on an empty stomach or sometimes before bed. Serious allergic reactions to trospium, though rare, have been reported, so the patient should make sure to talk to their doctor about the benefits and possible side effects of taking this medication.

Conditions treated

  • Overactive bladder

Type of Medicine

  • Antispasmodic

Side Effects

Common side effects experienced when using trospium are dry mouth, constipation, upset stomach, headache, dry eyes, blurred vision, and drowsiness. To relieve a dry mouth, the patient may suck on sugarless hard candy, chew sugarless gum, drink water, or use a saliva substitute. The use of alcohol, tobacco, and other drugs may exacerbate feelings of drowsiness or blurred vision in combination with the use of this medication. The patient should avoid using them together.

Sometimes the body takes time to get used to a medication and side effects will cease after a short time. If these problems persist or worsen, the patient should contact their doctor.

Other less common side effects have been reported, and can be serious. They are:

  • Signs of urinary tract infection (UTI) like blood in the urine, burning or pain when passing urine, fever, lower stomach pain, or pelvic pain
  • Dizziness, feelings of confusion, mental/mood changes, or hallucinations (seeing or hearing things that are not there)

Patients experiencing any of these symptoms should contact their doctor immediately.

Some patients experience an allergic reaction called angioedema. Side effects usually related to this condition are:

  • Swelling of the face, lips, eyes, throat, tongue, feet, ankles, hands, or lower legs
  • Rash, hives, itching, or other reactions that seem allergy related like tightness in the chest or throat, or trouble breathing

If the patient suspects that they are having an allergic reaction related to trospium, they should contact their doctor immediately. Other side effects may occur as a result of taking trospium. This list is not comprehensive. If the patient experiences discomfort after beginning the medication, they should contact their doctor.

Dosage

The patient should follow their doctor's instructions and make sure to read the label of their prescription carefully before taking this medication. Patients may be prescribed extended release capsules or tablets. Doses for children must be determined by a doctor. The following refers to average doses for adults and may not necessarily reflect the dose prescribed by the patient's doctor.

Patients prescribed extended release capsules (60 milligrams [mg]) should take the medication with a full glass of water in the morning on an empty stomach at least one hour before a meal. The patient should try to take it around the same time every day.

Tablets (20 milligrams) should be taken twice a day with a full glass of water at least one hour before mealtimes on an empty stomach. Patients should not drink alcohol within two hours after taking the medication as it may cause drowsiness. Trospium is also sometimes taken in tablet form before bedtime.

If the patient misses a dose, they should take it as soon as possible, as long as it is at least an hour before mealtime. If it is almost time for the next dose, the patient should not double dose. The patient should not change their dose or stop taking the medication without consulting their doctor, even if symptoms lessen.

Interactions

The patient should tell their doctor about all other medications they have or are currently taking as well as their use of nonprescription drugs, herbal products, supplements, alcohol, tobacco, and other drugs. Over-the-counter medicines like allergy medicine may contain ingredients that cause drowsiness and should be avoided while taking trospium.

Patients should take particular care to alert their doctor if they are taking medications that are removed by the kidneys, such as:

  • Metformin, tenofovir, vancomycin
  • Certain anti-Parkinson's drugs (e.g. benztropine or trihexyphenidyl)
  • Antimuscarinic drugs (e.g. dicyclomine, oxybutynin, scopolamine, tolterodine)
  • Potassium tablets/capsules
  • Pramlintide

In addition, patients should tell their doctor if they are taking anything else that may cause drowsiness, including:

  • Certain antihistamines (e.g. cetirizine, diphenhydramine)
  • Drugs for sleep or anxiety (e.g. alprazolam, diazepam, zolpidem)
  • Muscle relaxants
  • Narcotic pain relievers (e.g. codeine)

Warnings

The patient should tell their doctor if they are allergic to trospium or other medications. Vitamins, nutritional supplements, herbal products, and all other medications (including non-prescription) the patient has used or plans to use are also relevant and should be disclosed to their doctor.

The use of alcohol or other drugs while using trospium may make certain side effects worse, including drowsiness, dizziness, or blurred vision. It is not safe to operate machinery or drive a car if the patient is experiencing dizziness or unclear vision. The patient should not drink alcohol within two hours of taking trospium. If the patient feels these effects after taking trospium, they should wait until these symptoms have cleared before they drive, operate machinery, or do any other activities that require clear vision and precise thought.

Trospium may make it harder for the body to cool down, such as while exercising or during hot weather. The patient should avoid exposure to extreme heat and call their doctor if they show signs of heat stroke, have a faster than normal heartbeat, or feel confused after being exposed to warm conditions or engaging in physical activity. The patient should drink lots of fluids and avoid exercise or hard work in hot weather when possible.

In rare cases, trospium may cause a type of allergic reaction called angioedema. Symptoms of this reaction include rash, itching, trouble swallowing, trouble breathing, and unusual hoarseness. Swelling may occur in parts of the face and mouth, or in the hands, legs, feet, and sex organ of the patient. If the patient suspects they may be having an allergic reaction, they should consult their doctor immediately.

Patients that have or have ever had glaucoma or any type of blockage in the bladder or digestive system (like trouble passing urine or slow clearing of the stomach) may be advised by their doctor not to take trospium.

In addition, patients should tell their doctor if they have ever had:

  • Myasthenia gravis
  • Ulcerative colitis
  • Any disease of the stomach or intestines
  • Frequently occurring constipation
  • Benign prostatic hypertrophy (BPH)
  • Liver or kidney disease

If the patient is having surgery, including dental surgery, they should alert the doctor or dentist that they are taking trospium.

The patient should talk to their doctor if they are pregnant, plan on becoming pregnant, or are breastfeeding about the benefits and risks of taking trospium.

The risk of side effects may be higher for older patients.

Storage

Trospium should be kept at room temperature, out of excess heat and moisture. Due to fluctuations in temperature and moisture, the bathroom may not be the best place for the patient to store this medication. It should be kept out of reach of children and pets.

Medication that is out of date or is no longer needed should be disposed of right away and in the proper fashion. The patient should not throw the medicine in the garbage, as children or pets may get into it. It should also not be flushed down the toilet. The patient should talk to their doctor or visit the Food and Drug Administration's (FDA) website to determine the best way to dispose of unused trospium.

Summary

Trospium can be very helpful in relieving patients of the inconvenience and discomfort of having an overactive bladder. It is designed to relax the muscles in the bladder, alleviating the many possible negative symptoms of an overactive bladder. Available as either an extended release capsule or as a tablet, it is usually taken an hour before mealtime once or twice a day, or sometimes before bedtime.

Though extreme negative reactions are rare, the patient should take the proper precautions to prevent any side effects. Serious side effects could occur, and the patient is encouraged to consult their doctor right away if they suspect anything is wrong. Certain medications may interact with trospium, though these complications may be avoided by the patient providing a full medical history to their doctor. Alcohol and tobacco taken in concurrence with trospium may exacerbate some side effects, including drowsiness.

When used correctly, trospium can give people with an overactive bladder a more active and less stressful life by freeing them of the discomfort of that condition.

Resources
Last Reviewed:
December 23, 2017
Last Updated:
April 05, 2018
Content Source: