Trospium

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Substrate of
  • Inhibits
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Inkontan, Rekont, Spasmolyt, Trospasyt, Uraplex, Urivesc; Bulgaria: Inkontan, Spasmo-Lyt; Czech Republic: Spasmed, Uraplex; Denmark: Ceris, Spasmo-Lyt, Spasmoplex, Uraplex; Estonia: Spasmed; Finland: Spasmo-Lyt; France: Ceris; Germany: Céris, Spasmex, Spasmo, Spasmolyt, Trospi, Trospium, Urivesc; Greece: Urivesc; Hungary: Spasmo-Lyt; Ireland: Ceris, Flotros, Regurin; Italy: Urivesc; Latvia: Spasmed; Lithuania: Spasmed; Poland: Spasmo-Lyt; Portugal: Spasmoplex, Tróspio, Urivesc; Romania: Inkontan, Spasmolyt; Slovakia: Spasmed; Slovenia: Spasmex; Spain: Uraplex; UK: Regurin.

North America

Canada: Sanctura, Trosec; USA: Sanctura.

Latin America

Argentina: Spasmex.

Asia

Japan: Spasmex.

Drug combinations

Chemistry

Trospium Chloride: C~25~H~30~ClNO~3~. Mw: 427.96. (1) Spiro [8-azoniabicyclo[3.2.1]octane-8,1′-pyrrolidinium], 3-[(hydroxydiphenylacetyl)oxy]-, chloride, (1α, 3β, 5α); (2) 3a-Hydroxyspiro[1αH,5αH-nortropane-8,1′-pyrrolidinium] chloride benzilate. CAS-10405-02-4 (2001).

Pharmacologic Category

Genitourinary Smooth Muscle Relaxants; Anticholinergic Agent. (ATC-Code: G04BD09).

Mechanism of action

Trospium antagonizes effects of acetylcholine on muscarinic receptors in cholinergically innervated organs. Reduces smooth muscle tone of bladder.

Therapeutic use

Treatment of overactive bladder with symptoms of urgency, incontinence, and urinary frequency.

Pregnancy and lactiation implications

Adverse events observed in animal studies. There are no adequate, well-controlled studies in pregnant women. Use only if clearly needed. Excretion in breast milk unknown (use caution).

Unlabeled use

Contraindications

Hypersensitivity to trospium or any component of the formulation. Urinary retention. Gastric retention. Uncontrolled narrow-angle glaucoma.

Warnings and precautions

May cause drowsiness and/or blurred vision. Heat prostration may occur in presence of increased environmental temperature. Use with caution in Alzheimer’s disease. Use with caution in bladder flow obstruction (may increase risk of urinary retention), in gastrointestinal obstructive disorders (e.g. pyloric stenosis)(may increase risk of gastric retention), in controlled (treated) narrow-angle glaucoma, in moderate-to-severe hepatic impairment, and in myasthenia gravis due to decreased GI motility. Use of extended release formulation should be avoided in severe renal impairment (CrCl <30 mL/minute). Immediate release formulation should be used with caution in renal impairment. Use with caution in ulcerative colitis due to decreased GI motility. Active tubular secretion is a route of elimination; use caution with other medications eliminated by this route (e.g. procainamide, pancuronium, vancomycin, morphine).

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