Usual Adult Dose for Urinary Incontinence

Immediate Release Tablets/Syrup:
Initial dose: 5 mg orally 2 to 3 times a day
Maximum dose: 5 mg orally 4 times a day

Extended Release Tablets:
Initial dose: 5 to 10 mg orally once a day at the same time each day
Titration: Adjust in 5 mg increments weekly as tolerated
Maximum dose: 30 mg/day

Transdermal Gel 10%:
The contents of one sachet or one actuation of the metered-dose pump applied once daily to dry, intact skin on the abdomen, upper arms/shoulders, or thighs; application sites should be rotated; application should not be made to the same site on consecutive days

Uses:

• Immediate release tablets/Syrup: For the relief of symptoms of bladder instability associated with voiding in patients with uninhibited neurogenic or reflex neurogenic bladder (i.e., urgency, frequency, urinary leakage, urge incontinence, dysuria)
• Extended-release tablets: For the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and frequency.
• Gel: For overactive bladder with urge urinary incontinence, urgency and frequency

Usual Adult Dose for Urinary Frequency

Immediate Release Tablets/Syrup:
Initial dose: 5 mg orally 2 to 3 times a day
Maximum dose: 5 mg orally 4 times a day

Extended Release Tablets:
Initial dose: 5 to 10 mg orally once a day at the same time each day
Titration: Adjust in 5 mg increments weekly as tolerated
Maximum dose: 30 mg/day

Transdermal Gel 10%:
The contents of one sachet or one actuation of the metered-dose pump applied once daily to dry, intact skin on the abdomen, upper arms/shoulders, or thighs; application sites should be rotated; application should not be made to the same site on consecutive days

Uses:

• Immediate release tablets/Syrup: For the relief of symptoms of bladder instability associated with voiding in patients with uninhibited neurogenic or reflex neurogenic bladder (i.e., urgency, frequency, urinary leakage, urge incontinence, dysuria)
• Extended-release tablets: For the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and frequency.
• Gel: For overactive bladder with urge urinary incontinence, urgency and frequency

Usual Adult Dose for Neurogenic Bladder

Immediate Release Tablets/Syrup:
Initial dose: 5 mg orally 2 to 3 times a day
Maximum dose: 5 mg orally 4 times a day

Extended Release Tablets:
Initial dose: 5 to 10 mg orally once a day at the same time each day
Titration: Adjust in 5 mg increments weekly as tolerated
Maximum dose: 30 mg/day

Transdermal Gel 10%:
The contents of one sachet or one actuation of the metered-dose pump applied once daily to dry, intact skin on the abdomen, upper arms/shoulders, or thighs; application sites should be rotated; application should not be made to the same site on consecutive days

Uses:

• Immediate release tablets/Syrup: For the relief of symptoms of bladder instability associated with voiding in patients with uninhibited neurogenic or reflex neurogenic bladder (i.e., urgency, frequency, urinary leakage, urge incontinence, dysuria)
• Extended-release tablets: For the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and frequency.
• Gel: For overactive bladder with urge urinary incontinence, urgency and frequency

Usual Geriatric Dose for Urinary Incontinence

Immediate Release Tablets/Syrup:
Initial dose: 5 mg orally 2 to 3 times a day
Maximum dose: 5 mg orally 4 times a day
NOTE: Initial dose for the frail elderly is 2.5 mg orally 2 to 3 times a day

Extended Release Tablets:
Initial dose: 5 to 10 mg orally once a day at the same time each day
Titration: Adjust in 5 mg increment

Transdermal Gel 10%:
The contents of one sachet or one actuation of the metered-dose pump applied once daily to dry, intact skin on the abdomen, upper arms/shoulders, or thighs; application sites should be rotated; application should not be made to the same site on consecutive days

Uses:

• Immediate release tablets/Syrup: For the relief of symptoms of bladder instability associated with voiding in patients with uninhibited neurogenic or reflex neurogenic bladder (i.e., urgency, frequency, urinary leakage, urge incontinence, dysuria)
• Extended-release tablets: For the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and frequency.

Usual Geriatric Dose for Urinary Frequency

Immediate Release Tablets/Syrup:
Initial dose: 5 mg orally 2 to 3 times a day
Maximum dose: 5 mg orally 4 times a day
NOTE: Initial dose for the frail elderly is 2.5 mg orally 2 to 3 times a day

Extended Release Tablets:
Initial dose: 5 to 10 mg orally once a day at the same time each day
Titration: Adjust in 5 mg increment

Transdermal Gel 10%:
The contents of one sachet or one actuation of the metered-dose pump applied once daily to dry, intact skin on the abdomen, upper arms/shoulders, or thighs; application sites should be rotated; application should not be made to the same site on consecutive days

Uses:

• Immediate release tablets/Syrup: For the relief of symptoms of bladder instability associated with voiding in patients with uninhibited neurogenic or reflex neurogenic bladder (i.e., urgency, frequency, urinary leakage, urge incontinence, dysuria)
• Extended-release tablets: For the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and frequency.

Usual Geriatric Dose for Neurogenic Bladder

Immediate Release Tablets/Syrup:
Initial dose: 5 mg orally 2 to 3 times a day
Maximum dose: 5 mg orally 4 times a day
NOTE: Initial dose for the frail elderly is 2.5 mg orally 2 to 3 times a day

Extended Release Tablets:
Initial dose: 5 to 10 mg orally once a day at the same time each day
Titration: Adjust in 5 mg increment

Transdermal Gel 10%:
The contents of one sachet or one actuation of the metered-dose pump applied once daily to dry, intact skin on the abdomen, upper arms/shoulders, or thighs; application sites should be rotated; application should not be made to the same site on consecutive days

Uses:

• Immediate release tablets/Syrup: For the relief of symptoms of bladder instability associated with voiding in patients with uninhibited neurogenic or reflex neurogenic bladder (i.e., urgency, frequency, urinary leakage, urge incontinence, dysuria)
• Extended-release tablets: For the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and frequency.

Usual Pediatric Dose for Urinary Incontinence

Immediate Release Tablets:
5 years and older:
Initial dose: 5 mg orally 2 times a day
Maximum dose: 5 mg orally 3 times a day

Extended Release Tablets/Syrup:
6 years and older:
Initial dose: 5 mg orally once a day at the same time each day
Titration: Adjust in 5 mg increments weekly as tolerated
Maximum dose: 30 mg/day

Uses:

• Immediate Release Tablets/Syrup: For the relief of symptoms of bladder instability associated with voiding in patients with uninhibited neurogenic or reflex neurogenic bladder (i.e., urgency, frequency, urinary leakage, urge incontinence, dysuria) in patients 5 years of age and older.
• Extended Release Tablets: For the treatment of pediatric patients aged 6 years and older with symptoms of detrusor overactivity associated with a neurological condition (e.g., spina bifida).

Usual Pediatric Dose for Urinary Frequency

Immediate Release Tablets:
5 years and older:
Initial dose: 5 mg orally 2 times a day
Maximum dose: 5 mg orally 3 times a day

Extended Release Tablets/Syrup:
6 years and older:
Initial dose: 5 mg orally once a day at the same time each day
Titration: Adjust in 5 mg increments weekly as tolerated
Maximum dose: 30 mg/day

Uses:

• Immediate Release Tablets/Syrup: For the relief of symptoms of bladder instability associated with voiding in patients with uninhibited neurogenic or reflex neurogenic bladder (i.e., urgency, frequency, urinary leakage, urge incontinence, dysuria) in patients 5 years of age and older.
• Extended Release Tablets: For the treatment of pediatric patients aged 6 years and older with symptoms of detrusor overactivity associated with a neurological condition (e.g., spina bifida).

Usual Pediatric Dose for Neurogenic Bladder

Immediate Release Tablets:
5 years and older:
Initial dose: 5 mg orally 2 times a day
Maximum dose: 5 mg orally 3 times a day

Extended Release Tablets/Syrup:
6 years and older:
Initial dose: 5 mg orally once a day at the same time each day
Titration: Adjust in 5 mg increments weekly as tolerated
Maximum dose: 30 mg/day

Uses:

• Immediate Release Tablets/Syrup: For the relief of symptoms of bladder instability associated with voiding in patients with uninhibited neurogenic or reflex neurogenic bladder (i.e., urgency, frequency, urinary leakage, urge incontinence, dysuria) in patients 5 years of age and older.
• Extended Release Tablets: For the treatment of pediatric patients aged 6 years and older with symptoms of detrusor overactivity associated with a neurological condition (e.g., spina bifida).

Renal Dose Adjustments

Caution recommended.

Liver Dose Adjustments

Caution recommended.

Precautions

CONTRAINDICATIONS:

• Hypersensitivity to the active component or any of the ingredients
• Unstable cardiovascular status in acute hemorrhage
• Urinary retention
• Myasthenia gravis
• Toxic megacolon complicating ulcerative colitis
• Severe colitis
• GI retention and other severe decreased GI motility conditions
• Uncontrolled narrow-angle glaucoma

Dialysis

Data not available

Other Comments

Administration advice:

• Swallow tablet whole, with water.
• Swallow extended release tablets whole; do not chew, crush, or divide.
• Extended release tablets may be taken with or without food, at the same time each day.
• The tablet/syrup/solution formulations should be taken with food or milk to decrease GI distress.
• In case of a missed dose, the next dose should be taken at the regular time.
• The patch should be applied to dry, intact skin on the abdomen, hip, or buttock immediately after removal from the protective sachet.
• A new application site should be selected with each new patch to avoid reapplication to the same site within 7 days.

• Monitor for anticholinergic effects in first few months of beginning therapy or increasing dosage.

• Heat prostration (fever and heat stroke due to decreased sweating) can occur when this drug is administered in the presence of high environmental temperature.
• Patients should be advised to exercise caution because this drug can cause drowsiness (somnolence) or blurred vision.
• Alcohol may enhance the drowsiness caused by this drug.
• In case of a missed dose, the patient should wait and take the next dose at the regular time.
• The extended-release formulation is contained within a nondeformable material that is eliminated from the body and may appear in the stool.
• This drug is associated with anticholinergic central nervous system (CNS) effects, including hallucinations, agitation, confusion, and somnolence.