fesoterodine fumarate
Toviaz	Pharmaceutical company: Pfizer, Inc. www.toviaz.com

Pharmacologic classification: muscarinic receptor antagonist
Therapeutic classification: anticholinergic
Pregnancy risk category: C

AVAILABLE FORMS
Tablets: 4 mg, 8 mg

INDICATIONS AND DOSAGES
Symptoms of urge incontinence and urinary urgency and frequency due to an overactive bladder—
Adults: 4 mg P.O. once daily. Increase to 8 mg, if needed.
ADJUST-A-DOSE: Don't exceed 4 mg in patients with severe renal insufficiency or in those taking CYP3A4 inhibitors.

CONTRAINDICATIONS AND CAUTIONS
Contraindicated in patients with urinary retention, gastric retention, uncontrolled narrow-angle glaucoma and in those with hypersensitivity to the drug or its components. Avoid use in patients with severe hepatic impairment.
    Use cautiously in patients with bladder outlet obstruction, decreased GI motility, myasthenia gravis, and controlled narrow-angle glaucoma.

INTERACTIONS
Drug-drug. Strong cytochrome P450 (CYP3A4) inhibitors (ketoconazole, clarithromycin, itraconazole): May increase fesoterodine concentrations. Avoid use together.
Moderate CYP3A4 inhibitors (erythromycin): May increase fesoterodine concentrations. Use together cautiously.
Anticholinergics, antimuscarinics: May increase risk of anticholinergic effects (constipation, blurred vision, urinary retention). Use together cautiously.
Drug-lifestyle. Alcohol: May cause additive CNS depression. Discourage use together.

ADVERSE REACTIONS
CNS: insomnia.
CV: peripheral edema.
EENT: dry eyes.
GI: dry mouth, constipation, dyspepsia, nausea.
GU: urinary tract infection, dysuria, urinary retention.
Musculoskeletal: back pain.
Respiratory: upper respiratory infection, dry throat.
Skin: rash.

Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING.

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