Terol LA 4 Mg Tablets

Description

Terol LA 4 Mg Tablets

Terol LA 4 Mg Tablets contain tolterodine tartrate 4 mg in a long-acting (LA) extended-release formulation. Tolterodine is an antimuscarinic drug used to treat overactive bladder (OAB) and its symptoms of urinary urgency, urinary frequency, and urge incontinence. The extended-release formulation provides once-daily dosing and is associated with fewer dry mouth side effects compared with immediate-release tolterodine, improving patient comfort and adherence.

Composition

About the Manufacturer

Terol LA is manufactured by Sun Pharmaceutical Industries Limited, a leading global specialty generic pharmaceutical company headquartered in Mumbai, India. Sun Pharma has a broad urology and specialty product portfolio and distributes to regulated markets worldwide.

Mechanism of Action

Tolterodine competitively antagonises muscarinic receptors (M2 and M3 subtypes) in the bladder. M3 receptors mediate detrusor muscle contraction and bladder voiding. By blocking these receptors, tolterodine reduces involuntary bladder contractions, increases bladder capacity, and lowers the frequency and urgency of voiding. The extended-release formulation provides sustained receptor occupancy over 24 hours, allowing once-daily dosing.

Indications

• Overactive bladder (OAB) with symptoms of urinary urgency, frequency, and urge urinary incontinence

Dosage & Administration

• Adults: 4 mg once daily
• Patients with significant renal or hepatic impairment, or those taking CYP3A4 inhibitors: consider 2 mg once daily
• Swallow whole with liquid; do not crush, chew, or split the tablet
• Can be taken with or without food

Special Populations

• Elderly: Standard dosing; monitor for anticholinergic side effects such as cognitive impairment and constipation
• Severe hepatic impairment: Maximum 2 mg daily
• Severe renal impairment (CrCl <30 mL/min): Maximum 2 mg daily
• Children: Safety and efficacy not established; not indicated in paediatric patients
• Pregnancy: Not recommended; limited human data available

Precautions

• Use with caution in patients with clinically significant bladder outflow obstruction (risk of urinary retention)
• Use with caution in patients with gastrointestinal obstructive disorders (e.g. pyloric stenosis) due to reduced GI motility
• Cognitive effects: antimuscarinic drugs may impair memory and concentration, particularly in elderly patients
• Use with caution in patients with controlled narrow-angle glaucoma
• QT prolongation has been reported; use with caution in patients with known QT prolongation or on QT-prolonging drugs

Contraindications

• Hypersensitivity to tolterodine, fesoterodine, or any excipient
• Urinary retention
• Gastric retention or uncontrolled narrow-angle glaucoma
• Myasthenia gravis

Side Effects

• Very common: Dry mouth
• Common: Constipation, dry eyes, dyspepsia, headache, dizziness, abdominal pain
• Less common: Palpitations, peripheral oedema, blurred vision, urinary retention
• Rare: QT prolongation, angioedema, confusion, hallucinations

Drug Interactions

• CYP3A4 inhibitors (ketoconazole, itraconazole, clarithromycin): May significantly increase tolterodine plasma levels; reduce dose to 2 mg daily if used concomitantly
• QT-prolonging drugs: Additive risk of QT prolongation; avoid combination
• Other anticholinergic drugs: Additive antimuscarinic effects (dry mouth, constipation, urinary retention, confusion)
• Cholinergic drugs (e.g. bethanechol): May antagonise the effect of tolterodine

Storage

Store below 30°C in a dry place, protected from light and moisture. Keep out of the reach of children. Do not use after the expiry date printed on the pack.

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Frequently Asked Questions

What is Terol LA 4 Mg used for?

Terol LA 4 Mg is used to treat overactive bladder (OAB), reducing the symptoms of urinary urgency (the sudden need to urinate), increased urinary frequency, and urge urinary incontinence (leaking urine before reaching the toilet).

What does LA mean in Terol LA?

LA stands for Long-Acting. The extended-release formulation allows once-daily dosing by gradually releasing tolterodine over 24 hours, maintaining steady drug levels throughout the day and night.

How long before Terol LA starts working?

Some improvement in OAB symptoms may be noticed within 1–2 weeks, but full benefit usually takes 4–8 weeks of consistent use. Treatment should be reviewed at 3–6 months.

Why is dry mouth such a common side effect?

Tolterodine blocks muscarinic receptors not only in the bladder but also in salivary glands, reducing saliva production. Sipping water regularly, chewing sugar-free gum, and good dental hygiene can help manage this side effect.

Can elderly patients take Terol LA safely?

Terol LA can be used in elderly patients but with caution, as older people are more sensitive to anticholinergic side effects such as confusion, constipation, and urinary retention. Regular review by a doctor is important.

References

1. NHS – Tolterodine
2. MedlinePlus – Tolterodine
3. FDA – Tolterodine Tartrate Extended Release Prescribing Information
4. EMA – Detrusitol (Tolterodine) EPAR

Disclaimer: This page is for informational purposes only and does not constitute medical advice. Terol LA 4 Mg Tablets should be prescribed by a qualified healthcare professional following a proper assessment. If you experience urinary retention, severe abdominal pain, or confusion, seek medical attention promptly.