Toviaz is also used in neurogenic detrusor overactivity (NDO), a bladder dysfunction disorder, in children 6 years and older.
Toviaz works by blocking the activity of the neurotransmitter acetylcholine. When these receptors are activated, they cause contraction of bladder smooth muscle, resulting in the desire to urinate. Taking fesoterodine results in fewer receptors available to be activated by acetylcholine and a decrease in bladder smooth muscle contraction.
Toviaz is available by prescription as an oral tablet.
What Is Toviaz Used For?
The Food and Drug Administration (FDA) approved Toviaz to treat adults with OAB who experience symptoms of urge urinary incontinence (leaking urine), urgency (sudden desire to pass urine), and frequency (the need to urinate more frequently).
Brand Name(s): Toviaz
Drug Availability: Prescription
Therapeutic Classification: Muscarinic receptor antagonist
Available Generically: Yes
Controlled Substance: No
Administration Route: Oral
Active Ingredient: Fesoterodine fumarate
Dosage Form(s): Tablet
It is also approved to treat pediatric NDO in children 6 years and older and weighing more than 55 pounds. In NDO, there is an overactivity of the bladder wall muscle. This condition also causes similar symptoms to OAB but typically results from a disease or injury to the nervous system.
How to Take Toviaz
Follow your healthcare provider’s instructions for taking Toviaz. You may take it with or without food. Swallow tablets whole and do not crush, chew, or divide tablets.
Storage
Store at room temperature (between 68 F and 77 F) and protect from light and moisture. Keep the medication out of reach of children and pets to prevent accidental consumption.
What Are the Side Effects of Toviaz?
This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider or a pharmacist. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.
Common Side Effects
Common side effects associated with taking Toviaz include:
Dry mouthConstipationDiarrheaNauseaAbdominal painHeadacheUrinary tract infectionWeight gain
Severe Side Effects
Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you have a medical emergency. Serious side effects and their symptoms can include the following:
Inability to empty bladder (urinary retention) Angioedema (swelling under the skin)
Long-Term Side Effects
In long-term extensions of clinical trials that lasted up to three years, side effects possibly related to fesoterodine included:
Urinary retention Diverticulitis, which causes left-sided stomach pain, usually after eating Constipation Irritable bowel syndrome, a functional gastrointestinal disorder that causes crampy stomach pain, bloating, constipation, or diarrhea QTc interval prolongation, an irregularity in the electrical activity of the heart
Dosage: How Much Toviaz Should I Take?
Modifications
Certain factors may affect your use or dosage of Toviaz, such as:
If you experience a serious side effect, you or your healthcare provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
For oral dosage form (extended-release tablets): For neurogenic detrusor overactivity: Children 6 years of age and older—Dose is based on body weight and must be determined by your doctor. Weighing more than 35 kilograms (kg)—At first, 4 milligrams (mg) once a day. Your doctor may increase the dose to 8 mg once a day after 1 week. Weighing more than 25 and up to 35 kg—At first, 4 mg once a day. Your doctor may increase the dose as needed and tolerated. However the dose is usually not more than 8 mg once a day. Children younger than 6 years of age or weighing 25 kg or less—Use and dose must be determined by your doctor. For symptoms of an overactive bladder: Adults—At first, 4 milligrams (mg) once a day. Your doctor may increase your dose as needed and tolerated. However, the dose is usually not more than 8 mg once a day. Children—Use and dose must be determined by your doctor.
Pregnancy: The safety of using fesoterodine in pregnancy has not been established. There is no published human experience with fesoterodine in pregnancy to determine if it is linked to major birth defects, miscarriage, or adverse maternal and/or fetal outcomes. However, some animal studies have shown adverse effects. Breastfeeding: It is not known if Toviaz is excreted in human breast milk. There is no published human experience of lactation with Toviaz. Taking Toviaz while lactating may decrease milk supply by reducing serum prolactin and inhibiting oxytocin and growth hormone secretion. Adults 75 and older: In clinical trials, there was no observed difference in efficacy in older adults compared to younger people. However, in adults 75 years and older, the incidence of anticholinergic side effects (e. g. , dry mouth, constipation, dyspepsia, increase in residual urine, dizziness) was higher than in younger adults. Kidney problems: You may need a lower dose if you have severe kidney problems. It might also be necessary to lower the dose or stop treatment in children 6 years and older who weigh more than 77 pounds and have severe kidney problems.
Missed Dose
If you miss a dose of Toviaz, skip the missed dose and take the next dose at your usual time the next day. Do not double up on the medication to make up for a missed dose.
Overdose: What Happens If I Take Too Much Toviaz?
Overdose with Toviaz can result in severe anticholinergic side effects. Overdoses of Toviaz should be treated symptomatically. Electrocardiogram (ECG) monitoring is recommended.
Overdose symptoms may include:
DrowsinessFlushingFeverDry mouthRapid heartbeatHigh blood pressureNausea or vomitingAgitationConfusionHallucinations
Precautions
What Are Reasons I Shouldn’t Take Toviaz?
Do not take Toviaz if you have:
If someone collapses or isn’t breathing after taking Toviaz, call 911.
This medicine may cause a serious allergic reaction, called angioedema, which can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs after using this medicine.
This medicine may increase your risk of having urinary retention (trouble passing urine or not fully emptying the bladder). Check with your doctor if you have a decrease in urine volume, decrease in the frequency of urination, difficulty in passing urine (dribbling), or painful urination.
This medicine may make you sweat less, causing your body temperature to increase. Use extra care not to become overheated during exercise or hot weather while you are taking this medicine, since overheating may result in heat stroke.
Avoid drinking alcohol while you are taking this medicine.
This medicine may cause some people to become dizzy, drowsy, or have blurred vision. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
This medicine may cause dryness of the mouth, nose, and throat. For temporary relief of mouth dryness, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if your mouth continues to feel dry for more than 2 weeks, check with your medical doctor or dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Hypersensitivity to fesoterodine or any of the ingredients in Toviaz Urinary retention Gastric retention (delayed or slow emptying of the stomach) Uncontrolled narrow-angle glaucoma
What Other Medications Interact With Toviaz?
Before starting Toviaz, tell your healthcare provider about any other medications you take or plan to take, including over-the-counter (OTC) nonprescription products, vitamins, herbs, supplements, and plant-based medicines.
Toviaz can interact with:
Other antimuscarinic drugs, such as Enablex (darifenacin) Drugs that strongly inhibit an enzyme called cytochrome P450 3A4 (CYP3A4), such as ketoconazole, Sporanox (itraconazole), and Biaxin XL (clarithromycin)
Antimuscarinic Drugs
Taking Toviaz with other antimuscarinic drugs may increase the incidence and severity of anticholinergic side effects like dry mouth, constipation, and urinary retention. For this reason, it’s not advised to take these medications at the same time.
CYP3A4 Inhibitors
Taking fesoterodine with a strong CYP3A4 inhibitor increases the plasma concentration of fesoterodine by approximately double. For adults, limit doses of fesoterodine to 4 milligrams in these cases. It is not recommended for children taking strong CYP3A4 drugs to use fesoterodine. If you are unsure whether you are currently taking any CYP3A4 inhibitors, share your list of medications with a healthcare provider or pharmacist.
This is not a complete list of interactions, and others may occur. Talk with your pharmacist or healthcare provider for more detailed information about medication interactions with Toviaz.
What Medications Are Similar?
Toviaz is a muscarinic receptor antagonist used to treat OAB. Other MRAs used to treat OAB include:
Darifenacin Vesicare (solifenacin) Detrol (tolterodine) Trospium
People generally only take one MRA for OAB at a time, as taking more than one increases the incidence of side effects.
How Can I Stay Healthy While Taking Toviaz?
Toviaz can improve symptoms of OAB but commonly causes dry mouth and constipation. Drink water regularly and eat a diet rich in fiber to ease constipation.
Toviaz can also cause drowsiness, dizziness, and blurred vision. Do not drive or do activities that require alertness until you know how it affects you. Furthermore, alcohol can enhance the drowsiness caused by Toviaz.
Stay in contact with your healthcare provider after starting medications for OAB. You may need a dosage adjustment or try different medications if symptoms do not improve after one to two months. It can also be beneficial to familiarize yourself with non-drug lifestyle factors and tips to help you cope with OAB.
