Urotel XL
✅ Manages overactive bladder effectively
✅ Reduces urinary frequency
✅ Enhances bladder control
✅ All-day relief, extended-release
✅ FDA-approved for safety
Urotel XL contains tolterodine tartrate
✓ Medicinskt granskad av Morgan Ellis — Apoteksforskare · 8 års erfarenhet · Senast granskad: maj 2026
Quick Answer
Urotel XL innehåller tolterodine tartrate extended-release 4 mg ER made by Sun Pharma. It is used for overactive bladder (OAB) symptoms — urgency, frequency and urge incontinence. Take exactly as directed by your clinician — do not adjust the dose yourself.
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What Urotel XL is and how it works
Urotel XL contains tolterodine tartrate in an extended-release formulation, taken once daily. Tolterodine is a competitive muscarinic receptor antagonist that targets bladder muscarinic receptors with somewhat greater functional effect than salivary-gland receptors, giving a slightly better dry-mouth profile than oxybutynin (especially in the ER formulation).
It is licensed for OAB with symptoms of urinary frequency, urgency and urge incontinence. The ER capsule provides smoother plasma levels than the older immediate-release tablet and reduces the typical side effects (especially dry mouth) by ~30%.
Dose and how to take it
| Patient group | Recommended dose |
|---|---|
| Adults with OAB | 4 mg once daily |
| Reduced to 2 mg once daily if | Severe hepatic / renal impairment (eGFR <30); concurrent strong CYP3A4 inhibitor; CYP2D6 poor metaboliser with side effects |
| Svår leversvikt (Child-Pugh C) | Undvik |
Swallow the capsule whole, with or without food, at the same time each day. Do not crush, chew or open the capsule. Improvement begins in 1–2 weeks; full benefit in 4–8 weeks. If no useful effect at 8 weeks, review.
⚠ Slug-vs-molecule warning
The brand name Urotel XL contains the syllable “urotel” that some buyers associate with alpha-blockers (Urief / Urotel) for BPH. Do inte assume this is an alpha-blocker. Urotel XL is an antimuscarinic for OAB — a different class with different indications. If you have BPH-related obstruction, you need an alpha-blocker (silodosin, alfuzosin, tamsulosin), not tolterodine.
Biverkningar
| Side effect | Frekvens | Anteckningar |
|---|---|---|
| Dry mouth | Very common (~25% IR / ~17% ER) | Hydration, sugar-free gum |
| Constipation | Common (~7%) | Fibre, fluids; bulk laxative if needed |
| Torra ögon | Vanliga | Lubricant drops |
| Huvudvärk | Vanliga | Usually settles in 2 weeks |
| Indigestion | Vanliga | Take with food |
| Drowsiness, blurred vision | Vanliga | Avoid driving until adjusted |
| Urinary retention | Ovanliga | Stop and review |
| QT prolongation (high doses) | Sällsynt | Avoid combining with other QT-prolongers |
| Acute angle-closure glaucoma | Sällsynt | Same-day ophthalmology if eye pain |
Läkemedelsinteraktioner
| Combination | Effekt | Action |
|---|---|---|
| Strong CYP3A4 inhibitors (ketoconazole, ritonavir, clarithromycin) | Tolterodine levels rise — risk of QT effects | Reduce to 2 mg/day |
| Strong CYP2D6 inhibitors (fluoxetine, paroxetine) | Tolterodine accumulates | Watch for side effects |
| Other anticholinergics (oxybutynin, TCAs, sedating antihistamines) | Additive burden | Avoid stacking |
| QT-prolonging drugs (sotalol, amiodarone, methadone, ondansetron, citalopram > 20 mg) | Additive QT risk | Avoid combination |
| Warfarin | No clinically significant interaction | Standard INR monitoring |
Who should not take Urotel XL
- Urinary retention or bladder-outflow obstruction
- Severe ulcerative colitis, toxic megacolon, paralytic ileus
- Uncontrolled narrow-angle glaucoma
- Myasthenia gravis
- Svår leversvikt (Child-Pugh C)
- Known long QT syndrome or concurrent QT-prolonging drugs
- Pregnancy / breastfeeding (no human data)
Vanliga frågor
How is the ER capsule different from immediate-release tablets?
ER releases tolterodine over 24 hours, smoothing peak levels. Compared with twice-daily IR, dry-mouth rates drop ~30% and one capsule covers the day. Efficacy is similar.
When will I notice fewer urgency episodes?
Most users see a reduction within 1–2 weeks. Full benefit develops over 4–8 weeks. A 3-day bladder diary at baseline and at week 4 is the cleanest way to measure progress.
Why does the warning mention BPH?
Antimuscarinics relax the detrusor; in significant outflow obstruction (large prostate, urethral stricture) that can tip a man into urinary retention. Post-void residual urine should be checked before starting if you are male and over 50.
Can I combine Urotel XL with mirabegron?
Combination antimuscarinic + beta-3 agonist therapy (BESIDE / SYNERGY trials) is used for refractory OAB. It is started by a urologist; do not initiate on your own.
Is dry mouth really inevitable?
It is the commonest side effect but milder on ER than IR. Sips of water, sugar-free gum, lemon-flavoured artificial saliva sprays, and avoiding caffeine all help. If intolerable after 4 weeks, ask about mirabegron.
I forgot a dose — what do I do?
If it is the same day, take it when you remember. If it is the next day, skip the missed dose — do not double up. Resume normal once-daily dosing.
Will it interact with my heart medications?
Tolterodine modestly prolongs QT at high doses. Avoid combining with sotalol, amiodarone, methadone, ondansetron, or citalopram > 20 mg/day without specialist review. Standard beta-blockers (bisoprolol, metoprolol) are fine.
Can I stop suddenly?
Yes — there is no withdrawal syndrome. OAB symptoms simply return within 1–2 weeks if the underlying problem hasn’t resolved.
Is tolterodine safer for older adults than oxybutynin?
ER tolterodine has a slightly cleaner anticholinergic burden than oxybutynin and is preferred in older adults if an antimuscarinic is needed. Mirabegron is the alternative when anticholinergic burden is a concern.
Can I drink alcohol while taking Urotel XL?
Modest amounts are usually fine. Alcohol can worsen drowsiness and is a bladder irritant; reducing alcohol often improves OAB symptoms independently.
Other Bladder & Prostate Medications
- Vesigard (darifenacin XR) — M3-selective antimuscarinic
- Darilong (darifenacin XR) — alternative darifenacin brand
- Floslo (solifenacin) — once-daily M3-selective alternative
- Mirago (mirabegron) — beta-3 agonist, no anticholinergic load
- Oxyspas (oxybutynin) — older non-selective antimuscarinic
Medicinsk ansvarsfriskrivning. The information on this page is for general educational purposes only and is not a substitute for advice from a qualified clinician. Discuss any new medication or dose change with your doctor or pharmacist, especially if you are pregnant, breastfeeding, have other medical conditions, or take other medicines.
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| Styrka | 4 mg |
|---|---|
| Kvantitet | 30 Capsule/s, 60 Capsule/s, 90 Capsule/s |
| Farmaceutisk form | Kapsel/er |
| Tillverkare | Sun Pharma |
| Behandling | Overactive bladder (OAB) symptoms |
| Generiskt märke | Tolterodine Tartrate |
Urotel XL
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Urotel XL
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