Effect of tolterodine on gastrointestinal transit and bowel habits in healthy
subjects.
Author(s): Bharucha AE(1), Seide B, Guan Z, Andrews CN, Zinsmeister AR.
Affiliation(s): Author information:
(1)Clinical and Enteric Neuroscience Translational and Epidemiological Research
Program (CENTER), Mayo Clinic and Mayo Foundation, Rochester, MN 55905, USA.
bharucha.adil@mayo.edu
Publication date & source: 2008, Neurogastroenterol Motil. , 20(6):643-8
Clinical trials and observations suggest that constipation is an uncommon side
effect of treating overactive bladder with the muscarinic receptor antagonist
tolterodine. Because muscarinic antagonism inhibits gastrointestinal motor
activity, we evaluated the effects of tolterodine on bowel habits,
gastrointestinal and colonic transit in healthy subjects. In this double-blind
study, 36 healthy subjects were randomized to tolterodine extended release (ER, 4
mg daily) or placebo for 6 days. Gastric emptying (GE), small bowel and colonic
transit were assessed on days 4-6 by scintigraphy. Bowel habits were recorded by
diaries. Tolterodine did not significantly affect half-time for GE (GE t(half))
[116 +/- 6 min (mean +/- SEM) for placebo vs 126 +/- 7 min for tolterodine],
small bowel transit measured by colonic filling at 6 h (45 +/- 6% for placebo vs
36 +/- 6% for tolterodine) or the geometric center of colonic transit at 24 h
(2.9 +/- 0.2 for placebo vs 2.6 +/- 0.3 for tolterodine). Subjects who received
tolterodine had slightly fewer bowel movements (i.e. 1.34 +/- 0.1 stools per day
for placebo vs 1.0 +/- 0.1 for tolterodine; P = 0.02 for treatment effect).
Tolterodine did not significantly affect stool consistency or ease of defecation.
At the therapeutic dose used to treat overactive bladder, tolterodine did not
significantly affect gastrointestinal or colonic transit and had minor effects on
bowel habits in healthy subjects. Further studies are necessary to elucidate
whether these observations are explained by tolterodine effects at muscarinic
receptors which stimulate and inhibit gastrointestinal motility.
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