Desfesoterodine

Desfesoterodine_skeletal.svg

Desfesoterodine is a medication used to treat overactive bladder with symptoms of urinary incontinence, urgency, and urinary frequency. It is a muscarinic receptor antagonist that works by relaxing the muscles in the bladder, thereby reducing the symptoms of overactive bladder.

Mechanism of Action

Desfesoterodine is a prodrug of fesoterodine, which is rapidly converted to its active form, 5-hydroxymethyl tolterodine (5-HMT), after oral administration. 5-HMT exerts its therapeutic effects by inhibiting the action of acetylcholine on muscarinic receptors in the bladder, leading to decreased bladder muscle contractions.

Pharmacokinetics

After oral administration, desfesoterodine is quickly absorbed and converted to 5-HMT. The active metabolite has a half-life of approximately 7-8 hours, allowing for once-daily dosing. The drug is primarily metabolized in the liver by the cytochrome P450 enzyme system, particularly CYP2D6 and CYP3A4.

Indications

Desfesoterodine is indicated for the treatment of overactive bladder with symptoms of urinary incontinence, urgency, and frequency. It is typically prescribed when other treatments, such as lifestyle changes and bladder training, have not been effective.

Side Effects

Common side effects of desfesoterodine include:

• Dry mouth
• Constipation
• Dizziness
• Blurred vision
• Urinary retention

Serious side effects are rare but may include angioedema and anaphylaxis.

Contraindications

Desfesoterodine is contraindicated in patients with:

• Urinary retention
• Gastric retention
• Uncontrolled narrow-angle glaucoma
• Known hypersensitivity to the drug or its components

Dosage and Administration

Desfesoterodine is available in extended-release tablet form and is typically taken once daily, with or without food. The usual starting dose is 4 mg, which may be increased to 8 mg based on individual response and tolerability.

Monitoring

Patients taking desfesoterodine should be monitored for signs of urinary retention and other anticholinergic side effects. Regular follow-up visits are recommended to assess the effectiveness and tolerability of the medication.

See Also

• Overactive bladder
• Muscarinic receptor antagonist
• Fesoterodine
• Acetylcholine

External Links

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