Side Effects of fesoterodine: A Synthesis of Findings from 17 Studies

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Original Abstract of the Article

Major Research Findings

Fesoterodine fumarate is a newer antimuscarinic medication approved for the treatment of overactive bladder (OAB). 16 Fesoterodine fumarate is a unique drug because it shares the same active metabolite as tolterodine, 5-hydroxymethyltolterodine (5-HMT), but this conversion is established via ubiquitous esterases and not via the cytochrome P450 system, thus providing a faster and more efficient conversion to 5-HMT. 16 Clinical trials have shown fesoterodine fumarate to be effective in treating OAB with a dose-response relationship in efficacy parameters. 16 As with other antimuscarinics, the most common side effects of fesoterodine fumarate are dry mouth and constipation. 16 Fesoterodine fumarate has been shown to be less likely to cross the blood-brain barrier, potentially leading to fewer cognitive side effects. 13 , 14 Fesoterodine fumarate has been shown to be effective and safe for older patients, which is a challenge with other antimuscarinics, as they are often reluctant to prescribe them to older patients. 6

Reasons for Side Effects

Antimuscarinic drugs work by blocking the action of acetylcholine, a neurotransmitter that is involved in the contraction of smooth muscles, including the muscles of the bladder. 16 This blocking action can lead to side effects in other parts of the body, such as the mouth, digestive system, and eyes.

Common Side Effects

Dry Mouth

Dry mouth is a common side effect of fesoterodine fumarate, as it can block the action of acetylcholine in the salivary glands, reducing saliva production. 16 , 15

Constipation

Constipation is another common side effect, as fesoterodine fumarate can block the action of acetylcholine in the intestines, reducing muscle contractions that help move food through the digestive system. 16 , 15

Side Effects Management

Dry Mouth

To manage dry mouth, it is important to stay hydrated by drinking plenty of fluids throughout the day.

Constipation

To manage constipation, increasing dietary fiber intake and staying physically active are recommended.

Comparison Between Studies

Commonalities Between Studies

Most studies show that fesoterodine fumarate is effective in treating overactive bladder. 16 , 15 They also suggest that fesoterodine fumarate has a lower risk of crossing the blood-brain barrier, potentially leading to fewer central nervous system side effects. 13 , 14 , 12 However, common side effects like dry mouth and constipation are reported in multiple studies. 16 , 15

Differences Between Studies

While many studies show fesoterodine fumarate's effectiveness, the severity of side effects can differ across studies. This variation is likely influenced by factors such as patient populations and dosing regimens.

Real-Life Application Considerations

Fesoterodine fumarate can be an effective treatment for overactive bladder, but it is important to be aware of potential side effects. Consulting a doctor before starting this medication is crucial.

Limitations of Current Research

Long-term safety data regarding fesoterodine fumarate is limited, needing more comprehensive studies to assess its long-term impact.

Future Research Directions

Future research should focus on long-term safety evaluations of fesoterodine fumarate and conduct comparative studies with other antimuscarinic medications.

Conclusion

Fesoterodine fumarate is a promising treatment option for overactive bladder. While it offers potential benefits for patients, it is essential to understand its side effects. Consulting a healthcare professional before starting fesoterodine fumarate is highly recommended to ensure safe and effective treatment.

Literature analysis of 17 papers
Positive Content
15
Neutral Content
2
Negative Content
0
Article Type
3
1
3
6
17
1.

Yearly Trends of Overactive Bladder Medication Usage.

Author: ChuaKevin J, PatelHiren V, TabakinAlexandra, SrivastavaArnav, DoppalapudiSai Krishnaraya, HyamsElias, TunuguntlaHari S G R

Overactive bladder treatment
Cognitive side effects

This study examines prescribing patterns of overactive bladder (OAB) medications in the United States over time. It highlights the shift towards less brain-penetrant anticholinergics and the emergence of mirabegron, a beta-3 adrenoreceptor agonist, as a safer alternative.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

2.

Atomoxetine and fesoterodine combination improves obstructive sleep apnoea severity in patients with milder upper airway collapsibility.

Author: MessineoLudovico, Taranto-MontemurroLuigi, CalianeseNicole, GellLaura K, AzarbarzinAli, LabarcaGonzalo, VenaDan, YangHyung Chae, WangTsai-Yu, WellmanAndrew, SandsScott A

Genioglossus activity increase
OSA reduction
Side effects

Atomoxetine is a medication for attention-deficit/hyperactivity disorder (ADHD). It has been shown to improve sleep apnoea when combined with oxybutynin, a medication for overactive bladder. This study investigates whether a combination of atomoxetine and a newer medication for overactive bladder, fesoterodine, can also help improve sleep apnoea.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

4.

Which antimuscarinic agents used in the treatment of overactive bladder increase heart rate? a prospective randomized clinical trial.

Author: CetinelBulent, OnalBulent, GultekinMehmet Hamza, GuzelsoyMuhammed, TuregunFethi Ahmet, DincerMurat

OAB treatment
Increased heart rate

This study found that heart rate significantly increased in OAB patients treated with non-selective antimuscarinic drugs compared to those treated with selective drugs. Trospium chloride, tolterodine tartrate, fesoterodine fumarate, and propiverine hydrochloride appeared to have the most unfavorable properties with regard to increased heart rate side effect.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

5.

Fesoterodine: Pharmacological properties and clinical implications.

Author: GaméXavier, PeyronnetBenoit, CornuJean-Nicolas

Improved overactive bladder symptoms

This systematic review examined fesoterodine's pharmacological properties to explain its clinical benefits for overactive bladder (OAB) in general and elderly populations. The review found that fesoterodine's high affinity for both M2 and M3 muscarinic receptors, poor blood-brain barrier penetration, lack of hepatic first-pass activation, and extended-release formulation contribute to its good balance between efficacy and tolerability.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

6.

A pooled analysis of the efficacy of fesoterodine for the treatment of overactive bladder, and the relationship between safety, co-morbidity and polypharmacy in patients aged 65 years or older.

Author: WaggAdrian, ArumiDaniel, HerschornSender, Angulo CuestaJavier, HaabFrancois, NtaniosFady, CarlssonMartin, OelkeMatthias

OAB treatment
Adverse effects

This study examines the efficacy and safety of fesoterodine, an antimuscarinic medication for overactive bladder (OAB), in older patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Oral pharmacotherapy for overactive bladder in older patients: mirabegron as a potential alternative to antimuscarinics.

Author: WaggAdrian, NittiVictor W, KelleherCon, Castro-DiazDavid, SiddiquiEmad, BernerTodd

Improved OAB
Anticholinergic burden
Side effects

Mirabegron, a β3-adrenergic receptor agonist, offers a different tolerability profile compared to antimuscarinics for treating overactive bladder in older adults, minimizing the risk of anticholinergic burden.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

8.

Comparison of solifenacin and fesoterodine in treatment of overactive bladder.

Author: ErcanÖnder, KöstüBülent, BakacakMurat, Aytaç-TohmaYusuf, ÇoşkunBora, AvcıFazıl, EfeErkan

Effective OAB treatment
Fesoterodine more side effects

This study found that solifenacin and fesoterodine were similarly effective in treating overactive bladder, but fesoterodine was associated with a higher discontinuation rate due to side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

9.

[Impact on cognitive function of anticholinergic drugs used for the treatment of overactive bladder in the elderly].

Author: KerdraonJ, RobainG, JeandelC, Mongiat ArtusP, GaméX, FattonB, Scheiber-NogueiraM C, VetelJ-M, MaresP, PetitA-C, AmarencoG,

Improved bladder symptoms
Cognitive impairment
Drowsiness
Hallucinations

Anticholinergic drugs used for treating overactive bladder may cause central nervous system adverse effects in elderly patients. Oxybutinin is associated with cognitive impairment, while trospium chloride and fesoterodine show favorable CNS tolerability.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : French

10.

Fesoterodine fumarate and the oxybutynin ring for the treatment of urinary incontinence in women.

Author: RantellAngie, CardozoLinda, SrikrishnaSushma

UI treatment

Fesoterodine is a well-established treatment option for urgency urinary incontinence, but its use is hindered by side effects. The efficacy of the oxybutynin vaginal ring has only been demonstrated in small studies, and larger clinical trials are needed to assess its efficacy, tolerability, and acceptability.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

11.

[New perspectives of treatment with fesoterodine fumarate in patients with overactive bladder].

Author: García-BaqueroR, MadurgaB, GarcíaM V, FernándezM A, RosetyJ M, Álvarez-OssorioJ L

Improved emptying
Improved urgency
Reduced constipation
Reduced dry mouth

Fesoterodine fumarate is a good treatment option for patients with overactive bladder who have failed or are intolerant to conventional anticholinergic treatment.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Spanish

12.

Systematic review and meta-analysis: do clinical trials testing antimuscarinic agents for overactive bladder adequately measure central nervous system adverse events?

Author: PaquetteAmélie, GouPauline, TannenbaumCara

Overactive bladder treatment
Cognitive impairment
Confusion
Dizziness

Antimuscarinic drugs are used to treat overactive bladder. While studies in healthy volunteers suggest that these drugs may cause cognitive impairment, clinical trials in patients with overactive bladder only report rare central nervous system (CNS) side effects. This discrepancy may be explained by a lack of systematic measurement and reporting of CNS outcomes in clinical trials. This review and meta-analysis found that 77% of eligible trials did not measure or report CNS outcomes. Dizziness was the most commonly reported side effect, with confusion reported in less than 1% of cases.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

14.

Evaluation of brain anticholinergic activities of urinary spasmolytic drugs using a high-throughput radio receptor bioassay.

Author: JakobsenStine Mjåvatn, KerstenHege, MoldenEspen

Reduced cognitive impairment
Central anticholinergic effects

Tolterodine and fesoterodine have the highest pharmacodynamic potential to induce central anticholinergic side effects. Darifenacin exhibited the lowest anticholinergic activity, suggesting a more favorable pharmacological profile with respect to cognitive impairment in older adults.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

15.

Fesoterodine fumarate.

Author: GomelskyA, DmochowskiRoger R

Improved quality of life
Reduced UUI episodes
Reduced urgency
Constipation
Dry mouth

Fesoterodine fumarate is a muscarinic antagonist used to treat overactive bladder. It significantly reduces urgency and urinary incontinence episodes in patients. While some side effects like dry mouth and constipation were reported, few patients discontinued treatment due to these side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

17.

Muscarinic receptor antagonists for overactive bladder treatment: does one fit all?

Author: WitteLambertus P W, MulderWilhemina M C, de la RosetteJean J M C H, MichelMartin C

Overactive bladder relief
Side effects

Muscarinic receptor antagonists used for overactive bladder may cause greater exposure and side effects in patients with renal impairment, hepatic impairment, or genetic predisposition. Physicians should be aware of these potential risks and adjust dosing accordingly.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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