Effects of trospium: A Synthesis of Findings from 25 Studies

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Original Abstract of the Article

Major Research Findings

Trospium chloride is an atropine derivative used to treat urge incontinence, which is a condition where someone has a sudden urge to urinate, often leading to involuntary leakage. 24 Research on trospium chloride has focused on its potential interactions with other medications, particularly those involving enzymes and transporters in the body. 24 Studies have shown that trospium chloride can inhibit the activity of a specific enzyme called CYP2D6, which plays a role in breaking down certain drugs. 24 However, trospium chloride does not significantly affect the activity of other important enzymes involved in drug metabolism. 24 Furthermore, research has indicated that trospium chloride is a substrate for certain transporters, including OCT1, OCT2, OCT3, MATE1, and MATE2-K, which are involved in the elimination of substances from the body. 16 This means that trospium chloride can be transported by these systems, potentially affecting its distribution and elimination within the body. 16 Additionally, studies have found that trospium chloride can inhibit the uptake of certain drugs, such as ondansetron and pyrithiamine, by MATEs, which can lead to drug-drug interactions. 16

Benefits and Risks

Benefits Summary

Trospium chloride is a well-established treatment for urge incontinence, effectively reducing urinary urgency and frequency in many individuals. 10 It may offer a favorable safety profile for older adults, especially those with cognitive impairment or dementia, as it may limit its ability to cross the blood-brain barrier, reducing potential side effects on cognitive function. 22 Trospium chloride has also been investigated for its potential use in combination with other drugs, like xanomeline, to potentially mitigate cholinergic adverse events associated with those medications. 15

Risks Summary

While trospium chloride can effectively treat urge incontinence, it is important to be aware of potential side effects, such as constipation, dry mouth, blurred vision, and indigestion. 7 Research has also raised concerns about a potential link between trospium chloride use and an increased risk of dementia, particularly in older adults. 14 Given its interactions with certain enzymes and transporters, trospium chloride can interact with other medications, potentially altering their effectiveness and increasing the risk of side effects. 16 It is crucial to discuss any medications you are taking with your doctor before starting trospium chloride treatment to minimize the risk of drug interactions.

Comparison Between Studies

Commonalities

Many studies consistently demonstrate that trospium chloride effectively reduces symptoms associated with urge incontinence. 10 A significant number of studies also highlight the potential for trospium chloride to interact with other medications, emphasizing the importance of careful consideration of drug interactions. 16 This shared finding suggests the need for close monitoring of patients taking trospium chloride, especially those taking other medications.

Differences

While most studies agree on the effectiveness of trospium chloride for urge incontinence, findings regarding its side effects and safety can vary across studies. 14 The link between trospium chloride and dementia risk, for example, is a subject of ongoing research and requires further investigation to clarify. 14 Similarly, studies have reported inconsistent findings about trospium chloride's ability to inhibit certain enzyme activities, like CYP2D6, which highlights the need for more research in this area. 24 、 18

Consistency and Contradictions in Results

While there is strong consistency in demonstrating the effectiveness of trospium chloride for urge incontinence across various studies, the research regarding its side effects and safety presents inconsistencies and requires further investigation. 14 The potential link between trospium chloride use and an increased risk of dementia is a particular area of concern, requiring more robust studies to reach definitive conclusions. 14 、 9

Considerations for Real-World Application

Trospium chloride is a valuable tool for managing urge incontinence, but it's essential to be aware of its potential side effects and the possibility of drug interactions. 16 Close monitoring by a healthcare professional is crucial, especially for older adults, patients with dementia, and those taking other medications. 14 、 22 Be sure to inform your doctor about all medications you're taking before starting trospium chloride treatment, and follow your doctor's instructions carefully to minimize the risk of complications. 24

Limitations of Current Research

While research on trospium chloride has provided valuable insights into its effects, there are still limitations to the current body of knowledge. Larger-scale studies are needed to better understand the potential risk of dementia associated with trospium chloride, particularly in older adults. 14 、 9 Additionally, further research is required to fully elucidate the interactions of trospium chloride with other medications and to explore potential strategies for mitigating these interactions. 16

Future Research Directions

Future research should focus on conducting large-scale studies to comprehensively assess the potential link between trospium chloride use and dementia risk. 14 、 9 Further investigation into the interactions of trospium chloride with other medications is also crucial, including potential strategies for minimizing these interactions. 16 Longitudinal studies that monitor the effects of trospium chloride over extended periods are needed to gain a more complete understanding of its long-term benefits and risks.

Conclusion

Trospium chloride is a valuable treatment option for urge incontinence, offering relief from urinary urgency and frequency. However, it is essential to consider its potential side effects, such as constipation, dry mouth, blurred vision, and indigestion, as well as the risk of interactions with other medications. 16 If you are considering trospium chloride, it is vital to discuss its potential benefits and risks with your healthcare provider, especially if you are older, have dementia, or are taking other medications. 14 、 22 Open communication with your doctor is key to making informed decisions about your healthcare.

Literature analysis of 25 papers
Positive Content
20
Neutral Content
3
Negative Content
2
Article Type
3
1
1
5
25
1.

Effects of Anticholinergic Drugs Used for the Therapy of Overactive Bladder on P-Glycoprotein Activity.

Author: WakudaHirokazu, OkuraTakashi, Maruyama-FumotoKana, KagotaSatomi, ItoYoshihiko, Miyauchi-WakudaShino, OtaniNaoyuki, UemuraNaoto, YamadaShizuo, ShinozukaKazumasa

Drug interactions

This study evaluated the effects of anticholinergic drugs on P-glycoprotein activity in Caco-2 cells. Darifenacin and trospium interacted with P-glycoprotein, suggesting potential drug-drug interactions.

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

Language : English

4.

[Overactive bladder in a complicated patient: which drug to choose?]

Author: KulchavenyaE V, KholtobinD P

Overactive bladder treatment
Adverse effects

This literature review focuses on the pathogenesis and pathophysiology of overactive bladder (OAB).

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

Language : Russian

5.

Antimuscarinic use among older adults with dementia and overactive bladder: a Medicare beneficiaries study.

Author: KachruNandita, HolmesHolly M, JohnsonMichael L, ChenHua, AparasuRajender R

OAB management
Anticholinergic effects

Nearly one-third of dementia patients had overactive bladder and over one-fourth of them used antimuscarinics. The majority of incident users were prescribed non-selective antimuscarinics.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

6.

Effect of trospium chloride therapy on intraocular pressure and tear secretion in overactive bladder patients.

Author: TurkogluAli Riza, Parmak YenerNeslihan, CobanSoner, GuzelsoyMuhammet, EmulAli, DemirbasMurat, DemirciHakan

Safe for normal IOP
Symptom relief
Decreased tear secretion
Dry eye

Trospium chloride significantly decreased the symptoms in female patients with overactive bladder (OAB). Although trospium chloride did not cause a significant change in intraocular pressure (IOP) in these patients, it was found to decrease tear secretion significantly.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

[High doses of trospium chloride in patients with idiopathic overactive bladder. Data of large-scale, multicenter observational program Resource].

Author: KrivoborodovG G, TurE I, EfremovN S, ShkolnikovM E

Effective treatment
Safe treatment

This observational program found that individual approach to the selection of doses of trospium chloride in patients with idiopathic OAB can be quite effective and safe measure to achieve optimal clinical outcome with a good safety profile.

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.
Observational StudyResearch that observes and collects data on participants' behavior and outcomes in their natural state, without intervention.

Language : Russian

9.

Risk of Mortality Associated with Non-selective Antimuscarinic medications in Older Adults with Dementia: a Retrospective Study.

Author: KachruNandita, HolmesHolly M, JohnsonMichael L, ChenHua, AparasuRajender R

Increased mortality

The study found that non-selective antimuscarinics were associated with a 50% higher risk of mortality within 180 days of use compared to selective antimuscarinics in older adults with dementia and overactive bladder (OAB). Given the safety concerns, optimizing the use of non-selective antimuscarinics in OAB management for older patients with dementia is crucial.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

10.

Efficacy and Safety of Combination Pharmacotherapy for Patients with Overactive Bladder: A Rapid Evidence Assessment.

Author: GratzkeChristian, ChappleChristopher, MuellerElizabeth R, RobinsonDudley, RollandCatherine, StaskinDavid, StoelzelMatthias, MaanenRob van, SiddiquiEmad

Improved OAB symptoms
Improved quality of life
Gastrointestinal side effects

A review of published scientific studies found that mirabegron plus solifenacin was effective and well tolerated in patients with overactive bladder.

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.

Language : English

11.

Association between anticholinergic burden and anticholinergic adverse outcomes in the elderly: Pharmacological basis of their predictive value for adverse outcomes.

Author: LavradorMarta, Castel-BrancoM Margarida, CabralAna C, VeríssimoManuel T, FigueiredoIsabel V, Fernandez-LlimosFernando

Patient safety
Anticholinergic effects

Anticholinergic burden, the cumulative effect of anticholinergic drugs, is prevalent in older people and associated with adverse effects. Current tools for quantifying anticholinergic burden are limited in their predictive ability and require further refinement.

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.

Language : English

13.

Electrical stimulation with non-implanted electrodes for overactive bladder in adults.

Author: StewartFiona, GameiroLuis F, El DibRegina, GameiroMonica O, KapoorAnil, AmaroJoao L

OAB management

This study discusses different options for managing overactive bladder (OAB), including electrical stimulation with non-implanted devices.

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.
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

14.

Use of bladder antimuscarinics is associated with an increased risk of dementia: a retrospective population-based case-control study.

Author: HarnodTomor, YangYu-Cih, ChiuLu-Ting, WangJen-Hung, LinShinn-Zong, DingDah-Ching

Dementia risk

This study investigated the association between the use of bladder antimuscarinics and the risk of dementia in Taiwanese patients. The findings suggest that bladder antimuscarinic use may increase the risk of dementia.

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.

Language : English

15.

Evidence of trospium's ability to mitigate cholinergic adverse events related to xanomeline: phase 1 study results.

Author: BreierAlan, BrannanStephen K, PaulSteven M, MillerAndrew C

Alzheimer's treatment
Schizophrenia treatment
Cholinergic side effects

KarXT is a combination drug that is being developed to treat schizophrenia and other neuropsychiatric disorders. KarXT combines xanomeline, a muscarinic receptor agonist, with trospium, a muscarinic receptor antagonist. This combination is designed to improve tolerability by reducing cholinergic side effects.

Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Clinical Trial, Phase IThe first stage of clinical trials in humans. Evaluates the safety, tolerability, and pharmacokinetics of a new drug/treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

17.

[Effects of trospium chloride on the lower urinary tract function].

Author: SuzukiT, NishizawaO, SugayaK, KohamaT, MatsuzakiA, FukudaT, TsukadaT, HaradaT, TsuchidaS

Relief of hyperactive bladder symptoms

Trospium chloride, an antimuscarinic agent, was found to decrease the threshold pressure during the collecting phase and decrease maximum bladder pressure during the emptying phase in decerebrated dogs.

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 : Japanese

20.

Cancer Incidence after Initiation of Antimuscarinic Medications for Overactive Bladder in the United Kingdom: Evidence for Protopathic Bias.

Author: KayeJames A, MargulisAndrea V, FortunyJoan, McQuayLisa J, PlanaEstel, BartschJennifer L, BuiChristine L, Perez-GutthannSusana, AranaAlejandro

Early cancer detection
Protopathic bias

High incidence rates of bladder and prostate cancer soon after antimuscarinic medications for overactive bladder (AMOABs) initiation suggest that protopathic bias is a more likely explanation for these findings than causality.

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

Language : English

21.

Efficacy of trospium for prevention of catheter-related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study.

Author: SrivastavaVinit Kumar, AgrawalSanjay, DeshmukhSweta Anil, NoushadFebin, KhanSaima, KumarRaj

CRBD treatment

This study explores the efficacy of oral trospium, a drug used for overactive bladder, in managing catheter-related bladder discomfort (CRBD) in the postoperative period.

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

23.

[Neurogenic overactive bladder: focus on cognitive function].

Author: KorshunovaE S, KorshunovM N, NuzhnyiE P, ZakroyshhikovaI V, ZabirovaA Kh, KorshunovD M, NSuponeva A, DarenkovS P

This abstract discusses the common medical and social problems of overactive bladder and cognitive impairment, highlighting the importance of understanding the pathogenesis of underlying diseases and the pharmacologic properties of drugs used in treating these conditions.

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

Language : Russian

24.

Inhibitory effects of trospium chloride on cytochrome P450 enzymes in human liver microsomes.

Author: Beckmann-KnoppS, RietbrockS, WeyhenmeyerR, BöckerR H, BeckurtsK T, LangW, FuhrU

Trospium chloride has negligible inhibitory effects on CYP3A4, CYP1A2, CYP2E1, CYP2C19, CYP2C9 and CYP2A6 activity but is a reasonably potent inhibitor of CYP2D6 in vitro. However, inhibition of CYP2D6 by trospium chloride is without any clinical relevance.

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

Language : English

25.

A short review of drug-food interactions of medicines treating overactive bladder syndrome.

Author: PaśkoPaweł, RodackiTomasz, Domagała-RodackaRenata, OwczarekDanuta

Improved overactive bladder symptoms
Drug interactions

Food and fruit juice can affect the pharmacokinetic and therapeutic effects of medications used in treating overactive bladder syndrome. While tolterodine and mirabegron do not interact with food or grapefruit juice, other medications, such as darifenacin, fesoterodine, oxybutynin, and solifenacin, do interact with grapefruit juice.

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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