What is Toviaz prescribed for?
Toviaz (fesoterodine) is an extended-release, once-daily medication primarily prescribed to address conditions involving involuntary bladder muscle contractions. It is indicated for two main patient populations:
Overactive Bladder (OAB) in Adults
In adults, Toviaz is used to treat the collection of symptoms that define OAB. These symptoms include:
- Urge urinary incontinence: Uncontrolled leakage of urine following a strong, sudden urge to urinate.
- Urinary urgency: The sudden and immediate need to urinate.
- Urinary frequency: The need to urinate more often than usual.
Neurogenic Detrusor Overactivity (NDO) in Pediatric Patients
For children aged 6 years and older who weigh more than 25 kg, Toviaz is prescribed to treat NDO, a condition where the bladder muscles contract involuntarily due to a neurological disorder. This helps increase the amount of urine the bladder can hold and reduces urine leakage.
How does Toviaz work?
Toviaz belongs to a class of medications called muscarinic receptor antagonists, also known as anticholinergics or antispasmodics. Its active ingredient, fesoterodine, is a prodrug that is converted by the body into its active metabolite, 5-hydroxymethyl tolterodine. This active form works by blocking muscarinic receptors on the smooth muscles of the bladder, which are responsible for controlling bladder contractions. By blocking these receptors, Toviaz:
- Reduces bladder muscle spasms.
- Increases the bladder's capacity to hold urine.
- Reduces the frequency and urgency of urination episodes.
This mechanism effectively addresses the underlying cause of OAB and NDO symptoms by preventing the bladder from contracting unnecessarily.
Administration
Toviaz is available as a prolonged-release tablet and must be swallowed whole with liquid. It should not be crushed, chewed, or divided. The medication can be taken with or without food, and consistency in timing is recommended for a stable effect. The appropriate dosage is determined by a healthcare provider based on the individual's condition and response to treatment.
Important considerations and side effects
Like all medications, Toviaz can cause side effects. The most common ones include dry mouth and constipation. Less common, but still possible, side effects include dry eyes, blurred vision, headaches, dizziness, and upset stomach. Serious side effects are rare but may include severe allergic reactions (angioedema), significant urinary retention, and central nervous system effects.
Precautions:
- Patients with specific conditions, such as uncontrolled narrow-angle glaucoma, urinary retention, or gastric retention, should not take Toviaz.
- Since the medication can decrease sweating, caution is advised in hot environments to avoid overheating.
- It is crucial to inform your doctor about all other medications and supplements you are taking, as some, particularly strong CYP3A4 inhibitors, can interact with fesoterodine.
Toviaz versus other OAB treatments
When considering treatment for overactive bladder, Toviaz is one of several options. The following table provides a brief comparison with other common treatments. Your healthcare provider can determine the best option for your specific situation.
| Feature | Toviaz (Fesoterodine) | Myrbetriq (Mirabegron) | Botox for OAB | Behavioral Therapy |
|---|---|---|---|---|
| Class of medication | Muscarinic receptor antagonist (Anticholinergic) | Beta-3 adrenergic agonist | Botulinum toxin injection | Non-pharmacological |
| Mechanism of action | Relaxes bladder muscles by blocking muscarinic receptors | Relaxes the bladder by activating beta-3 receptors | Prevents nerve signals from causing bladder contractions | Strengthens pelvic floor muscles and uses timed voiding |
| Administration | Oral tablet, once daily | Oral tablet, once daily | Bladder injection, typically once every 6-9 months | No medication involved |
| Typical side effects | Dry mouth, constipation, blurred vision | Headache, increased blood pressure | Urinary tract infection, incomplete bladder emptying | No side effects from medication |
| Onset of effect | Weeks to see full effect | Can take several weeks | Takes several days to a week | Long-term and ongoing |
Conclusion
In summary, Toviaz is a proven treatment for managing the symptoms of overactive bladder (OAB) in adults and neurogenic detrusor overactivity (NDO) in pediatric patients. It works by relaxing the bladder muscles to reduce involuntary contractions, thereby decreasing urinary frequency, urgency, and incontinence episodes. While effective, it is not suitable for everyone and requires careful consideration of potential side effects and contraindications. Patients should always consult with a healthcare provider to determine if Toviaz is the appropriate course of treatment for their condition and to receive personalized guidance. Other options, including different medications or behavioral therapies, are also available if Toviaz is not the right choice. For additional information, consult the official FDA-approved prescribing information from Pfizer.
