Tolterodine Tartrate
Antimuscarinic agent with atropine-like action.
At latest update no published data on excretion into breast milk were found.
A high plasma protein-binding capacity makes it unlikely its passage into breast milk.
Its low oral bioavailability hinders the passage from ingested milk towards the infant’s plasma, except in preterm babies and immediate neonatal period, which may show an increased intestinal permeability. There are few poor metabolizers (CYP2D6 deficient) who may exhibit increasing oral bioavailability to 66%
Take as smallest dose as possible and avoid long-term use since anticholinergics can reduce milk production.
Monitoring anticholinergic symptoms in infants (dry mouth, constipation ..) is warranted.
Alternatives
- Oxybutynin (Low Risk probable)
Very Low Risk
Compatible. Not risky for breastfeeding or infant.
Low Risk
Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.
High Risk
Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.
Very High Risk
Not recommended. Cessation of breastfeeding or alternative.
Writings
- τολτεροδίνη τρυγική (Greek)
- Тольтеродина Тартрат (Cyrillic)
- 酒石酸トルテロジン (Japanese)
- C22H31NO,C4H6O6 (Molecular formula)
Drug trade names
References
- Pfizer. Tolterodine. Drug Summary. 2015 Full text (in our servers)
- AEMPS. Tolterodina. Ficha técnica. 2012 Full text (in our servers)
- De Martino F, De Matteo A, L'Abbate V, Soricelli A, Fontana A, Petrenga E, Cesarone M. [Inhibitory effects of atropine on serum prolactin levels after TRH stimulation]. Boll Soc Ital Biol Sper. 1980Abstract
- Bizzarro A, Iannucci F, Tolino A, Soricelli A, Guarino G, Verdoliva A. Inhibiting effect of atropine on prolactin blood levels after stimulation with TRH. Clin Exp Obstet Gynecol. 1980Abstract