Donepezil with Tolterodine Interaction Details
Brand Names Associated with Donepezil
- Aricept®
- Aricept® ODT
- Donepezil
- Namzaric®(as a combination product containing Donepezil, Memantine)
Brand Names Associated with Tolterodine
- Detrol®
- Detrol® LA
- Tolterodine
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 17, 2023
Interaction Effect
Decreased efficacy of donepezil and tolterodine, increased risk of seizures, and QT-interval prolongation
Interaction Summary
Concomitant use of donepezil (a cholinesterase inhibitor) with tolterodine (an anticholinergic agent) may decrease the efficacy of both drugs. Additionally, QT-interval prolongation and seizure threshold lowering effects have been associated with donepezil and tolterodine. If concomitant use cannot be avoided, monitor for reduced donepezil efficacy, seizures, and QT-interval prolongation.
Severity
Major
Onset
Unspecified
Evidence
Theoretical
How To Manage Interaction
Concomitant use of donepezil (a cholinesterase inhibitor) with tolterodine (an anticholinergic agent) may decrease the efficacy of both drugs. Additionally, QT-interval prolongation and seizure threshold lowering effects have been associated with donepezil and tolterodine. If concomitant use cannot be avoided, monitor for reduced donepezil efficacy, seizures, and QT-interval prolongation.
Mechanism Of Interaction
Interference with the cholinergic effects of donepezil and the anticholinergic effects of tolterodine; additive seizure threshold lowering effect; additive QT-interval prolongation
Donepezil Overview
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Donepezil is used to treat dementia (a brain disorder that affects the ability to remember, think clearly, communicate, and perform daily activities and may cause changes in mood and personality) in people who have Alzheimer's disease (AD; a brain disease that slowly destroys the memory and the ability to think, learn, communicate and handle daily activities). Donepezil is in a class of medications called cholinesterase inhibitors. It improves mental function (such as memory, attention, the ability to interact with others, speak, think clearly, and perform regular daily activities) by increasing the amount of a certain naturally occurring substance in the brain. Donepezil may improve the ability to think and remember or slow the loss of these abilities in people who have AD. However, donepezil will not cure AD or prevent the loss of mental abilities at some time in the future.
Tolterodine Overview
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Tolterodine is used treat overactive bladder (a condition in which the bladder muscles contract uncontrollably and cause frequent urination, urgent need to urinate, and inability to control urination). Tolterodine is in a class of medications called antimuscarinics. It works by relaxing the bladder muscles preventing bladder contraction.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.