Trospium
Trospium is an antimuscarinic (bladder-calming) medicine taken by mouth to treat overactive bladder with urge urinary incontinence, urgency, and urinary frequency.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 27 clinical label sets within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
Trospium treats overactive bladder by blocking acetylcholine, the signal that makes the bladder muscle squeeze, so the bladder relaxes and holds more; on the U.S. market since about 2009 and available generically, it is one of several similar options, often chosen for older adults because it is thought to reach the brain less than some. Most people tolerate it reasonably well, with dry mouth and constipation the effects they notice most, and sometimes dry eyes. Get emergency help for swelling of the face, lips, tongue or throat, and tell your prescriber first about kidney problems, glaucoma or trouble emptying your bladder.
Clinical pearls
- Take it with water at least one hour before a meal, because food reduces how much trospium your body absorbs.
- Avoid alcohol within two hours of an extended-release capsule dose, since it can add to drowsiness and dizziness.
- Severe kidney disease rules out the extended-release capsules and calls for a reduced tablet schedule.
- Other anticholinergic medicines, including some sleep aids and allergy medicines, stack up dry mouth, constipation and confusion.
Patient information guide A plain-language walkthrough of Trospium, written from its FDA label.
What Trospium is used for
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Trospium is used for overactive bladder (OAB) in these products:
- Trospium chloride tablets: OAB with urge urinary incontinence, urgency, and urinary frequency.
- Trospium chloride extended-release capsules: OAB with urge urinary incontinence, urgency, and urinary frequency.
How Trospium works
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Trospium is an antimuscarinic. It blocks acetylcholine at muscarinic receptors in organs such as the bladder. This lowers the tone of the bladder's smooth muscle.
It is selective for muscarinic over nicotinic receptors. It binds the M2 and M3 receptor subtypes, which are found in the bladder and may play a role in overactive bladder.
Trospium dosage
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Trospium is taken by mouth with water on an empty stomach, at least one hour before a meal.
- Tablets: usually taken twice daily. A once-daily bedtime schedule is used for severe kidney impairment. Adults 75 and older may be lowered to once daily if needed.
- Extended-release capsules: taken once daily in the morning. Not recommended for severe kidney impairment.
Follow your prescriber and product label for exact directions.
Dosing details from the FDA-approved label
From the Trospium prescribing information (“Dosage and Administration”). Doses are set by your prescriber for your product, condition, kidney function and age — never change a dose on your own.
- Trospium chloride tablets: usual dose
- 20 mg twice daily (one 20 mg tablet twice daily)
- Dose at least one hour before meals or on an empty stomach; take with water
- Severe renal impairment (creatinine clearance less than 30 mL/min), tablets
- 20 mg once daily at bedtime
- Creatinine clearance less than 30 mL/min
- Geriatric patients greater than or equal to 75 years of age, tablets
- Dose may be titrated down to 20 mg once daily based upon tolerability
- Age 75 years or older
- Trospium chloride extended-release capsules: usual dose
- One 60 mg capsule daily in the morning
- Take with water on an empty stomach, at least one hour before a meal
- Severe renal impairment (creatinine clearance less than 30 mL/minute), extended-release capsules
- Not recommended for use in these patients
- Creatinine clearance less than 30 mL/minute
Read the label’s full dosing text
2 DOSAGE AND ADMINISTRATION The recommended dosage of trospium chloride extended-release capsules is one 60 mg capsule daily in the morning. Trospium chloride extended-release capsules should be dosed with water on an empty stomach, at least one hour before a meal. Trospium chloride extended-release capsules are not recommended for use in patients with severe renal impairment (creatinine clearance less than 30 mL/minute) [see Warnings and Precautions ( 5.6 ), Use in Specific Populations ( 8 .6 ), and Clinical Pharmacology ( 12 .3 )]. The recommended dosage of trospium chloride extended-release capsules is one 60 mg capsule daily in the morning. Trospium chloride extended-release capsules should be dosed with water on an empty stomach, at least one hour before a meal. ( 2 ) Trospium chloride extended-release capsules are not recommended for use in patients with severe renal impairment (creatinine clearance less than 30 mL/minute). ( 2 )
Read the full Dosage and Administration section on DailyMed →
Trospium side effects
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The most common side effects are:
Common side effects
- Dry mouth
- Constipation
- Dry eyes
- Gas (flatulence)
- Nausea
- Stomach pain
- Indigestion
- Urinary tract infection
- Nasal dryness
When to get medical help
- Swelling of the face, lips, tongue, or throat (angioedema) can be life-threatening. Get emergency help right away, especially if breathing is affected.
- Call your doctor if you cannot empty your bladder or have trouble passing urine (urinary retention).
- Call your doctor if you have severe stomach problems or cannot pass stool.
- Call your doctor if you notice confusion, hallucinations, dizziness, or unusual sleepiness.
- Seek help for a rash, severe skin reaction, or signs of an allergic reaction (anaphylaxis).
- Report chest pain, fainting, or a racing or pounding heartbeat.
Dry mouth and constipation often start early, sometimes in the first week. Seek help for facial or throat swelling, trouble urinating, confusion, hallucinations, severe rash, fainting, or chest pain.
Trospium warnings and precautions
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- Angioedema: swelling of the face, lips, tongue, or throat can happen, even after the first dose, and can be life-threatening.
- Retention: use caution with blocked urine flow or digestive blockages. Not for people with urinary or gastric retention.
- Slowed gut: use caution with ulcerative colitis, intestinal atony, or myasthenia gravis.
- Glaucoma: not for uncontrolled narrow-angle glaucoma. Treated narrow-angle glaucoma needs careful monitoring.
- Nervous system effects: dizziness, confusion, hallucinations, and sleepiness can occur. Avoid driving until you know how it affects you.
- Alcohol: may add to drowsiness.
Trospium interactions
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Trospium has few metabolic interactions, but these matter:
- Other anticholinergic medicines: can increase dry mouth, constipation, and similar effects.
- Drugs actively secreted by the kidney: may compete with trospium for removal.
- Metformin immediate-release: lowered trospium exposure in a study.
- Antacids: changed trospium levels in some people.
- Other oral medicines: absorption may change because trospium slows the gut.
- Alcohol: avoid within 2 hours of the extended-release capsules; it can worsen drowsiness.
Interactions listed in the FDA-approved label
From the Trospium prescribing information (“Drug Interactions”): what the manufacturer studied or reported to the FDA.
- Drugs actively secreted by the kidney: Some drugs actively secreted by the kidney may interact with trospium by competing for renal tubular secretion.
- Other antimuscarinic agents that produce dry mouth, constipation and other anticholinergic effects: Concomitant use may increase the frequency and/or severity of such effects.
- Drugs whose absorption is affected by gastrointestinal motility: Trospium may potentially alter the absorption of some concomitantly administered drugs due to anticholinergic effects on gastrointestinal motility.
- Digoxin: Concomitant use of trospium chloride 20 mg twice daily and digoxin did not affect the pharmacokinetics of either drug.
- Antacid (aluminum hydroxide and magnesium carbonate): Systemic exposure of trospium on average was comparable with and without antacid, but 5 out of 11 individuals showed either an increase or decrease in trospium exposure in presence of antacid. The clinical relevance of these findings is not known.
- Metformin immediate-release tablets: 500 mg metformin immediate-release tablets twice daily reduced steady-state systemic exposure of trospium by approximately 29% for mean AUC (0-24) and by 34% for mean Cmax. The effect of a decrease in trospium exposure on efficacy of the extended-release capsules is unknown; the effect of metformin at higher doses on trospium PK is unknown.
Read the label’s full interactions text
7 DRUG INTERACTIONS Trospium is metabolized by ester hydrolysis and excreted by the kidneys through a combination of tubular secretion and glomerular filtration. Based on in vitro data, no clinically relevant metabolic drug-drug interactions are anticipated with Trospium Chloride Extended-Release Capsules. However, some drugs which are actively secreted by the kidney may interact with Trospium Chloride Extended-Release Capsules by competing for renal tubular secretion. The concomitant use of Trospium Chloride Extended-Release Capsules with other antimuscarinic agents that produce dry mouth and constipation and other anticholinergic effects may increase the frequency and/or severity of such effects. Trospium Chloride Extended-Release Capsules may potentially alter the absorption of some concomitantly administered drugs due to anticholinergic effects on gastrointestinal motility. • Some drugs which are actively secreted by the kidney may interact with Trospium Chloride Extended-Release Capsules by competing for renal tubular secretion. ( 7 ) • Concomitant use with digoxin did not affect the pharmacokinetics of either drug. ( 7.1 ) • Exposure to trospium on average was comparable in the presence of and without antacid, however, some individuals demonstrated increases or decreases in trospium exposure in the presence of antacid. The clinical relevance of these findings is not known. ( 7.2 ) • Concomitant use with metformin immediate release tablets reduced exposure and peak concentration of trospium. ( 7.3 ) 7.1 Digoxin Concomitant use of trospium chloride 20 mg twice daily and digoxin did not affect the pharmacokinetics of either drug [ see CLINICAL PHARMACOLOGY (12.3) ]. 7.2 Antacid While the systemic exposure of trospium on average was comparable with and without antacid containing aluminum hydroxide and magnesium carbonate, 5 out of 11 individuals in a drug interaction study demonstrated either an increase or decrease in trospium exposure, in presence of antacid.
Excerpted — the section continues on the label. Read the full Drug Interactions section on DailyMed →
Not a complete list. The label covers the interactions the manufacturer studied or reported, and our own interaction database does not cover every medicine either. Bring your full medication list, including vitamins and herbal products, to your pharmacist.
Before taking Trospium
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- Do not use with urinary retention, gastric retention, or uncontrolled narrow-angle glaucoma.
- Do not use with a known allergy to trospium or its ingredients.
- Tell your doctor about blockages in the bladder outlet or digestive tract, ulcerative colitis, weak gut movement, or myasthenia gravis.
- Kidney disease: severe impairment changes how trospium is used.
- Liver disease: use caution with moderate to severe impairment.
- Pregnancy and breastfeeding: use only if the benefit outweighs the risk.
- Children: safety and effectiveness have not been established.
- Older adults: more dry mouth, constipation, and urinary retention were seen; a few adults 75 and older reported falls.
Trospium overdose
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Too much trospium, like other antimuscarinic medicines, can cause severe antimuscarinic effects. Treatment is supportive and based on symptoms. ECG (heart tracing) monitoring is recommended, so seek medical help right away.
What Trospium does in the body
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In studies of immediate-release trospium, it increased maximum bladder capacity and the volume at which the bladder first contracted involuntarily. It did not lengthen the QT interval (a heart rhythm measure). Heart rate rose in a dose-related way, by about 3 beats per minute with the extended-release capsules in the phase 3 trials.
How your body processes Trospium
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Trospium is poorly absorbed, with about 9.6% bioavailability for the immediate-release form. A high-fat meal reduced absorption of the extended-release capsules, which is why it is taken on an empty stomach. The extended-release capsules peak around 5 hours after a dose, with a half-life of about 35 hours.
CYP enzymes do not play a major role in clearing it. Most of an oral dose leaves in the feces. The kidneys clear what is absorbed, partly by active secretion.
How to store Trospium
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Store at 20° to 25°C (68° to 77°F) . Dispense in a tight container.
Written from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →
Supplements & herbs that interact with Trospium
47 supplements and herbal products have documented interactions with Trospium in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.
- Major · 3
- Moderate · 33
- Minor · 11
Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.
Trospium: pharmacist answers to common questions
Quick, plain-English answers to the questions patients ask most about Trospium — the kind of thing our pharmacy team would talk through with you at the counter.
What is trospium for?
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How should I take it?
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What side effects should I expect?
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When should I call my doctor or get emergency help?
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Can I have a drink with it?
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Is it safe in pregnancy or for older adults?
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Is Trospium available over the counter?
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When was Trospium first available?
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Who makes Trospium?
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Answers drafted from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →
More about Trospium on HelloPharmacist
Trospium forms and strengths (how it comes)
Trospium is available in 3 forms. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.
Need a version that does not list lactose, a gluten source, a dye or gelatin? Inactive ingredients differ by manufacturer: see Trospium inactive ingredients by manufacturer.
Tablet
How this form is used
- Trospium chloride tablets treat overactive bladder with urge urinary incontinence, urgency, and urinary frequency.
- Trospium chloride tablets are taken twice daily with water on an empty stomach, at least one hour before a meal.
- Trospium chloride tablets use a once-daily bedtime schedule for severe kidney impairment.
- Trospium chloride tablets may be lowered to once daily in adults 75 and older, based on tolerability.
Extended-release capsule
How this form is used
- Trospium chloride extended-release capsules treat overactive bladder with urge urinary incontinence, urgency, and urinary frequency.
- Trospium chloride extended-release capsules are taken once daily in the morning with water on an empty stomach, at least one hour before a meal.
- Trospium chloride extended-release capsules are not recommended for severe kidney impairment.
- Do not drink alcohol within 2 hours of taking trospium chloride extended-release capsules.
Capsule
Trospium on the U.S. market: products, makers and brands
How Trospium appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.
19 companies list 27 Trospium product records with the FDA, mostly as tablet, extended-release capsule, capsule; the earliest marketing or approval year on record is 2004. Brand names on the directory include Sanctura, Sanctura XR, Trospium Chloride and 1 more; the rest are generics.
FDA-listed product records by dose form (tablet variants merged) — FDA National Drug Code Directory. Record counts are not sales or prescription volume.
Also listed with the FDA, not a patient dose form: Powder (8) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.
Share of FDA-listed product records by manufacturer — FDA National Drug Code Directory. Record counts are not sales or prescription volume.
How widely Trospium is used (Medicaid data)
A general measure of how commonly Trospium is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Trospium is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Trospium prescribed? Of the 1,601 medications we measure, Trospium ranks #671 by Medicaid prescriptions — more than 58% of them.
Utilization by Trospium product
Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.
trospium chloride 20 MG Oral Tablet Most dispensed
Summed across the 8 of 30 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 857560
24 HR trospium chloride 60 MG Extended Release Oral Capsule
Summed across the 5 of 22 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 857564
Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Trospium, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 13 of 52 listed Trospium NDCs with Medicaid activity.
Compare Trospium products
A representative set of FDA-listed product records for Trospium — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Extended-release capsule | ||||
| 60 mg | Oral | Actavis Pharma, Inc. | ANDA | View NDC → |
| 60 mg | Oral | Bluepoint Laboratories | ANDA | View NDC → |
| 60 mg | Oral | Bryant Ranch Prepack × 3 listings | ANDA | View NDC → |
| 60 mg | Oral | Golden State Medical Supply, Inc. | ANDA | View NDC → |
| 60 mg | Oral | Granules Pharmaceuticals Inc. | ANDA | View NDC → |
| 60 mg | Oral | Padagis US LLC | ANDA | View NDC → |
| 60 mg | Oral | Proficient Rx LP | ANDA | View NDC → |
| 60 mg | Oral | Slate Run Pharmaceuticals, LLC | ANDA | View NDC → |
| 💊Tablet | ||||
| 20 mg | Oral | Aphena Pharma Solutions - Tennessee, LLC | ANDA | View NDC → |
| 20 mg | Oral | Bryant Ranch Prepack × 4 listings | ANDA | View NDC → |
| 20 mg | Oral | Chartwell RX, LLC | ANDA | View NDC → |
| 20 mg | Oral | Cipla Usa Inc., | ANDA | View NDC → |
| 20 mg | Oral | Exelan Pharmaceuticals Inc. | ANDA | View NDC → |
| 20 mg | Oral | Glenmark Pharmaceuticals Inc., USA | ANDA | View NDC → |
| 20 mg | Oral | Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc. | ANDA | View NDC → |
| 20 mg | Oral | Macleods Pharmaceuticals Limited | ANDA | View NDC → |
| 20 mg | Oral | Major Pharmaceuticals × 2 listings | ANDA | View NDC → |
| 20 mg | Oral | Padagis US LLC | ANDA | View NDC → |
| 20 mg | Oral | PD-Rx Pharmaceuticals, Inc. | ANDA | View NDC → |
| 20 mg | Oral | Remedyrepack Inc. | ANDA | View NDC → |
| 20 mg | Oral | Zameer Pharmaceuticals LLC | ANDA | View NDC → |
Showing 27 of 27 products — FDA National Drug Code Directory. See every product, package size and price: browse all 27 Trospium NDCs →
Trospium side effects reported to the FDA (FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Trospium — a signal of what to watch for, not proof the drug caused it.
The effects most often named in FDA reports that mention Trospium are nausea, vomiting, constipation; about 48% of the reports were classed as serious. These are voluntary reports, so they show what people report, not how often it happens.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Trospium in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
Trospium FDA approval history
How Trospium went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Trospium was first approved by the FDA in 2004 (Brand: SANCTURA · Allergan); the first generic version was approved in 2010. It remains available in U.S. pharmacies today.
Source: Drugs@FDA.
Trospium recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
The FDA’s enforcement reports list one Trospium recall since July 2021. It is still ongoing. A recall names specific lots from one company, so check the lot number on your own bottle rather than assuming every product is affected; your pharmacist can check whether your supply came from an affected lot.
- Trospium Chloride Extended-Release Capsules, 60 mg, 30 Capsules per bottle, Rx Only, Manufactured By: Sidmak Laboratories (India) Pvt. Ltd. Plot No. 20, Pharmacity, Selaqui Industrial Area, Dehradun-… Lots: Lot: 231104, 231105, 231106, exp 7/31/2025 FDA record D-0139-2024 →
Source: FDA enforcement (recall) reports, via openFDA; our copy was last updated Sep 24, 2026.
RxNorm Concept Web — From Ingredient to Every Form and Strength
This page starts with one ingredient concept (IN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). Combination products remain separate concepts with their own pages.
RxCUI 236778 2 dose forms · 2 strengths
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Dose form (SCDF) Extended Release Oral Capsule RxCUI 731222In current FDA listingsClinical drug / strength (SCD) 24 HR trospium chloride 60 MGRxCUI 857564 -
Dose form (SCDF) Oral Tablet RxCUI 452425In current FDA listingsClinical drug / strength (SCD) chloride 20 MGRxCUI 857560
Look up RxCUI 236778 in the RxCUI Atlas →
RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.
Trospium supply and shortage status
Whether Trospium is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
💵 What Trospium costs pharmacies (NADAC benchmark)
The national average invoice price pharmacies pay for the drug itself, from CMS's NADAC survey (data as of Sep 30, 2026). This is a supply-cost benchmark — not a retail price and not what you'd pay at the counter.
| Form | Strength | Pharmacy acquisition benchmark | |
|---|---|---|---|
| Tablet, Film Coated · Oral | 20 mg | $0.211 per tablet | NDC details & price history |
| Capsule, Extended Release · Oral | 60 mg | $1.64 per capsule | NDC details & price history |
| Tablet · Oral | 20 mg | $0.211 per tablet | NDC details & price history |
Source: CMS National Average Drug Acquisition Cost (NADAC), a survey of retail pharmacy invoice prices. Benchmarks shown are the range across package sizes of a representative product for each form and strength — other manufacturers' products may differ.
Trospium brand names
Trospium is sold under 4 brand names in the FDA directory — Sanctura, Sanctura XR, Trospium Chloride, Trospium Chloride ER. A brand and its generic contain the same active ingredient; the brand name belongs to one company's product.
Who makes Trospium: manufacturers and labelers
19 companies list Trospium products with the FDA. By number of product records, the largest are Bryant Ranch Prepack, Major Pharmaceuticals, Padagis US LLC. Labelers include manufacturers and repackagers; the product in your bottle depends on which one your pharmacy stocks.
Trospium drug class (RxNorm)
Trospium belongs to the Cholinergic Muscarinic Antagonist class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
Sources for this Trospium page
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How this page is built
HelloPharmacist combines public FDA and NLM records and does not author the underlying clinical facts. The plain-language sections are written with AI from the FDA-approved label text and reviewed by our pharmacy team before publication. Bryant Ranch Prepack is the representative DailyMed label linked for verification and dates. This is general education, not medical advice: always talk to your doctor or pharmacist about your own medicines. How we build and review drug pages →