HomeNDC LookupIngredientsFesoterodine Fumarate › 31722-0033-30
FESOTERODINE FUMARATE 4 mg Tablet, Film Coated, Extended Release, 30-count — NDC 31722-0033-30 package photo

FESOTERODINE FUMARATE 4 mg Tablet, Film Coated, Extended Release, 30-count

by Camber Pharmaceuticals, Inc. · 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-033-30)
NDC 31722-0033-30
🏷️ FDA NDC (as labeled) 31722-033-30 billing pads the product segment with a zero
This package
Contains30-count Cost per ea$0.7909 NADAC Per package$23.73 / 30 tablets Pack sizes2 compare ↓
Also priced by: Medicaid pays $1.13/unit · Part D plans $1.66/unit — full pricing hub ↓
Also comes in: 90 tablets 31722-0033-90
Rx only Generic On market Non-controlled
🗂️ Data synced Jul 24, 2026 · sources: openFDA · FDA label (DailyMed) · FDA Orange & Purple Book · First Databank · CMS NADAC, ASP, Medicare & Medicaid · RxNorm
📋 All sources & update times →
⚠️
Other active recalls for Fesoterodine Fumarate (different manufacturers) — 2 · tap to view
These affect other manufacturers’ products for the same ingredient — not necessarily the exact NDC on this page.
Class III · Dec 16, 2025 — Failed Impurities/Degradation Specifications: Due to levels of 'Diester Impurity' exceeding the specification limit. (Alembic Pharmaceuticals Limited) · FDA recall D-0248-2026
Class III · Oct 10, 2025 — Failed Impurities/Degradation Specifications: Due to levels of 'Diester Impurity' exceeding the specification limit. (Alembic Pharmaceuticals Limited) · FDA recall D-0156-2026
Each entry is an official FDA enforcement report — look up any recall number in the FDA recall database ↗

🆔 Identity & classification

FDA NDC (as labeled) 31722-033-30
Product NDC 31722-033
11-digit billing NDC 31722003330
NCPDP billing unit EA — each (per item)
RxCUI 810071, 810077
UNII EOS72165S7
UPC 0331722033305, 0331722034302
Application # ANDA204792
SPL Set ID dc532c6c-ff0d-488a-8a92-b1b0f37c944e
DEA schedule Non-controlled
Marketing category ANDA
Marketing status On market
FDA listing status Listed (active directory)
Marketing start 2024-01-09
Route ORAL
Dosage form TABLET, FILM COATED, EXTENDED RELEASE
Substance FESOTERODINE FUMARATE
GPI-14 54100020207520
GCN Seq No 064000
GCN 99711
HICL code 035606
Ingredient (HICL) Fesoterodine Fumarate
HIC1 code R
Therapeutic class — broad (HIC1) Kidney/Urinary Tract
HIC2 code R1
Therapeutic class — intermediate (HIC2) Affect Primarily Kidneys/Urinary Tract
HIC3 code R1A
Therapeutic class — specific (HIC3) Urinary Tract Antispasmodic/Antiincontinence Agent
AHFS code 86:12.04.00
AHFS class Antimuscarinics
FDB label name FESOTERODINE ER 4 MG TABLET
FDB brand name Fesoterodine Fumarate Er
Legend status F — Federal legend — prescription drug or device
TE code (Orange Book) AB · RLD · RS
Why two NDCs? The FDA registers this code as 31722-033-30 — a 5-3-2 layout, and that's what's printed on the package and shown on DailyMed. For insurance claims, every NDC is standardized to a uniform 11-digit 5-4-2 format by adding a zero to the product segment → 31722-0033-30. Same drug, same package — only the format differs.
Where does this data come from?
Identifiers from the FDA openFDA NDC Directory and Structured Product Labeling; RxCUI from RxNorm (NLM); GPI from Medi-Span; GCN / HIC / AHFS / legend from First Databank.

🏷️ RxNorm drug class

This medicine belongs to the Drugs for urinary frequency and incontinence class.

Drug family (ATC) Drugs for urinary frequency and incontinence
Where does this data come from?
Therapeutic classes from RxNorm RxClass (U.S. National Library of Medicine) — Established Pharmacologic Class (FDA), ATC drug family (WHO) and mechanism of action, matched by this product’s RxCUI.

🏭 Manufacturer & labeler

LabelerCamber Pharmaceuticals, Inc.
Application holderHETERO LABS LTD UNIT V
FDA applicationANDA204792 (ANDA)
Labeler code31722
First marketedJan 2024
Product typeHuman Prescription Drug
Portfolio603 products on file
The labeler markets the product; the application holder owns the FDA approval. They’re often the same company but can differ (e.g. a repackager or an authorized generic). A mailing address / phone appears here when the manufacturer includes it in the product’s FDA label (not all do).
Where does this data come from?
Labeler, application holder and registered establishment from the FDA openFDA NDC Directory and Drugs@FDA; address/contact from the product’s FDA label.

🩺 Clinical

Label name FESOTERODINE ER 4 MG TABLET Ingredient Fesoterodine Fumarate
📖 What it is MedlinePlus · NLM

Fesoterodine is used to 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). Fesoterodine is in a class of medications called antimuscarinics. It works by relaxing the bladder muscles to prevent urgent, frequent, or uncontrolled urination.

Read the full MedlinePlus article ↗
📗 Our plain-language guide HelloPharmacist
  • It's calming down overactive signals in your bladder muscle. When your bladder squeezes too often or too urgently, it's because certain nerve receptors are overstimulated. Fesotero...
  • What is fesoterodine actually doing for my bladder?
  • No, you can take it with or without food — it works either way. The one thing that does matter is how you take the tablet: swallow it whole with a glass of liquid. Don't chew, crus...
  • Dry mouth is the most common side effect, and it's more noticeable at higher doses. Sipping water throughout the day, chewing sugar-free gum, or using sugar-free hard candies can h...
📖 Read our full Fesoterodine guide →
Where does this data come from?
Plain-language summary from MedlinePlus (U.S. National Library of Medicine); supplement & herbal interactions and nutrient depletion data from the Natural Medicines database; our full guide is HelloPharmacist editorial content.

💊 What it looks like

Color blue
ShapeOval
ImprintH;F7
Size8 mm
ScoringNot scored
One label can cover several strengths, so colors may be combined — always confirm a loose pill against the dispensed prescription label or a pharmacist.
Where does this data come from?
Physical description (imprint, shape, color, scoring, coating) from this product’s FDA Structured Product Labeling (SPL), mirrored from DailyMed / openFDA.

🧪 Inactive Ingredients / Excipients

Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.

💡 Tap an ingredient (hover on desktop) to see what it is and why it’s used.

  • UNII 2968PHW8QP
    A weak organic acid derived from citrus fruits or made through fermentation. It works as a buffer to control pH, a preservative to extend shelf life, and a flavoring agent in medications.
  • UNII L06K8R7DQK
    A synthetic blue dye approved by the FDA for use in medications and foods. It serves as a colorant to make pills and liquids visually distinct and easier to identify.
  • UNII R8WTH25YS2
    Glyceryl dibehenate is a wax-like substance made from behenate fatty acids and glycerol. It functions as a binder and release-control agent in tablets and capsules, helping hold ingredients together and regulate how quickly the medicine dissolves and releases in your body.
  • UNII B1QE5P712K
    Hypromellose 2208 is a plant-derived thickening agent that dissolves in water. It's used as a binder to help hold tablet ingredients together and as a coating on pills to control how quickly the medicine releases in your body.
  • UNII VM7F0B23ZI
    Hypromellose 2208 is a plant-derived thickening agent that forms a protective coating on tablets and capsules. It slows down how quickly the medicine dissolves, controlling drug release into your body.
  • UNII 39J80LT57T
    Hypromellose 2208 is a plant-derived thickening agent used as a binder and film-coating material. It helps hold tablet ingredients together and creates a protective coating on pills to control how quickly medicine dissolves.
  • UNII 1DI56QDM62
    A natural fatty substance from soybeans that helps mix oil and water-based ingredients together. It acts as an emulsifier and lubricant in medicines to improve texture and help the product break down properly in your body.
  • UNII G2M7P15E5P
    Polyethylene glycol 3350 is a synthetic polymer used as a solvent, humectant, and thickening agent in medicines. It helps dissolve other ingredients, retain moisture in the product, and achieve the desired consistency.
  • UNII 532B59J990
    Polyvinyl alcohol is a synthetic polymer made from plant-derived materials. It's used as a binder to hold ingredients together, a film-former in coatings, and a thickener in liquid formulations.
  • UNII ETJ7Z6XBU4
    Silicon dioxide is a naturally occurring mineral used as a glidant and anti-caking agent. It helps powder ingredients flow smoothly and prevents clumping during manufacturing and storage.
  • UNII O8232NY3SJ
    A plant-based carbohydrate derived from corn kernels. It acts as a filler to add bulk, a binder to hold ingredients together, and a disintegrant to help the tablet break apart in your stomach for absorption.
  • UNII 7SEV7J4R1U
    A powder made from a naturally occurring mineral. In medicines, talc works as a glidant and anti-caking agent, helping tablets and capsules flow smoothly during manufacturing and preventing clumping.
  • UNII 15FIX9V2JP
    Titanium dioxide is a bright white mineral powder commonly used as a colorant and opacifying agent. It makes pills and tablets white or lighter in color and helps make coatings non-transparent.

13 inactive ingredients listed in the exact product block matched to this NDC.

Where does this data come from?
Data sourced from official FDA Structured Product Labeling (SPL) via DailyMedingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.

Inactive ingredient FAQ

Are inactive ingredients the same for every manufacturer?
No. Inactive ingredients can differ by manufacturer, dosage form, strength, and package / product version.
Why might an inactive ingredient be missing?
Some SPLs do not provide a complete structured inactive-ingredient list, and older or unusual labels may only include the information in narrative text.
Can inactive ingredients matter?
Yes. They can matter for allergies, intolerances, dyes, gluten / lactose concerns, preservatives, and formulation differences — but confirm with a pharmacist or the manufacturer when it’s clinically important.

💲 Pricing

A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.

Price systemPer eaPer package
Retail pharmacies payNADAC · weekly $0.791 $23.73 / 30 tablets
Medicaid paysCMS SDUD · 12 mo $1.13 $33.83 / 30 tablets
Medicare drug plans payPart D · Q2 2026 $1.66 $49.93 / 30 tablets
NADAC price history (per ea) — tap or hover for the price & month
Dec 2025 Feb 2026 May 2026 Aug 2026 $0.909 $0.790
▼ Down 13% over the last 9 months.
Where does this data come from?
NADAC (National Average Drug Acquisition Cost) is the CMS weekly pharmacy-acquisition-cost survey — what pharmacies pay. ASP (Average Sales Price) is the CMS Medicare Part B drug-payment file, published quarterly. Medicaid pays is computed by us from CMS State Drug Utilization Data (total reimbursed ÷ units, trailing 12 months) — gross of rebates and inclusive of dispensing fees, so it reflects what Medicaid paid, not an acquisition cost. Medicare drug plans pay is the median negotiated point-of-sale unit cost across plans listing this NDC in the CMS quarterly Prescription Drug Plan pricing files, before rebates. The VA pays is the federal contract price (FSS, and the statutory Big 4 ceiling where listed) from the VA National Acquisition Center pharmaceutical price file. All are free public government data; each measures a different payer, so the figures are not directly comparable.

🔁 Therapeutic equivalents

ProductLabelerPackNADAC/unitTEStatusPrice vs. this
Fesoterodine Fumarate 4 mgthis 31722-0033-30 Camber 30 tablets $0.791 AB Availability likely
Fesoterodine fumarate 4 mg 43598-0247-30 Dr.Reddy's 30 tablets $0.791 AB Availability likely
Fesoterodine Fumarate 4 mg 65862-0766-30 Aurobindo 30 tablets $0.791 AB Availability likely
Fesoterodine Fumarate 4 mg 67877-0064-30 Ascend 30 tablets $0.791 AB Availability likely
fesoterodine fumarate 4 mg 68382-0479-06 Zydus 30 tablets $0.791 AB Availability likely
Fesoterodine Fumarate 4 mg 72603-0413-01 NorthStar 30 tablets $0.791 AB Availability likely
Toviaz 4 mg 00069-0242-30 Pfizer 30 tablets $9.262 AB Availability likely +1071%
Fesoterodine Fumarate 4 mg 46708-0175-10 Alembic 100 tablets AB FDA listed
Fesoterodine fumarate 4 mg 51407-0661-30 Golden 30 tablets AB FDA listed
Fesoterodine Fumarate 4 mg 62332-0175-10 Alembic 100 tablets AB FDA listed
Fesoterodine Fumarate 4 mg 65162-0369-03 Amneal 30 tablets AB FDA listed
fesoterodine fumarate 4 mg 70771-1168-03 Zydus 30 tablets AB FDA listed
About this product: this is a generic version of the medicine. FDA equivalence ratings are shown when available, and other versions are listed above, least expensive first.
Where does this data come from?
Equivalents are other NDCs of the same ingredient, form and route from the openFDA NDC Directory, ranked least-expensive-first by NADAC. Therapeutic-equivalence (AB) ratings come from the FDA Orange Book; biologics use the FDA Purple Book for biosimilar & interchangeable status.

Availability & generic status

🏛️
2024
On the market since
Jan 2024
📍
2026
Currently FDA-listed
2 years listed
🔓
·
Generic on the market
this product is a generic
This is a generic drug

This product is an FDA-approved generic. Other versions of the same drug are listed under Therapeutic equivalents, least expensive first.

Where does this data come from?
Patents and exclusivity from the FDA Orange Book (small-molecule drugs), refreshed from public FDA data. Generic launch timing is an estimate, not a guarantee.

🗺️ Medicaid utilization & spend

📍 This exact package only: Medicaid data is reported per full 11-digit NDC — labeler, product and pack size — so every number here is for 31722-0033-30, not the drug overall. Other pack sizes report separately.
💊 Pharmacy benefit only: These are Medicaid outpatient pharmacy claims, billed by NDC. They exclude the medical benefit — clinic- or hospital-administered drugs billed under HCPCS J-codes — so drugs used mostly that way (e.g. Avastin, Lucentis, Keytruda) can look low or missing here. That’s expected, not an error.
📅 Q1 2025 – Q4 2025 · 4 quarters of data
ⓘ The newest quarter is usually incomplete when first published; states restate recent quarters in later CMS releases, so the latest figures typically revise upward. State coverage-policy changes can also shift quarter-to-quarter totals.
Prescriptions last 4 qtrs
692
Units reimbursed last 4 qtrs
24.5K
Gross reimbursed last 4 qtrs
$27.6K
Avg / prescription
$39.87
Avg / unit
$1.1275
Latest quarter Q4 2025
313Rx
Medicaid pays / ea
$1.1275
gross reimbursed
vs
NADAC / ea
$0.7909
acquisition cost
=
Spread
+$0.3366
+43% vs cost
What Medicaid paid per ea (before rebates; includes the pharmacy’s dispensing fee) compared with NADAC — the average price pharmacies pay to buy the drug. A positive spread means Medicaid reimbursed more than the purchase price, before manufacturer rebates.
Fee-for-service vs managed care
43% FFS 57% MCO
Fee-for-service · 300 Rx Managed care · 392 Rx
State Medicaid map
Alaska: no data reported AK Maine: no data reported ME Washington: no data reported WA Idaho: no data reported ID Montana: no data reported MT North Dakota: no data reported ND Minnesota: no data reported MN Wisconsin: 1,203 units · 20.4 per 100k residents WI Michigan: 3,624 units · 36.1 per 100k residents MI New York: 4,884 units · 25.0 per 100k residents NY Vermont: no data reported VT New Hampshire: no data reported NH Oregon: no data reported OR Nevada: no data reported NV Wyoming: no data reported WY South Dakota: no data reported SD Iowa: no data reported IA Illinois: no data reported IL Indiana: no data reported IN Ohio: 2,514 units · 21.3 per 100k residents OH Pennsylvania: no data reported PA New Jersey: no data reported NJ Massachusetts: no data reported MA California: 510 units · 1.3 per 100k residents CA Utah: no data reported UT Colorado: 1,464 units · 24.9 per 100k residents CO Nebraska: no data reported NE Missouri: 1,271 units · 20.5 per 100k residents MO Kentucky: no data reported KY West Virginia: no data reported WV Virginia: 872 units · 10.0 per 100k residents VA Maryland: no data reported MD Connecticut: no data reported CT Rhode Island: no data reported RI Arizona: no data reported AZ New Mexico: no data reported NM Kansas: 1,036 units · 35.2 per 100k residents KS Arkansas: no data reported AR Tennessee: 392 units · 5.5 per 100k residents TN North Carolina: 1,193 units · 11.0 per 100k residents NC South Carolina: no data reported SC Delaware: no data reported DE Oklahoma: no data reported OK Louisiana: 3,210 units · 70.2 per 100k residents LA Mississippi: no data reported MS Alabama: no data reported AL Georgia: 679 units · 6.2 per 100k residents GA D.C.: no data reported DC Hawaii: no data reported HI Texas: 750 units · 2.5 per 100k residents TX Florida: 870 units · 3.8 per 100k residents FL
Units reimbursed · per 100k residents
1.370.2
gray = no data reported
Colors are per 100,000 residents, so big states don’t automatically dominate. Tap or hover a state for its actual totals.
Tap or hover a state
…for its Medicaid breakdown
🏆 Top states by units · per 100k residents
1 Louisiana 70.2 /100k
2 Michigan 36.1 /100k
3 Kansas 35.2 /100k
4 New York 25.0 /100k
5 Colorado 24.9 /100k
6 Ohio 21.3 /100k
7 Missouri 20.5 /100k
8 Wisconsin 20.4 /100k
National units — by quarter
💵 About the dollar figures: “reimbursed” is what Medicaid paid pharmacies before confidential manufacturer rebates, so the program’s real net cost is lower than these numbers. Fee-for-service and managed-care claims are combined unless split above. Source: CMS State Drug Utilization Data; per-100k rates use 2023 Census population estimates.

💊 Medicaid utilization by pack size

Medicaid (SDUD) totals over the four most recent reported quarters for every package size of this drug — handy when a specific package (e.g. a starter/titration pack) carries little or no Medicaid volume on its own.
90 tablets31722-0033-90 No Medicaid data
Drug total (last 4 qtrs): 692 Rx · 24,472 units · $27,592 gross reimbursed
Tap a pack size to open its page. Source: CMS State Drug Utilization Data, last 4 quarters.

📊 Medicare Part D spend CMS · PART D · 2026 (Q1)

Medicare Part D (outpatient prescription) spending for Fesoterodine Fumarate ER (matched by generic name) — the program that covers self-administered drugs. 7 manufacturers.
⚠️ Drug-level data: CMS publishes Part D spending by drug, not by NDC — these figures combine every manufacturer, strength and package size sold under the name Fesoterodine Fumarate ER. CMS lists 2 products for this generic; we show the highest-spend one. That’s a different level of aggregation than the Medicaid card above, which is specific to this exact 11-digit NDC (pack size included), so the two aren’t directly comparable.
Period
Total Part D spend
$3.07M
Claims incl. refills
31K
Beneficiaries
19.5K
Spend / beneficiary
$157.85
Spend / claim
$99.15
Trend by period
💵 About the dollar figures: spending is what Part D plans paid before confidential manufacturer rebates, so the program’s real net cost is lower. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part D Spending by Drug (data.cms.gov), updated quarterly.

🔬 Reported adverse events (FAERS)

Read carefully: FAERS reports are voluntary and unverified. Counts are not incidence, do not establish causation, are subject to reporting bias, and cannot be used to compare one drug to another. Shown for signal context only. Reports for Fesoterodine fumarate — the ingredient across all brands.

Top reported reactions

Dry Mouth823
Fall534
Fatigue519
Constipation504
Urinary Retention502
Pain456
Headache431

Age at onset

Neonate4
Child2
Adolescent1
Adult314
Elderly405

Reporter sex

10,773 reports
Male · 31%
Female · 68%
Unknown · 1%

Serious outcomes

Hospitalization2,320
Death439
Life-threatening278
Disabling196
Reports over time (by year) — tap or hover for the count & year
2019 2021 2023 2026 882 0
Most recent year is provisional (FAERS lags ~3 months).
Where does this data come from?
Adverse-event reports from the FDA Adverse Event Reporting System (FAERS) via openFDA. FAERS reports are voluntary and unverified — counts are not incidence and don’t establish causation.

📦 Packaging — all sizes for this product

Package NDCDescription Per unit Per pack Marketing startStatus
31722-0033-30 You're viewing this 30 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-033-30) $0.7909 / ea $23.73 2024-01-09 Active
31722-0033-90 90 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (31722-033-90) 2024-01-09 Active

You're viewing the smallest of 2 pack sizes for this product.

In Medicaid, this is the most-dispensed pack of this product — about 100% of fills over the last four reported quarters. See all packs ↓

Pack size FAQ

What quantity is in NDC 31722-0033-30?
NDC 31722-0033-30 is a 30-count package — 30 tablet, film coated, extended release in 1 bottle.
What is the difference between NDC 31722-0033-30 and NDC 31722-0033-90?
Both are FESOTERODINE FUMARATE 4 mg Tablet, Film Coated, Extended Release — the drug itself is identical. NDC 31722-0033-30 is the 30-count package, while NDC 31722-0033-90 is the 90 tablets package.
What NDC number is used to bill for this package of FESOTERODINE FUMARATE 4 mg Tablet, Film Coated, Extended Release?
Bill NDC 31722-0033-30 — the 11-digit billing format is 31722003330. Pharmacy and medical claims use the 11-digit form; the FDA label may print a shorter form of the same code.

Prices are the latest CMS NADAC pharmacy acquisition cost per NDC; per-pack figures are per-unit × pack quantity, shown only when the pack is denominated in the same measure NADAC prices.

📄 Full prescribing information FDA SPL

The complete FDA label for this product — the official prescribing information, verbatim, section by section. Jump with a chip, search within the label, or expand everything.
🎯 Indications and Usage 117 words

1 INDICATIONS AND USAGE Fesoterodine fumarate extended-release tablets are indicated for the treatment of: • Overactive bladder (OAB) in adults with symptoms of urge urinary incontinence, urgency, and frequency. ( 1.1 ) • Neurogenic detrusor overactivity (NDO) in pediatric patients 6 years of age and older and weighing greater than 25 kg. (1.2)

1.1Adult Overactive Bladder Fesoterodine fumarate extended-release tablets are indicated for the treatment of overactive bladder (OAB) in adults with symptoms of urge urinary incontinence, urgency, and frequency.

1.2Pediatric Neurogenic Detrusor Overactivity Fesoterodine fumarate extended-release tablets is indicated for the treatment of neurogenic detrusor overactivity (NDO) in pediatric patients 6 years of age and older with a body weight greater than 25 kg.

⏱️ Dosage and Administration ~3 min read

2 DOSAGE AND ADMINISTRATION • OAB in Adults: The recommended starting dosage is 4 mg orally once daily. Based upon individual response and tolerability, increase to the maximum dosage of 8 mg once daily. ( 2.1 ) • NDO in Pediatric Patients 6 Years and Older: • Pediatric Patients Weighing Greater than 25 kg and up to 35 kg: The recommended dosage is 4 mg orally once daily.

If needed, dosage may be increased to 8 mg orally once daily. ( 2.2 ) • Pediatric Patients Weighing Greater than 35 kg: The recommended starting dosage is 4 mg orally once daily. After one week, increase to 8 mg orally once daily.

( 2.2 ) • Adult or Pediatric Patients with Renal Impairment: Refer to the full prescribing information for recommended dosage. ( 2.3 , 2.4 ) • Dosage Modifications Due to Strong CYP3A4 Inhibitors: Refer to the full prescribing information for recommended dosage. ( 2.5 ) • Administration: Swallow whole with liquid.

Do not chew, divide, or crush. Take with or without food. ( 2.6 )

2.1Recommended Dosage for Adult Patients With OAB The recommended starting dosage of fesoterodine fumarate extended-release tablets in adults is 4 mg orally once daily. Based upon individual response and tolerability, increase to the maximum dosage of fesoterodine fumarate extended-release tablets 8 mg once daily. For administration instructions, see Dosage and Administration ( 2.6 ).

2.2Recommended Dosage for Pediatric Patients Aged 6 Years and Older With NDO Pediatric Patients Weighing Greater than 25 kg and up to 35 kg The recommended dosage of fesoterodine fumarate extended-release tablets is 4 mg orally once daily. If needed, dosage may be increased to fesoterodine fumarate extended-release tablets 8 mg orally once daily. For administration instructions, see Dosage and Administration ( 2.6 ).

Pediatric Patients Weighing Greater than 35 kg The recommended starting dosage of fesoterodine fumarate extended-release tablets is 4 mg orally once daily. After one week, increase to fesoterodine fumarate extended-release tablets 8 mg orally once daily. For administration instructions, see Dosage and Administration ( 2.6 ).

2.3Recommended Dosage in Adult Patients With Renal Impairment The recommended dosage of fesoterodine fumarate extended-release tablets in adult patients with renal impairment is described in Table 1 [see Use in Specific Populations ( 8.6 )] . For administration instructions, see Dosage and Administration ( 2.6 ). Table 1: Fesoterodine Fumarate Extended-Release Tablets Recommended Dose in Adult Patients With Renal Impairment (Administered Orally Once Daily) Estimated Creatinine Clearance 1 Recommended Dose CLcr 30 to 89 mL/min 8 mg CLcr 15 to 29 mL/min 4 mg CLcr <15 mL/min 4 mg 1 Calculate CLcr using the Cockcroft-Gault formula

2.4Recommended Dosage in Pediatric Patients With Renal Impairment Pediatric Patients Weighing Greater than 25 kg and up to 35 kg The recommended dosage of fesoterodine fumarate extended-release tablets in pediatric patients with renal impairment weighing greater than 25 kg and up to 35 kg is described in Table 2 [see Use in Specific Populations ( 8.6 )] . For administration instructions, see Dosage and Administration ( 2.6 ) . Table 2: Fesoterodine Fumarate Extended-Release Tablets Recommended Dose in Pediatric Patients Aged 6 Years and Older Weighing Greater Than 25 kg and up to 35 kg With Renal Impairment (Administered Orally Once Daily) Estimated Glomerular Filtration Rate (GFR) 1 Recommended Dose 2 eGFR 30 to 89 mL/min/1.73m 2 4 mg eGFR 15 to 29 mL/min/1.73m 2 Use is Not Recommended eGFR <15 mL/min/1.73m 2 or requiring dialysis Use is Not Recommended 1 Estimate GFR using a validated GFR estimating equation for the pediatric age range of the approved indication.

2 Dosing was derived assuming similar proportional effects of renal impairment in adults and pediatric patients 6 years and older. Pediatric Patients weighing greater than 35 kg The recommended dosage of fesoterodine fumarate extended-release tablets in ped…

💊 Dosage Forms and Strengths 62 words

3 DOSAGE FORMS AND STRENGTHS Extended-release tablets: · 4 mg are light blue, oval, biconvex, film coated tablets debossed with 'H' on one side and 'F6' on the other side. · 8 mg are blue, oval, biconvex, film coated tablets debossed with 'H' on one side and 'F7' on the other side. Extended-release tablets: 4 mg and 8 mg ( 3 )

Contraindications 136 words

4 CONTRAINDICATIONS Fesoterodine fumarate extended-release tablets are contraindicated in patients with any of the following: · known or suspected hypersensitivity to fesoterodine fumarate extended-release tablets or any of its ingredients, or to tolterodine tartrate tablets or tolterodine tartrate extended-release capsules [see Clinical Pharmacology ( 12.1 )] . Reactions have included angioedema [see Warnings and Precautions ( 5.1 )] · urinary retention [see Warnings and Precautions ( 5.2 )] · gastric retention [see Warnings and Precautions ( 5.3 )] · uncontrolled narrow-angle glaucoma [see Warnings and Precautions ( 5.4 )] · Known or suspected hypersensitivity to fesoterodine fumarate extended-release tablet or any of its ingredients or to tolterodine tartrate tablets or tolterodine tartrate extended-release capsules.

( 4 ) · Urinary retention ( 4 ) · Gastric retention ( 4 ) · Uncontrolled narrow-angle glaucoma. ( 4 )

⚠️ Warnings and Cautions ~2 min read

5 WARNINGS AND PRECAUTIONS · Angioedema: Promptly discontinue fesoterodine fumarate extended-release tablets and provide appropriate therapy. ( 5.1 ) · Urinary Retention: Fesoterodine fumarate extended-release tablets are not recommended in patients with clinically significant bladder outlet obstruction because of the risk of urinary retention. ( 5.2 ) · Decreased Gastrointestinal Motility: Fesoterodine fumarate extended-release tablets are not recommended for use in patients with decreased gastrointestinal motility, such as those with severe constipation.

( 5.3 ) · Worsening of Narrow-Angle Glaucoma: Use fesoterodine fumarate extended-release tablets with caution in patients being treated for narrow-angle glaucoma. ( 5.4 ) · Central Nervous System Effects: Somnolence has been reported with fesoterodine fumarate extended-release tablets. Advise patients not to drive or operate heavy machinery until they know how fesoterodine fumarate extended-release tablets affects them.

( 5.5 ) · Worsening of Myasthenia Gravis Symptoms: Use fesoterodine fumarate extended-release tablets with caution in patients with myasthenia gravis. ( 5.6 )

5.1Angioedema Angioedema of the face, lips, tongue, and/or larynx has been reported with fesoterodine. In some cases, angioedema occurred after the first dose; however, cases have been reported to occur hours after the first dose or after multiple doses. Angioedema associated with upper airway swelling may be life-threatening.

Fesoterodine fumarate extended-release tablets are contraindicated in patients with a known or suspected hypersensitivity to fesoterodine fumarate extended-release tablets or any of its ingredients [see Contraindications ( 4 )] . If involvement of the tongue, hypopharynx, or larynx occurs, fesoterodine should be promptly discontinued and appropriate therapy and/or measures to ensure a patent airway should be promptly provided.

5.2Urinary Retention in Adult Patients With Bladder Outlet Obstruction The use of fesoterodine fumarate extended-release tablets, like other antimuscarinic drugs, in patients with clinically significant bladder outlet obstruction, including patients with urinary retention, may result in further urinary retention and kidney injury. The use of fesoterodine fumarate extended-release tablets is not recommended in patients with clinically significant bladder outlet obstruction, and is contraindicated in patients with urinary retention [see Contraindications ( 4 ) and Adverse Reactions ( 6.1 )].

5.3Decreased Gastrointestinal Motility Fesoterodine fumarate extended-release tablets are associated with decreased gastric motility. Fesoterodine fumarate extended-release tablet is contraindicated in patients with gastric retention [see Contraindications ( 4 )] . The use of fesoterodine fumarate extended-release tablets are not recommended in patients with decreased gastrointestinal motility, such as those with severe constipation.

5.4Worsening of Narrow-Angle Glaucoma Fesoterodine fumarate extended-release tablets can worsen controlled narrow-angle glaucoma. Fesoterodine fumarate extended-release tablets are contraindicated in patients with uncontrolled narrow-angle glaucoma [see Contraindications ( 4 )] . Fesoterodine fumarate extended-release tablets should be used with caution in patients being treated for narrow-angle glaucoma.

5.5Central Nervous System Effects Fesoterodine fumarate extended-release tablets are associated with anticholinergic central nervous system (CNS) adverse reactions [see Adverse Reactions ( 6.1 )] . A variety of CNS anticholinergic effects have been reported, including headache, dizziness, and somnolence. Patients should be monitored for signs of anticholinergic CNS effects, particularly after beginning treatment or increasing the dose.

Advise patients not to drive or operate heavy machinery until they know how fesoterodine fumarate extended-release tablet affects them. If a patient experiences anticholinergic CNS effects, fesoterodine fu…

🤒 Adverse Reactions ~3 min read

6 ADVERSE REACTIONS The following clinically significant adverse reactions are described elsewhere in labeling: · Angioedema [see Warnings and Precautions ( 5.1 )] · Urinary Retention [see Warnings and Precautions ( 5.2 )] · Decreased Gastrointestinal Motility [see Warnings and Precautions ( 5.3 )] • Most frequently reported adverse events with fesoterodine fumarate extended-release tablets in adult patients with OAB (≥4%) were: dry mouth (placebo, 7%; fesoterodine 4 mg, 19%; fesoterodine 8 mg, 35%) and constipation (placebo, 2%; fesoterodine 4 mg, 4%; fesoterodine tablets 8 mg, 6%).

( 6.1 ) • Most frequently reported adverse reactions with fesoterodine fumarate extended-release tablets in pediatric patients (≥2%) with NDO were: diarrhea, urinary tract infection (UTI), dry mouth, constipation, abdominal pain, nausea, weight increased, and headache. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Annora Pharma Private Limited at 1-866-495-1995 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

6.1Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. Adult Overactive Bladder (OAB) The safety of fesoterodine fumarate extended-release tablets was evaluated in Phase 2 and 3 controlled trials in a total of 2859 patients with overactive bladder, of which 2288 were treated with fesoterodine.

Of this total, 782 received fesoterodine fumarate extended-release tablets 4 mg/day, and 785 received fesoterodine fumarate extended-release tablets 8 mg/day with treatment periods of 8- or 12-weeks. Approximately 80% of these patients had greater than 10-weeks of exposure to fesoterodine fumarate extended-release tablets in these trials. A total of 1964 patients participated in two 12-week, Phase 3 efficacy and safety studies and subsequent open-label extension studies.

In these two studies combined, 554 patients received fesoterodine fumarate extended-release tablets 4 mg/day and 566 patients received fesoterodine fumarate extended-release tablets 8 mg/day. In Phase 2 and 3 placebo-controlled trials combined, the incidences of serious adverse events in patients receiving placebo, fesoterodine fumarate extended-release tablets 4 mg, and fesoterodine fumarate extended-release tablets 8 mg were 1.9%, 3.5%, and 2.9%, respectively. All serious adverse events were judged to be not related or unlikely to be related to study medication by the investigator, except for four patients receiving fesoterodine fumarate extended-release tablets who reported one serious adverse reaction each: angina, chest pain, gastroenteritis, and QT prolongation on ECG.

The most commonly reported adverse event in patients treated with fesoterodine fumarate extended-release tablets was dry mouth. The incidence of dry mouth was higher in those taking 8 mg/day (35%) and in those taking 4 mg/day (19%), as compared to placebo (7%). Dry mouth led to discontinuation in 0.4%, 0.4%, and 0.8% of patients receiving placebo, fesoterodine fumarate extended-release tablets 4 mg, and fesoterodine fumarate extended-release tablets 8 mg, respectively.

For those patients who reported dry mouth, most had their first occurrence of the event within the first month of treatment. The second most commonly reported adverse event was constipation. The incidence of constipation was 2% in those taking placebo, 4% in those taking 4 mg/day, and 6% in those taking 8 mg/day.

Table 4 lists adverse events, regardless of causality, that were reported in the combined Phase 3, randomized, placebo-controlled trials at an incidence greater than placebo and in 1% or more of patients treated with fesoterodine fumarate extended-release tablets 4 mg or 8 mg once daily for up to 12-weeks. Table 4: Adverse Events With an Incidence Exceeding the Placebo Rate and Reported by ≥1% of…

🔄 Drug Interactions ~3 min read

7 DRUG INTERACTIONS

7.1Antimuscarinic Drugs Coadministration of fesoterodine fumarate extended-release tablets with other antimuscarinic agents that produce dry mouth, constipation, urinary retention, and other anticholinergic pharmacological effects may increase the frequency and/or severity of such effects. Anticholinergic agents may potentially alter the absorption of some concomitantly administered drugs due to anticholinergic effects on gastrointestinal motility.

7.2CYP3A4 Inhibitors Doses of fesoterodine fumarate extended-release tablets greater than 4 mg are not recommended in adult patients taking strong CYP3A4 inhibitors, such as ketoconazole, itraconazole, and clarithromycin [see Dosage and Administration ( 2.5 )]. The fesoterodine fumarate extended-release tablets dose in pediatric patients taking strong CYP3A4 inhibitors is recommended to be reduced to 4 mg once daily in patients >35 kg and is not recommended in patients weighing greater than 25 kg and up to 35 kg [see Dosage and Administration ( 2.5 )].

In a study in adults, coadministration of the strong CYP3A4 inhibitor ketoconazole with fesoterodine led to approximately a doubling of the maximum concentration (C max ) and area under the concentration versus time curve (AUC) of 5-hydroxymethyl tolterodine (5-HMT), the active metabolite of fesoterodine. Compared with CYP2D6 extensive metabolizers not taking ketoconazole, further increases in the exposure to 5-HMT were observed in subjects who were CYP2D6 poor metabolizers taking ketoconazole [see Clinical Pharmacology ( 12.3 )].

There is no clinically relevant effect of moderate CYP3A4 inhibitors on the pharmacokinetics of fesoterodine. Following blockade of CYP3A4 by coadministration of the moderate CYP3A4 inhibitor fluconazole 200 mg twice a day for 2 days, the average (90% confidence interval) increase in C max and AUC of the active metabolite of fesoterodine was approximately 19% (11% to 28%) and 27% (18% to 36%) respectively. No dosing adjustments are recommended in the presence of moderate CYP3A4 inhibitors (e.g., erythromycin, fluconazole, diltiazem, verapamil and grapefruit juice).

The effect of weak CYP3A4 inhibitors (e.g. cimetidine) was not examined; it is not expected to be in excess of the effect of moderate inhibitors [see Clinical Pharmacology ( 12.3 )].

7.3CYP3A4 Inducers No dosing adjustments are recommended in the presence of CYP3A4 inducers, such as rifampin and carbamazepine. Following induction of CYP3A4 by coadministration of rifampin 600 mg once a day, C max and AUC of the active metabolite of fesoterodine decreased by approximately 70% and 75%, respectively, after oral administration of fesoterodine fumarate extended-release tablets 8 mg. The terminal half-life of the active metabolite was not changed.

7.4CYP2D6 Inhibitors The interaction with CYP2D6 inhibitors was not tested clinically. In poor metabolizers for CYP2D6, representing a maximum CYP2D6 inhibition, C max and AUC of the active metabolite are increased 1.7- and 2-fold, respectively. No dosing adjustments are recommended in the presence of CYP2D6 inhibitors.

7.5Drugs Metabolized by Cytochrome P450 In vitro data indicate that at therapeutic concentrations, the active metabolite of fesoterodine does not have the potential to inhibit or induce Cytochrome P450 enzyme systems [see Clinical Pharmacology ( 12.3 )].

7.6Oral Contraceptives In the presence of fesoterodine, there are no clinically significant changes in the plasma concentrations of combined oral contraceptives containing ethinyl estradiol and levonorgestrel [see Clinical Pharmacology ( 12.3 )].

7.7Warfarin A clinical study has shown that fesoterodine 8 mg once daily has no significant effect on the pharmacokinetics or the anticoagulant activity (PT/INR) of warfarin 25 mg. Standard therapeutic monitoring for warfarin should be continued [see Clinical Pharmacology ( 12.3 )].

7.8Drug-Laboratory Test Interactions Interactions between fesoterodine fumarate extended-relea…

👥 Use in Specific Populations ~3 min read

8 USE IN SPECIFIC POPULATIONS

8.1Pregnancy Risk Summary There are no available data with the use of fesoterodine fumarate extended-release tablets in pregnant women and adolescents to evaluate for a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes. In animal reproduction studies, oral administration of fesoterodine to pregnant mice and rabbits during organogenesis resulted in fetotoxicity at maternal exposures that were 6 and 3 times respectively the maximum recommended human dose (MRHD) of 8 mg/day, based on AUC (see Data) .

The background risk of major birth defects and miscarriage for the indicated population are unknown. However, in the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively. Data Animal Data No dose-related teratogenicity was observed in reproduction studies performed in mice and rabbits.

In mice at 6 to 27 times the expected exposure at the maximum recommended human dose (MRHD) of 8 mg based on AUC (75 mg/kg/day, oral), increased resorptions and decreased live fetuses were observed. One fetus with cleft palate was observed at each dose (15, 45, and 75 mg/kg/day), at an incidence within the background historical range. In rabbits treated at 3 to 11 times the MRHD (27 mg/kg/day, oral), incompletely ossified sternebrae (retardation of bone development) and reduced survival were observed in fetuses.

In rabbits at 9 to 11 times the MRHD (4.5 mg/kg/day, subcutaneous), maternal toxicity and incompletely ossified sternebrae were observed in fetuses (at an incidence within the background historical range). In rabbits at 3 times the MRHD (1.5 mg/kg/day, subcutaneous), decreased maternal food consumption in the absence of any fetal effects was observed. Oral administration of 30 mg/kg/day fesoterodine to mice in a pre- and post-natal development study resulted in decreased body weight of the dams and delayed ear opening of the pups.

No effects were noted on mating and reproduction of the F 1 dams or on the F 2 offspring.

8.2Lactation Risk Summary There is no information on the presence of fesoterodine in human milk, the effects on the breastfed child, or the effects on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for fesoterodine and any potential adverse effects on the breastfed child from fesoterodine or from the underlying maternal condition.

8.4Pediatric Use The safety and effectiveness of fesoterodine fumarate extended-release tablets have been established for the treatment of neurogenic detrusor overactivity (NDO) in pediatric patients aged 6 years and older and weighing greater than 25 kg. The information on this use is discussed throughout labeling. Use of fesoterodine fumarate extended-release tablets for treatment of NDO is supported by evidence from a randomized, open-label trial with an initial 12-week efficacy phase followed by a 12-week safety extension phase in pediatric patients from 6 years to 17 years of age (Study 3) [see Adverse Reactions ( 6.1 ) and Clinical Studies ( 14.2 )] .

Study results demonstrated that treatment with fesoterodine fumarate extended-release tablets 4 mg and 8 mg daily resulted in improvements from baseline to Week 12 in maximum cystometric bladder capacity (MCBC) for patients weighing greater than 25 kg [see Clinical Studies ( 14.2 ) and Clinical Pharmacology ( 12.3 )] . The most commonly reported adverse reactions in patients who received fesoterodine fumarate extended-release tablets 4 mg or 8 mg in Study 3 (≥2%) were diarrhea, UTI, dry mouth, constipation, abdominal pain, nausea, weight increase and headache [see Adverse Reactions ( 6.1 )] .

Mean increases from baseline in heart rate were reported with both the 4 mg and 8 mg daily doses of fesoterodine fumarate extended-release tablets, with larger mean increases reported in…

🤰 Pregnancy ~1 min read

8.1Pregnancy Risk Summary There are no available data with the use of fesoterodine fumarate extended-release tablets in pregnant women and adolescents to evaluate for a drug-associated risk of major birth defects, miscarriage or adverse maternal or fetal outcomes. In animal reproduction studies, oral administration of fesoterodine to pregnant mice and rabbits during organogenesis resulted in fetotoxicity at maternal exposures that were 6 and 3 times respectively the maximum recommended human dose (MRHD) of 8 mg/day, based on AUC (see Data) .

The background risk of major birth defects and miscarriage for the indicated population are unknown. However, in the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively. Data Animal Data No dose-related teratogenicity was observed in reproduction studies performed in mice and rabbits.

In mice at 6 to 27 times the expected exposure at the maximum recommended human dose (MRHD) of 8 mg based on AUC (75 mg/kg/day, oral), increased resorptions and decreased live fetuses were observed. One fetus with cleft palate was observed at each dose (15, 45, and 75 mg/kg/day), at an incidence within the background historical range. In rabbits treated at 3 to 11 times the MRHD (27 mg/kg/day, oral), incompletely ossified sternebrae (retardation of bone development) and reduced survival were observed in fetuses.

In rabbits at 9 to 11 times the MRHD (4.5 mg/kg/day, subcutaneous), maternal toxicity and incompletely ossified sternebrae were observed in fetuses (at an incidence within the background historical range). In rabbits at 3 times the MRHD (1.5 mg/kg/day, subcutaneous), decreased maternal food consumption in the absence of any fetal effects was observed. Oral administration of 30 mg/kg/day fesoterodine to mice in a pre- and post-natal development study resulted in decreased body weight of the dams and delayed ear opening of the pups.

No effects were noted on mating and reproduction of the F 1 dams or on the F 2 offspring.

🧒 Pediatric Use ~1 min read

8.4Pediatric Use The safety and effectiveness of fesoterodine fumarate extended-release tablets have been established for the treatment of neurogenic detrusor overactivity (NDO) in pediatric patients aged 6 years and older and weighing greater than 25 kg. The information on this use is discussed throughout labeling. Use of fesoterodine fumarate extended-release tablets for treatment of NDO is supported by evidence from a randomized, open-label trial with an initial 12-week efficacy phase followed by a 12-week safety extension phase in pediatric patients from 6 years to 17 years of age (Study 3) [see Adverse Reactions ( 6.1 ) and Clinical Studies ( 14.2 )] .

Study results demonstrated that treatment with fesoterodine fumarate extended-release tablets 4 mg and 8 mg daily resulted in improvements from baseline to Week 12 in maximum cystometric bladder capacity (MCBC) for patients weighing greater than 25 kg [see Clinical Studies ( 14.2 ) and Clinical Pharmacology ( 12.3 )] . The most commonly reported adverse reactions in patients who received fesoterodine fumarate extended-release tablets 4 mg or 8 mg in Study 3 (≥2%) were diarrhea, UTI, dry mouth, constipation, abdominal pain, nausea, weight increase and headache [see Adverse Reactions ( 6.1 )] .

Mean increases from baseline in heart rate were reported with both the 4 mg and 8 mg daily doses of fesoterodine fumarate extended-release tablets, with larger mean increases reported in pediatric patients who received the 8 mg daily dose [see Adverse Reactions ( 6.1 )]. The safety and effectiveness of fesoterodine fumarate extended-release tablets have not been established in pediatric patients younger than 6 years of age or weighing 25 kg or less.

🧓 Geriatric Use 147 words

8.5Geriatric Use No dose adjustment is recommended for the elderly. The pharmacokinetics of fesoterodine are not significantly influenced by age. Of the 1,567 patients who received fesoterodine fumarate extended-release tablets 4 mg or 8 mg orally once daily in Phase 2 and 3, placebo-controlled, efficacy and safety studies for OAB, 515 (33%) were 65 years of age or older, and 140 (9%) were 75 years of age or older.

No overall difference in effectiveness was observed between patients younger than 65 years of age and those 65 years of age or older in these studies. However, the incidence of antimuscarinic adverse reactions, including dry mouth, constipation, dyspepsia, increase in residual urine, dizziness (8 mg only) and urinary tract infection, was higher in patients 75 years of age and older as compared to younger patients [see Clinical Studies ( 14.1 ) and Adverse Reactions ( 6 )].

🆘 Overdosage 29 words

10 OVERDOSAGE Overdosage with fesoterodine fumarate extended-release tablets can result in severe anticholinergic effects. Treatment should be symptomatic and supportive. In the event of overdosage, ECG monitoring is recommended.

🧬 Clinical Pharmacology ~3 min read

12 CLINICAL PHARMACOLOGY

12.1Mechanism of Action Fesoterodine is a competitive muscarinic receptor antagonist. After oral administration, fesoterodine is rapidly and extensively hydrolyzed by nonspecific esterases to its active metabolite, 5-hydroxymethyl tolterodine, which is responsible for the antimuscarinic activity of fesoterodine. Muscarinic receptors play a role in contractions of urinary bladder smooth muscle.

Inhibition of these receptors in the bladder is presumed to be the mechanism by which fesoterodine produces its effects.

12.2Pharmacodynamics In a urodynamic study involving patients with involuntary detrusor contractions, the effects after the administration of fesoterodine on the volume at first detrusor contraction and bladder capacity were assessed. Administration of fesoterodine increased the volume at first detrusor contraction and bladder capacity in a dose-dependent manner. These findings are consistent with an antimuscarinic effect on the bladder.

Cardiac Electrophysiology The effect of fesoterodine 4 mg and 28 mg on the QT interval was evaluated in a double-blind, randomized, placebo- and positive-controlled (moxifloxacin 400 mg once a day) parallel trial with once-daily treatment over a period of 3 days in 261 male and female subjects aged 44 to 65 years. Electrocardiographic parameters were measured over a 24-hour period at pre-dose, after the first administration, and after the third administration of study medication. Fesoterodine 28 mg was chosen because this dose, when administered to CYP2D6 extensive metabolizers, results in an exposure to the active metabolite that is similar to the exposure in a CYP2D6 poor metabolizer receiving fesoterodine 8 mg together with CYP3A4 blockade.

Corrected QT intervals (QTc) were calculated using Fridericia's correction and a linear individual correction method. Analyses of 24-hour average QTc, time-matched baseline-corrected QTc, and time-matched placebo-subtracted QTc intervals indicate that fesoterodine at doses of 4 and 28 mg/day did not prolong the QT interval. The sensitivity of the study was confirmed by positive QTc prolongation by moxifloxacin.

In this study, conducted in subjects aged 44 to 65 years, fesoterodine fumarate extended-release tablets was associated with an increase in heart rate that correlates with increasing dose. When compared to placebo, the mean increase in heart rate associated with fesoterodine 4 mg/day and fesoterodine 28 mg/day was 3 beats/minute and 11 beats/minute, respectively. In the two, phase 3, placebo-controlled studies in adult in patients with overactive bladder, the mean increases in heart rate compared to placebo were 3 to 4 beats/minute in the fesoterodine 4 mg/day group and 3 to 5 beats/minute in the fesoterodine 8 mg/day group.

12.3Pharmacokinetics Absorption After oral administration, fesoterodine is well absorbed. Due to rapid and extensive hydrolysis by nonspecific esterases to its active metabolite 5-hydroxymethyl tolterodine, fesoterodine cannot be detected in plasma. Bioavailability of the active metabolite is 52%.

After single or multiple-dose oral administration of fesoterodine in doses from 4 mg to 28 mg, plasma concentrations of the active metabolite are proportional to the dose. Maximum plasma levels are reached after approximately 5 hours. No accumulation occurs after multiple-dose administration.

A Summary of pharmacokinetic parameters for the active metabolite after a single dose of fesoterodine fumarate extended-release tablets 4 mg and 8 mg in extensive and poor metabolizers of CYP2D6 is provided in Table 8. Table 8: Summary of Geometric Mean [CV] Pharmacokinetic Parameters for the Active Metabolite After a Single Dose of Fesoterodine Fumarate Extended-Release Tablets 4 mg and 8 mg in Extensive and Poor CYP2D6 Metabolizers Fesoterodine fumarate extended-release tablets 4 mg Fesoterodine fumarate extended-release tablets 8 mg Parameter EM (N=16) PM (N=8) EM (N=16) PM (N=8) C max (ng/mL) 1.89 [43%] 3.…

🧬 Mechanism of Action 69 words

12.1Mechanism of Action Fesoterodine is a competitive muscarinic receptor antagonist. After oral administration, fesoterodine is rapidly and extensively hydrolyzed by nonspecific esterases to its active metabolite, 5-hydroxymethyl tolterodine, which is responsible for the antimuscarinic activity of fesoterodine. Muscarinic receptors play a role in contractions of urinary bladder smooth muscle.

Inhibition of these receptors in the bladder is presumed to be the mechanism by which fesoterodine produces its effects.

📦 How Supplied / Storage and Handling 106 words

16 HOW SUPPLIED/STORAGE AND HANDLING Fesoterodine fumarate extended-release tablets 4 mg are light blue, oval, biconvex, film coated tablets debossed with 'H' on one side and 'F6' on the other side. They are supplied as follows: Bottles of 30 tablets NDC 31722-033-30 Bottles of 90 tablets NDC 31722-033-90 Fesoterodine fumarate extended-release tablets 8 mg are blue, oval, biconvex, film coated tablets debossed with 'H' on one side and 'F7' on the other side. They are supplied as follows: Bottles of 30 tablets NDC 31722-034-30 Bottles of 90 tablets NDC 31722-034-90 Store at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature].

Protect from moisture.

📋 Description 138 words

11 DESCRIPTION Fesoterodine fumarate tablet contains fesoterodine fumarate and is an extended-release tablet. Fesoterodine is rapidly de-esterified to its active metabolite (R)-2-(3-diisopropylamino-1-phenylpropyl)-4-hydroxymethyl-phenol, or 5-hydroxymethyl tolterodine, which is a muscarinic receptor antagonist. Chemically, fesoterodine fumarate is designated as Isobutyric acid 2-((R)-3-diisopropylammonium-1-phenylpropyl)-4-(hydroxymethyl) phenyl ester hydrogen fumarate.

The empirical formula is C 30 H 41 NO 7 and its molecular weight is 527.66. The structural formula is: Fesoterodine fumarate is a white to off-white powder, which is freely soluble in water and soluble in methanol. Each Fesoterodine fumarate extended-release tablet contains either 4 mg or 8 mg of fesoterodine fumarate and the following inactive ingredients: citric acid monohydrate, colloidal silicon dioxide, FD&C blue#2/ indigo carmine aluminum lake, glyceryl behenate, hypromellose, lecithin, polyethylene glycol, polyvinyl alcohol, pregelatinized starch, talc and titanium dioxide.

The botanical source for pregelatinized starch is maize starch. structure

💬 Information for Patients 200 words

17 PATIENT COUNSELING INFORMATION Advise the patient to read the FDA-Approved Patient Labeling (Patient Information). Angioedema Inform patients and/or their caregivers that fesoterodine fumarate extended-release tablets may cause angioedema, which could result in life-threatening airway obstruction. Advise patients and/or their caregivers to promptly discontinue fesoterodine fumarate extended-release tablets and seek immediate medical attention if they experience edema of the lips, tongue or laryngopharynx, or difficulty breathing.

Antimuscarinic Effects Inform patients that fesoterodine fumarate extended-release tablets, like other antimuscarinic agents, may produce clinically significant adverse effects related to antimuscarinic pharmacological activity including constipation and urinary retention. Fesoterodine fumarate extended-release tablets, like other antimuscarinics, may be associated with blurred vision, therefore, patients should be advised to exercise caution in decisions to engage in potentially dangerous activities until the drug's effects on the patient have been determined.

Heat prostration (due to decreased sweating) can occur when fesoterodine fumarate extended-release tablets, like other antimuscarinic drugs, is used in a hot environment. Alcohol Patients should also be informed that alcohol may enhance the drowsiness caused by fesoterodine fumarate extended-release tablets, like other anticholinergic agents. Manufactured for: Camber Pharmaceuticals, Inc.

Piscataway, NJ 08854 By: Annora Pharma Pvt. Ltd. Sangareddy - 502313, Telangana, India.

Revised: 02/2025 camberlogo

Source: FDA Structured Product Labeling, mirrored from DailyMed / openFDA. Prefer the government’s original formatting? View this label on DailyMed ↗
For educational and professional reference only — not medical advice. Pricing reflects published NADAC and CMS ASP (free public data) and may differ from your acquisition cost; always verify before billing or dispensing.