Fesoterodine fumarate
Brand names: Toviaz
Fesoterodine fumarate is an oral antimuscarinic prodrug used for overactive bladder with urgency, frequency, and urge incontinence. It is converted to its active metabolite, which is shared with tolterodine.
ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.
Clinical monograph
How it works
Its active metabolite competitively antagonises muscarinic receptors on detrusor smooth muscle, reducing involuntary bladder contractions and urgency.
Prescribing in practice
- Contraindicated in urinary retention, gastric retention, and uncontrolled narrow-angle glaucoma because antimuscarinic effects can worsen these conditions.
- Be mindful of cumulative anticholinergic burden when combined with other antimuscarinic or sedating drugs, particularly in frail older patients.
- Dose restriction is needed with potent CYP3A4 inhibitors and in severe renal or hepatic impairment per the SPC.
Monitoring
Review symptomatic response after several weeks and monitor for anticholinergic effects and urinary retention.
Counselling the patient
- Dry mouth and constipation are common; adequate fluids and fibre can help.
- Seek advice if you cannot pass urine or develop eye pain or blurred vision.
- Swallow the prolonged-release tablet whole.
Evidence & guidelines
Licensed for overactive bladder on the basis of randomised trials demonstrating reductions in urgency incontinence episodes versus placebo.
Reference: NICE NG123; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).
Related
Curated clinical cross-links plus same-class fallbacks.