Fesoterodine
TOVIAZ
Pronunciation: fes-oe-TER-oe-deen (TOE-vee-as)
“Two-vizor Fester”
“Red as a beet” → antimuscarinic
What it isMuscarinic antagonist, a prodrug converted by esterases to the active metabolite of tolterodine; overactive bladder.
Why this oneEsterase activation avoids CYP2D6-dependent drug formation, making conversion more consistent than tolterodine's.
What limits itAnticholinergic burden as for the class. Renally adjusted.
FDA-approved for
- overactive bladder (2008)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Overactive bladder | adult | 4 mg QD | 8 mg QD |
Renal CLcr <30 mL/min: maximum 4 mg QD.
Hepatic Undefined
Instructions
- Swallow whole with liquid; do not chew, divide, or crush.
- Take with or without food.
Available strengths
- ER tab 4, 8 mg
Contraindications
- Urinary retention
- Gastric retention
- Uncontrolled narrow-angle glaucoma
Cautions
- Angioedema (may occur after first or later doses)
- Urinary retention in bladder outlet obstruction
- Decreased GI motility (avoid in severe constipation)
- Worsening of narrow-angle glaucoma
- CNS effects/somnolence
- Worsening of myasthenia gravis
Adverse reactions
- Dry mouth
- Constipation
Pregnancy No human data; fetotoxicity in animal studies.
Lactation No information on presence in human milk.
Cost
Generic entry2015
NO BOXED WARNINGS
Principal riskAnticholinergic burden
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityGenerally tolerated at therapeutic doses; clinically important risks are agent-specific and increase with interactions or organ impairment.
Active metabolites
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