Trospium is an antispasmotic and anticholinergic agent used to treat urinary incontinence and overactive bladder syndrome. Trospium has not been implicated in causing liver enzyme elevations or clinically apparent acute liver injury.
Trospium (trose' pee um) is a synthetic anticholinergic agent that inhibits muscarinic actions of acetylcholine on autonomic nerve endings, decreasing secretions and inhibiting gastrointestinal and bladder motility. Trospium increases bladder capacity and decreases bladder contractions and the urgency of urination. Trospium was approved for use in the United States in 1975 and indications include urinary urge incontinence and symptoms of overactive bladder such as urinary urgency and frequency. Trospium is available in tablets of 20 mg in generic forms and under the brand name Sanctura. The recommended adult oral dose is 20 once or twice daily. Common side effects are those of parasympathetic stimulation and include dryness of the mouth and eyes, decreased sweating, headache, visual blurring, constipation, urinary retention, restlessness, confusion and hallucinations. Anticholinergic agents can precipitate acute narrow angle glaucoma and acute urinary retention.
Like other anticholinergic agents, trospium has not been linked to episodes of liver enzyme elevations or clinically apparent liver injury. A major reason for its safety may relate to the low daily dose. Trospium is probably metabolized in the liver but its metabolic pathways have not been defined.
References on the safety and potential hepatotoxicity of anticholinergics are given together in the overview section on anticholinergic agents.
Drug Class: Anticholinergic Agents
Trospium – Generic, Sanctura®
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