Anticholinergic ADEs are common with trospium (Table 4). More than half of the patients in the clinical trials experienced one or more ADEs. The most commonly reported ADEs were dry mouth, constipation, abdominal pain (upper), constipation (aggravated), headache, and fatigue.

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Trospium chloride is a quaternary amine that antagonizes the effect of acetylcholine on muscarinic receptors in cholinergically innervated organs. It exhibits parasympatholytic action by reducing the detrusor tone of smooth muscle in the bladder as well as uncontrolled detrusor contractions that can cause OAB with incontinence.

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Less than 10% of the trospium dose is absorbed following oral administration; peak plasma concentrations (C_max) are achieved five to six hours after a single dose. Exposure causes a decrease in the C_max and an area-under-the-curve (AUC) concentration of up to 59% and 33%, respectively, for evening doses and morning doses. Because high-fat meals decrease the absorption of trospium by 70% to 80%, this agent should be taken one hour before meals or on an empty stomach.

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INTRODUCTION

Overactive bladder (OAB) is a symptom syndrome that refers to the layered, smooth muscle that surrounds the bladder, the detrusor muscle. This muscle contracts spastically, sometimes without a known cause, resulting in sustained, high bladder pressure and the urgent need to urinate. People with OAB often experience urgency at inconvenient and unpredictable times. This urgency can interfere with daily routines, intimacy, and sexual function, all of which can lead to embarrassment, low self-esteem, and a diminished quality of life.

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