fesoterodine / Generic mfg. - LARVOL DELTA

Persistence of Anticholinergic Agents in Patients With Overactive Bladder: A Cohort Study From the French National Health Insurance Claim Database (SNDS) (ISPOR-EU 2025) - "Solifenacin was the most prescribed at initiation (41.4%), followed by fesoterodine (38.4%). This study reveals limited persistence with ACH in the management of OAB in France. Most patients discontinued after a single delivery and remained without OAB treatment after 1-year of follow-up. These results highlight the need for strategies addressing treatment optimization and maintaining treatment adherence."

Claims database • Clinical • Reimbursement • US reimbursement • Cardiovascular • Hypertension • Overactive Bladder

Comparative assessment of oral medications for overactive bladder in older adults: a systematic review and network meta-analysis. (PubMed, Aging Male) - "In terms of reducing Micturitions, the interventions were ranked: trospium chloride (TRO), fesoterodine (FES) 4/8 mg, vibegron (VIB), mirabegron (MIR) 25/50 mg, tolterodine ER (TOL) 4 mg, placebo (PBO), of which only TOL showed no significant difference compared to placebo; Forsafety, the TEAE of TOL 4/8 mg had the highest incidence and was significantly different from others; MIR, VIB, and FES 4mg were well-tolerated regarding dry mouth and constipation; TOL 4 mg, FES 4/8 mg, and VIB showed a statistically increase from placebo for headache and FES 4/8mg and MIR 25 mg showed a statistically increase for dizziness. TRO 60 mg has the best efficacy in reducing micturitions, but increases the incidence of dry mouth and constipation; VIB and MIR are well tolerated in dry mouth and constipation, but may increase the risk of headache or dizziness."

Clinical • Journal • Retrospective data • Review • Constipation • Gastroenterology • Gastrointestinal Disorder • Overactive Bladder • Pain • Xerostomia • MIR25

Evaluation of the Potential Inhibitory Effects of Medications for Detrusor Overactivity on Platelet-Activating Factor (PAF)-Induced Mechanical Activity in Guinea Pig Bladder Smooth Muscle. (PubMed, Biol Pharm Bull) - "Ten clinically used DO drugs-oxybutynin, tolterodine, fesoterodine, propiverine, propantheline, solifenacin, imidafenacin, flavoxate, urapidil, and clenbuterol-were tested at a concentration of 10 μM, exceeding typical therapeutic plasma levels. Furthermore, oxybutynin (10 μM) also decreased 60 mM KCl-induced contractions by a similar extent and nearly abolished acetylcholine (ACh, 10 μM)-induced contractions. These findings suggest that oxybutynin suppresses PAF-induced UBSM hyperactivity through a mechanism distinct from its anticholinergic effect, likely mediated by blockade of voltage-dependent Ca2+ channels (VDCCs)."

Journal • Overactive Bladder

Comparison of the Efficacy of Vibegron and Fesoterodine for Neurogenic Detrusor Overactivity in Individuals With Spinal Cord Lesion: A Single-Center Prospective Randomized Crossover Trial. (PubMed, Neurourol Urodyn) - "Vibegron significantly improved CMG parameters in addition to alleviating UI symptoms, demonstrating efficacy that was not inferior to that of fesoterodine. With a lower incidence of adverse events and high patient satisfaction, vibegron may serve as a useful therapeutic option for the treatment of NDO in individuals with SCL."

Journal • CNS Disorders • Orthopedics

Antimuscarinics for burn patients: Helpful or harmful for sensation recovery? (PubMed, Burns) - "Burn patients on antimuscarinic therapy were more likely to develop paresthesia, possibly indicating nerve regeneration. While this may reflect sensory recovery, it could also lead to abnormal or painful sensations that negatively impact quality of life. Further research is needed to assess functional outcomes."

Journal • Diabetes • Metabolic Disorders • Overactive Bladder • Pain • Thermal Injury

Medication Use in Multiple Sclerosis: A Population-Based Comparison With the General Danish Population. (PubMed, Ann Clin Transl Neurol) - "This large, population-based study reveals extensive use of medications targeting symptoms and comorbidities in individuals with multiple sclerosis. These insights can guide healthcare providers in optimizing patient management, addressing overlooked treatment needs, and improving overall care."

Journal • Chronic Obstructive Pulmonary Disease • CNS Disorders • Constipation • Gastroenterology • Gastrointestinal Disorder • Immunology • Multiple Sclerosis • Pain • Pulmonary Disease • Respiratory Diseases

Drug-Related Visual Blurring: Findings from the U.S. Food and Drug Administration Adverse Event Reporting System Database. (PubMed, Eur J Pharmacol) - "Preventing drug-related vision issues is vital. Early risk assessment and intervention with personalized medication can reduce side effects, ensure safety, and improve quality of life."

Adverse events • Journal • Oncology • Ophthalmology • Retinal Disorders

Pharmacotherapy for overactive bladder syndrome and the risk of incident dementia. (PubMed, World J Urol) - "Most anticholinergic medications and mirabegron are associated with an increased risk of dementia compared to untreated controls with OAB, while fesoterodine was not found to be associated with an increased risk in any group."

Clinical • Journal • Retrospective data • Alzheimer's Disease • CNS Disorders • Dementia • Overactive Bladder

Can Pharmacogenetics Be Used to Predict the Response to Fesoterodine Fumarate? (PubMed, Urogynecology (Phila)) - "In this pilot study with limited sample size, CYP2D6 normal and IM metabolizer status was not associated with effectiveness or moderate-severe AEs to fesoterodine fumarate. The proportion of poor metabolizers was low; thus, further investigation in this population is warranted."

Biomarker • Journal • Oncology • Urinary Incontinence • Urology • CYP2D6

Comparisons of urinary bladder responses to common antimuscarinics reveals unique effects of darifenacin. (PubMed, Front Physiol) - "Carbachol concentration-response curves were performed on paired tissues in the absence or presence of commonly prescribed antimuscarinics: darifenacin, fesoterodine, oxybutynin, solifenacin, trospium, and tolterodine. Darifenacin reduced the maximum contraction in adult U&LP preparations to carbachol by 49% and to αβ-methylene-ATP by 35%. Darifenacin presents as an antimuscarinic medication that influences non-muscarinic pathways in urinary bladder tissue, indicating its potential to assist OAB patients with non-muscarinic pathophysiology."

Journal • Overactive Bladder

Bladder drugs and risk of dementia: Danish nationwide active comparator study. (PubMed, BMJ Med) - "Conditional logistic regression provided incidence rate ratios for associations between anticholinergic bladder drugs and dementia compared with non-use and mirabegron use adjusted for educational level, cardiovascular disease, diabetes, hypertension, dyslipidaemia, and Charlson Comorbidity Index...Compared with non-use, all types of anticholinergic bladder drugs were associated with increased incidence rate ratios for dementia: tolterodine 1.43 (95% CI 1.38 to 1.49), solifenacin 1.37 (1.29 to 1.46), trospium 1.52 (1.37 to 1.67), and fesoterodine 1.48 (1.26 to 1.74)...These findings highlight the relevance of using an active comparator. Future research should evaluate the risk of cognitive impairment and dementia for both types of bladder drugs."

Journal • Alzheimer's Disease • Cardiovascular • CNS Disorders • Cognitive Disorders • Dementia • Diabetes • Dyslipidemia • Hypertension • Metabolic Disorders • Urinary Incontinence • Urology

Brain distribution and muscarinic receptor occupancy of an active metabolite of fesoterodine in rats. (PubMed, J Pharmacol Exp Ther) - "SIGNIFICANCE STATEMENT: This study reports that 5-hydroxymethyl tolterodine, the active metabolite of fesoterodine, has much lower brain distribution and muscarinic receptor occupancy compared with oxybutynin and trihexyphenidyl based on brain microdialysis and in vivo receptor-binding analysis with unlabeled muscarinic tracer in rats. The low brain distribution and muscarinic receptor occupancy of 5-hydroxymethyl tolterodine might be the reasons for the insignificant effect of fesoterodine on cognitive function."

Journal • Preclinical • Alzheimer's Disease • CNS Disorders • Dementia • Overactive Bladder

Drug-induced urinary retention: a real-world pharmacovigilance study using FDA and Canada vigilance databases. (PubMed, Front Pharmacol) - "Disproportionality analysis revealed significant signals for 34 drugs (68%), with the highest RORs observed in Fesoterodine, Mirabegron, and Solifenacin. Initial signal detection identified potential new UR signals for Abiraterone, Valacyclovir, Fluoxetine, Empagliflozin, Clopidogrel, and Amlodipine, with CVAR confirming signals for Abiraterone, Fluoxetine, and Empagliflozin...The study identifies a rising trend in drug-related UR reports over the past 2 decades. The validation of new signals for Abiraterone, Fluoxetine, and Empagliflozin underscores the critical need for continuous drug safety monitoring and targeted research to better understand the mechanisms behind drug-induced UR."

Adverse events • Journal • Real-world evidence • Oncology

Trends in Medicare Coverage of Overactive Bladder Medications in the United States. (PubMed, Urogynecology (Phila)) - "Beta-3 agonists had worse coverage across insurers nationwide. Current trends in Medicare coverage reveal a need for improved coverage of preferred OAB medications for an aging population already at risk of cognitive dysfunction."

Journal • Medicare • Reimbursement • US reimbursement • Cognitive Disorders • Overactive Bladder

Risk of dementia associated with anticholinergic drugs for overactive bladder in adults aged ≥55 years: nested case-control study. (PubMed, BMJ Med) - "Cumulative drug use (defined using total standardised daily dose) of different anticholinergic drugs used for the treatment of an overactive bladder, and a non-anticholinergic drug, mirabegron, in the period 3-16 years before a diagnosis of dementia (or equivalent date in matched controls)...No significant increases in the risk of dementia associated with darifenacin, fesoterodine fumarate, flavoxate hydrochloride, propiverine hydrochloride, and trospium chloride were found...Of the different anticholinergic drugs used to treat an overactive bladder, oxybutynin hydrochloride, solifenacin succinate, and tolterodine tartrate were found to be most strongly associated with the risk of dementia in older adults. This finding emphasises the need for clinicians to take into account the possible long term risks and consequences of the available treatment options for an overactive bladder in older adults, and to consider prescribing alternative treatments that might be associated..."

Journal • Alzheimer's Disease • CNS Disorders • Dementia • Overactive Bladder • Urinary Incontinence • Urology

Disproportionality analysis of drug-induced dry mouth using data from the United States food and drug administration adverse event reporting system database. (PubMed, Heliyon) - "Disproportionality analysis revealed that the top five drugs with the highest reporting odds ratio (ROR) were darifenacin, solifenacin succinate, fesoterodine fumarate, tolterodine tartrate, and niraparib. Tiotropium bromide monohydrate was the most frequently reported drug for dry mouth, whereas darifenacin had the highest ROR. Collectively, our findings emphasize the necessity for improved recognition and management of drug-induced dry mouth, particularly for medications not adequately flagged for this side effect in their labels."

Adverse events • Journal • Xerostomia

Two Cases of Interstitial Cystitis and Nephrology Consultation (KIDNEY WEEK 2024) - "She was started on amitriptyline, gabapentin, duloxetine and multimodal pain medications without any response. She was started on hydroxychloroquine with no response after 3 months then switched to methotrexate without any reduction in bladder pain...At this point, nephrology was consulted for a trial of off-label cyclosporine therapy prior to offering cystectomy.Case #2: A 39-year-old Chinese male developed ulcerating eosinophilic interstitial cystitis with hematuria and pyuria from ketamine use vs primary cystitis...The patient was treated with trials of antibiotics, fesoterodine, oxybutynin, trospium chloride, and mirabegron over the course of 3 years...Multidisciplinary management and early involvement of nephrology may result in improved outcomes in patients suffering from interstitial cystitis. Given the complex and potentially intransigent nature of the disease, nephrologists should be aware of potential standard and off-label treatments for these patients.."

Clinical • Acute Kidney Injury • Chronic Kidney Disease • Fibromyalgia • Gynecology • Immunology • Inflammatory Arthritis • Interstitial Cystitis • Musculoskeletal Pain • Nephrology • Pain • Renal Disease • Rheumatoid Arthritis • Rheumatology • Urology

An Investigational Study on the Role of CYP2D6, CYP3A4 and UGTs Genetic Variation on Fesoterodine Pharmacokinetics in Young Healthy Volunteers. (PubMed, Pharmaceuticals (Basel)) - "Fesoterodine is extensively hydrolyzed by esterases to 5-hydroxymethyl tolterodine (5-HMT), the major active metabolite. CYP2D6 might have a more important role than CYP3A4 in fesoterodine pharmacokinetics, and its phenotype might be a better predictor of variation in its pharmacokinetics. An association was observed between different genetic variants of different genes of the UGT family and AUC, Cmax, and CL/F of 5-HMT, which should be confirmed in other studies."

Journal • PK/PD data • Overactive Bladder • COMT • CYP3A4 • NAT2

An update on the cognitive safety of antimuscarinics in the treatment of overactive bladder. (PubMed, Expert Opin Drug Saf) - "Fesoterodine has shown tolerance without cognitive decline in controlled trials. However, Tolterodine and Solifenacin present conflicting evidence regarding cognitive impairment and dementia risk, respectively, necessitating additional research to ascertain their safety profiles. Careful monitoring and treatment of patients taking these medications for cognitive impairment are essential. Further research, particularly in vulnerable populations, is crucial to establish cognitive safety profiles of various antimuscarinics and inform optimal OAB treatment strategies."

Journal • Review • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Dementia • Overactive Bladder

The impact of anticholinergics on cognitive function in patients with neurogenic lower urinary tract dysfunction: A narrative review. (PubMed, Indian J Urol) - "Two studies (one in people with SCI and another in MS) found evidence of cognitive impairment with the use of OAB anticholinergics (specifically oxybutynin and tolterodine)...Two recent studies in children with SB studied 12 months of solifenacin and 6 months of fesoterodine/oxybutynin and found there was no significant change in neuropsychological testing...Further study is necessary to confirm cognitive safety, particularly as the NLUTD population may have a high exposure to OAB anticholinergics. Advocating for potentially safer OAB medications is necessary if there is concern about cognitive risks."

Journal • Review • Alzheimer's Disease • Cardiovascular • CNS Disorders • Cognitive Disorders • Dementia • Movement Disorders • Multiple Sclerosis • Orthopedics • Overactive Bladder • Parkinson's Disease

Predicting muscarinic receptor occupancy in human bladder mucosa from urinary concentrations of antimuscarinic agents for overactive bladder. (PubMed, Drug Metab Pharmacokinet) - "The bladder muscarinic receptor occupancy was higher than that in the parotid gland calculated based on the mean plasma or serum unbound concentrations and Ki values for muscarinic receptors in the parotid gland. These results suggest that sufficient and selective muscarinic receptor occupancy by antimuscarinic agents, to exert pharmacological effects, in the bladder mucosa can be predicted using urinary concentrations."

Journal • Overactive Bladder

Can you name that tablet? A cross-sectional study on recognition of common urology medications. (PubMed, Ir J Med Sci) - "Patients often do not reliably know their own medications other than to describe them or show an unpackaged tablet. Prescribing safety is paramount to ensuring patient safety and reducing the risk of adverse drug reactions. This study shows that even experienced clinicians do not recognise the medications they regularly prescribe, and decisions should not be made without accurate medication reconciliation."

Journal • Observational data • Urology

A Double-blind, Randomised Four-way Crossover Study to Compare the Effects of Fesoterodine 4 and 8 mg Once Daily and Qxybutynin 5 mg Twice Daily After Steady-state Dosing Versus Placebo on Cognitive Function in Overactive Bladder-wet Patients over the Age of 75 Years with Mild Cognitive Impairment. (PubMed, Eur Urol Focus) - "Exposure to steady-state dosing of fesoterodine 4 and 8 mg or oxybutynin 5 mg b.i.d. was not associated with any detectable effect on cognitive function using a sensitive battery of cognitive tests in a group of older adult patients with MCI and OAB."

Journal • Alzheimer's Disease • CNS Disorders • Cognitive Disorders • Dementia • Overactive Bladder

Risks of Dementia After Treatment with an Anticholinergic, Beta-3 Agonist, or Combination of Both for an Overactive Bladder: A Korean National Cohort Study. (PubMed, Eur Urol Focus) - "In this large Korean cohort, the use of anticholinergics with or without a beta-3 agonist increased the risk of new-onset dementia compared with the use of a beta-3 agonist alone. Given that the risk of dementia was most significantly elevated with combination treatments, care should be taken when considering combination treatment for OAB patients with risk factors for dementia. Furthermore, there could be a possible association between beta-3 agonists and dementia, although future studies are needed."

Journal • Alzheimer's Disease • CNS Disorders • Dementia • Overactive Bladder

Robust fragment-based method of calculating hydrogen atom transfer activation barrier in complex molecules. (PubMed, Phys Chem Chem Phys) - "The two APIs studied: fesoterodine and imipramine, display considerable conformational complexity and have multiple ways of forming hydrogen bonds with the abstracting radical-a hydroxymethyl peroxyl radical. We also show that structural elements and NCIs outside the reaction site minimally influence TS core geometry and covalent activation barrier, although they more strongly affect reactant binding and consequently the overall activation barrier. We further propose a robust and economical fragment-based method to obtain overall activation barriers, by combining the covalent activation barrier calculated for a small molecular fragment with the binding free energy calculated for the whole molecule."

Journal