Comparative Pharmacology
Head-to-head clinical analysis: DUO MEDIHALER versus TOLTERODINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DUO MEDIHALER versus TOLTERODINE.
DUO-MEDIHALER vs TOLTERODINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Combination of fluticasone propionate, a corticosteroid with anti-inflammatory activity, and salmeterol, a long-acting beta2-adrenergic agonist (LABA) that relaxes bronchial smooth muscle by stimulating intracellular adenyl cyclase, increasing cyclic AMP levels.
Competitive antagonist of muscarinic acetylcholine receptors (M1, M2, M3, M4, M5), with selectivity for the M3 receptor subtype involved in detrusor muscle contraction, reducing bladder smooth muscle contractility and increasing bladder capacity.
Two inhalations (50 mcg ipratropium bromide and 100 mcg fenoterol hydrobromide per inhalation) four times daily via metered-dose inhaler.
2 mg PO twice daily; may reduce to 1 mg twice daily if tolerated.
None Documented
None Documented
Clinical Note
moderateTolterodine + Sulfisoxazole
"The metabolism of Sulfisoxazole can be decreased when combined with Tolterodine."
Clinical Note
moderateTolterodine + Cyclosporine
"The metabolism of Cyclosporine can be decreased when combined with Tolterodine."
Clinical Note
moderateTolterodine + Fluconazole
"The metabolism of Fluconazole can be decreased when combined with Tolterodine."
Clinical Note
moderateTolterodine + Clotrimazole
Terminal elimination half-life of 3-4 hours for the bronchodilator component and 6-8 hours for the corticosteroid component; clinically requires twice-daily dosing.
Terminal elimination half-life is 2-4 hours in extensive CYP2D6 metabolizers; increased to 4-10 hours in poor metabolizers or with CYP3A4 inhibitors.
Renal: 70-80% (free drug and metabolites), Biliary/Fecal: 10-20%
Primarily hepatic metabolism via CYP2D6 and CYP3A4; renal excretion accounts for <5% of unchanged drug; ~80% excreted in urine as metabolites, ~20% in feces.
Category C
Category A/B
Anticholinergic/Beta2-Agonist Combination
Anticholinergic
"The metabolism of Clotrimazole can be decreased when combined with Tolterodine."