|Trade names||Toviaz, others|
|Main uses||Overactive bladder syndrome (OAB)|
|Side effects||Dry mouth, constipation|
|Typical dose||4 to 8 mg/day|
|Bioavailability||52% (active metabolite)|
|Protein binding||50% (active metabolite)|
|Metabolism||Liver (CYP2D6- and 3A4-mediated)|
|Elimination half-life||7–8 hours (active metabolite)|
|Excretion||Kidney (70%) and fecal (7%)|
|Chemical and physical data|
|Molar mass||411.586 g·mol−1|
|3D model (JSmol)|
|(what is this?)|
Fesoterodine, sold under the brand name Toviaz among others, is a medication used to treat the symptoms of overactive bladder syndrome (OAB). It is a second line medication for this use. It is taken by mouth.
Common side effects include dry mouth and constipation. Other side effects may include urinary retention, trouble sleeping, and dizziness. It is not recommended in people with severe liver problems or myasthenia gravis. It is an antimuscarinic and works via the same chemical as tolterodine.
Fesoterodine was approved for medical use in Europe in 2007, the United States in 2008, and Canada in 2012. In the United States it costs about 310 USD per month as of 2021. This amount in the United Kingdom costs the NHS about £26.
Fesoterodine has the advantage of allowing more flexible dosage than other muscarinic antagonists. Its tolerability and side effects are similar to other muscarinic antagonists and as a new drug seems unlikely to make great changes in practices of treatment for overactive bladder.
A Japanese study from 2017, showed that urgency and urge incontinence are improved after 3 days administration of the drug, with full efficacy able to be judged after 7 days administration. Overactive bladder was found to be resolved in 88% of patients after seven days usage. 
It is usually used at 4 to 8 mg once per day.
Mechanism of action
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