Trospium chloride: the European experience

Abstract

The primary pharmacological therapy for overactive bladder syndrome is muscarinic receptor antagonists. Muscarinic receptor blockade is effective in decreasing the symptoms of urinary urgency and urgency incontinence, but can be associated with troublesome complications, such as dry mouth, blurred vision, constipation and CNS side effects. Trospium chloride, an antimuscarinic medication, has been available in Europe for > 20 years and has recently been approved by the FDA for the treatment of overactive bladder. Trospium chloride is a quaternary amine that is minimally metabolised, not highly protein bound and, importantly, has not been demonstrated to cross the unaltered blood–brain barrier in healthy volunteers. Some characteristics of this unique antimuscarinic agent and the European experience with trospium chloride are reviewed in this article.

Acknowledgments

The authors wish to thank ESPRIT Pharma for funding this publication and IMPRINT Publication Science, New York, for their editorial support in the preparation and styling of this manuscript. H Madersbacher is an advisory board member of Indevus (USA), Apogepha (Germany) and UCB (Austria). E Rovner has served on Speakers Bureau or received consulting fees from Pfizer, Astellas, Indevus and Novartis and grant/research support from Pfizer and Q-med.