Bladder antimuscarinics
Fesoterodine
A bladder antimuscarinic taken to calm an overactive bladder and reduce urgency and leaks; it commonly causes a dry mouth and constipation.
What is Fesoterodine?
Fesoterodine is an antimuscarinic medicine used to treat an overactive bladder, helping to reduce the sudden urges to pass urine, going too often, and urgency-related leaks. It works by relaxing the bladder muscle so the bladder can hold more comfortably. Common effects include a dry mouth and constipation, and it can cause confusion in some older people.
Education and reference only. This is a plain-language guide to Fesoterodine — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Fesoterodine is a bladder antimuscarinic (anticholinergic) medicine used in the UK to treat overactive bladder, where the bladder contracts when it should be relaxed, causing a sudden need to pass urine, going too frequently, and sometimes leaks. It is taken as a modified-release tablet that is swallowed whole. It is used alongside bladder-training and lifestyle measures rather than instead of them, and its effect builds up over a few weeks.
How it works
An overactive bladder is partly driven by a chemical messenger called acetylcholine, which makes the bladder muscle contract. Fesoterodine blocks the muscarinic receptors that acetylcholine acts on in the bladder, which relaxes the bladder muscle and reduces unwanted contractions. This allows the bladder to fill and hold urine more comfortably, easing urgency, frequency and urge leaks. Because the same receptors exist elsewhere in the body, blocking them also explains side effects such as dry mouth, constipation and blurred vision.
Company & origin
Originated / developed by: Developed by Pfizer..
Fesoterodine is a bladder antimuscarinic developed by Pfizer and introduced in the late 2000s for overactive bladder.
What it treats
Conditions Fesoterodine is used for
Practical use
How to take Fesoterodine
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Swallow the tablet whole with water; do not crush or chew it.
- Take it at around the same time each day to keep the effect steady.
- Give it a fair trial of several weeks, as the full benefit builds up gradually, and combine it with bladder-training advice.
- Manage a dry mouth with sips of water or sugar-free sweets, and ease constipation with enough fluids and fibre.
- Tell your prescriber if you notice confusion, marked drowsiness or blurred vision, especially if you are older.
- Have your eyes checked if you have, or are at risk of, the type of glaucoma that raises eye pressure.
Weighing it up
Advantages & disadvantages of Fesoterodine
Advantages
- It effectively reduces urgency, frequency and urge-related leaks for many people.
- It is taken once a day, which is simple to fit into a routine.
- It works well alongside bladder-training and lifestyle measures.
Disadvantages
- Dry mouth and constipation are common and can be bothersome.
- It can cause confusion or memory problems in some older people.
- The full effect takes a few weeks, so it does not work straight away.
Practical use
Good to know
Like other antimuscarinics it commonly causes a dry mouth, constipation and sometimes blurred vision, because it blocks the same receptors throughout the body. In older people it can occasionally cause confusion or worsen memory, so it is used carefully and the benefit is reviewed. It can take a few weeks to work fully, so it is worth giving it a fair trial alongside bladder training. The tablet should be swallowed whole rather than crushed or chewed. Sips of water, sugar-free sweets and good fluid and fibre intake can help with dry mouth and constipation.
Who should not take it / use with caution
- People with urinary retention (difficulty emptying the bladder) or a blockage of the stomach or bowel.
- People with the type of glaucoma that raises eye pressure (uncontrolled narrow-angle glaucoma).
- People with severe ulcerative colitis or certain serious bowel or liver problems, and anyone allergic to fesoterodine.
Monitoring
- Review of whether bladder symptoms have improved after a few weeks.
- Watching for troublesome dry mouth, constipation, blurred vision and confusion, especially in older people.
- Checking that the bladder is emptying properly if retention is a concern.
Side effects
- Dry mouth, which is the most common effect.
- Constipation and sometimes indigestion.
- Blurred vision and dry eyes.
- Confusion or drowsiness, more likely in older people.
Key interactions
- Other medicines with antimuscarinic effects (such as some antihistamines, certain antidepressants and other bladder medicines) add to dry mouth, constipation and confusion.
- Some medicines that affect liver enzymes can raise fesoterodine levels and may need a lower dose.
- Tell your prescriber about all your medicines, as combined anticholinergic effects can build up.
Available as: Modified-release tablets taken by mouth.
Answers
Fesoterodine: frequently asked questions
How does fesoterodine help an overactive bladder?
It blocks the signals that make the bladder muscle contract when it should be relaxed. This calms unwanted contractions so the bladder can hold urine more comfortably, reducing sudden urges, going too often and urgency-related leaks.
Why does it give me a dry mouth?
Fesoterodine blocks receptors not only in the bladder but in other parts of the body, including the glands that make saliva. This is why a dry mouth is the most common effect; sips of water and sugar-free sweets can help.
How long does it take to work?
The full benefit usually builds up over a few weeks, so it is worth giving it a fair trial rather than expecting an immediate change. Combining it with bladder-training advice tends to give the best results.
Is it safe for older people?
It can be used in older people, but it may sometimes cause confusion or affect memory, so the benefit is reviewed carefully. Tell your prescriber if you or a relative notice new confusion or drowsiness while taking it.
Should I swallow the tablet whole?
Yes. It is a modified-release tablet designed to release the medicine slowly, so it should be swallowed whole with water and not crushed or chewed, which could release too much at once.
The wider class
About Bladder antimuscarinics
Fesoterodine belongs to the bladder antimuscarinics class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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