What is it used for?

• Incontinence
• Passing urine too frequently (urinary frequency)
• Uncontrollable urges to pass urine (urinary urgency)

How does it work?

• Detrunorm tablets and Detrunorm XL modified release capsules both contain the active ingredient propiverine hydrochloride, which is a type of medicine called an anticholinergic (or antimuscarinic) muscle relaxant. It works by relaxing the involuntary muscle that is found in the wall of the bladder.
• The muscle in the wall of the bladder is called the detrusor muscle. It can sometimes contract in uncontrollable spasms, and this is often referred to as having an overactive bladder. This condition may have no known cause, or may be a result of problems with the nerve supply to the bladder following an injury to the spinal cord. The overactive detrusor muscle can increase the number of times you need to pass urine, or cause uncontrollable urges to pass urine or involuntary leakage of urine (urinary incontinence).
• Propiverine works by relaxing the detrusor muscle in the wall of the bladder. It does this by blocking receptors called cholinergic (or muscarinic) receptors that are found on the surface of the muscle cells. This prevents a natural body chemical called acetylcholine from acting on these receptors.
• Normally when acetylcholine acts on these receptors, it causes the detrusor muscle to contract and the bladder to empty. By blocking acetylcholine, propiverine helps the muscle in the bladder wall to relax. This reduces unstable, involuntary contractions of the bladder, and thereby increases the capacity of the bladder to hold urine. In turn, this reduces the need to pass urine.
• Detrunorm tablets are known as an immediate release dose form. This means that the medicine is absorbed into the bloodstream from the gut soon after the tablets are taken. These tablets are taken between two to four times a day, as your doctor feels necessary.
• Detrunorm XL capsules are known as modified release capsules. They are designed to release the medicine slowly over the day as the capsule passes through the gut. This means the capsules only need to be taken once a day. These capsules should be swallowed whole with liquid. They should not be broken, chewed or crushed, as this would stop their modified release action from working.

Warning!

• This medicine may cause drowsiness and blurred vision. If affected do not drive or operate machinary.
• If you are taking this medicine for prolonged periods of time your doctor may need to take blood tests to monitor your liver function.
• People who are at risk of developing glaucoma should have regular tests to monitor the pressure inside the eye (intraocular pressure) while taking this medicine.

Use with caution in

• Elderly people
• Decreased kidney function
• Disorder of the involuntary nerves that control the internal organs (autonomic neuropathy)
• Heart failure
• Irregular heart beats (arrhythmias)
• Increased heart rate (tachycardia)
• Coronary artery disease
• Enlarged prostate gland
• Inflammation of the foodpipe (reflux oesophagitis) as a result of acid reflux caused by a hiatus hernia
• Overactive thyroid gland (hyperthyroidism)

Not to be used in

• Children
• Blockage of the outflow of urine from the bladder
• Blockage of the bowel (bowel obstruction)
• A loss in the ability of the gut to contract (intestinal atony or paralysis)
• Severe ulcerative colitis
• Sudden expansion of the large intestine seen in advanced ulcerative colitis or Crohn's disease (toxic megacolon)
• Abnormal muscle weakness (myasthenia gravis)
• Uncontrolled closed angle glaucoma
• Fast, abnormal heart beats (tachyarrhythmias)
• Moderately to severely decreased liver function
• Pregnancy
• Breastfeeding
• Rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption (Detrunorm tablets and Detrunorm XL capsules contain lactose).

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and Breastfeeding

• This medicine should not be used during pregnancy as its safety has not been established. Seek medical advice from your doctor.
• This medicine may pass into breast milk. It should not be used by breastfeeding mothers. Seek medical advice from your doctor.

Side effects

• Dry mouth
• Blurred vision
• Constipation
• Fatigue
• Headache
• Nausea and vomiting
• Dizziness
• Tremor
• Difficulty in passing urine (urinary retention)
• Hot flushes
• Low blood pressure (hypotension)
• Drowsiness
• Rash (allergic reaction)
• Awareness of your heart beat (palpitations)
• Restlessness
• Confusion
• Fast or irregular heart beat

The side effects listed above may not include all of the side effects reported by the drug's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

There may be an increased risk of anticholinergic side effects, such as dry mouth, blurred vision, constipation and difficulty passing urine, if this medicine is taken with other medicines that have anticholinergic effects, such as the following:

• amantadine
• anticholinergic medicines for spasms of the stomach or intestines, eg hyoscine, atropine
• anticholinergic medicines for Parkinson's symptoms, eg procyclidine, orphenadrine, trihexiphenidyl (benzhexol)
• other anticholinergic medicines for urinary incontinence, eg oxybutinin and propantheline
• antihistamines, eg brompheniramine, chlorphenamine
• antipsychotic medicines, eg haloperidol, chlorpromazine, clozapine
• MAOI antidepressants, eg phenelzine
• tricyclic antidepressants, eg amitriptyline, clomipramine.

If you experience a dry mouth as a side effect of this medicine you may find that medicines that are designed to dissolve and be absorbed from under the tongue, eg sublingual glyceryl trinitrate (GTN) tablets, become less effective. This is because the tablets do not dissolve properly in a dry mouth. To resolve this, drink a mouthful of water before taking sublingual tablets.

There may be an increased risk of drowsiness if this medicine is taken with any of the following medicines (which can also cause drowsiness):

• tricyclic antidepressants, eg amitriptyline
• opioid painkillers, eg morphine, codeine
• benzodiazepines, eg diazepam, temazepam
• sedating antihistamines, eg chlorphenamine, promethazine
• sleeping tablets.

There may be an increased risk of a fast or irregular heart beat if this medicine is taken in combination with beta sympathomimetic medicines, such as the following:

• adrenaline
• beta agonists for asthma, eg salbutamol, salmeterol
• nasal decongestants, eg ephedrine.

If this medicine is taken with medicines that work by stimulating muscarinic/cholinergic receptors (cholinergic medicines) the medicines may antagonise each others' effects. This may make this or the other medicine less effective. Cholinergic medicines include the following:

• donepezil, galantamine or rivastigmine used to treat Alzheimer's disease
• neostigmine, pyridostigmine and distigmine for myaesthenia gravis.

This medicine may reduce the effects of the following medicines on the gut:

• metoclopramide
• cisapride
• domperidone.

Blood pressure may be reduced in people taking this medicine in combination with isoniazid.

References:

https://www.hpra.ie/img/uploaded/swedocuments/2199761.PA1

https://www.netdoctor.co.uk/medicines/liver-kidney-urinary-system/a6545/detrunorm/

https://www.medicines.org.uk/emc/medicine/18501

https://patient.info/medicine/propiverine-detrunorm

https://www.medicines.ie/medicines/detrunorm-xl-30-mg-modified-release-capsules-31831/smpc

https://www.drugs.com/uk/detrunorm-15mg-coated-tablets-leaflet.html

https://www.drugs.com/uk/detrunorm-xl-30mg-modified-release-capsules-leaflet.html