What is the dosing regimen for Cystistat (Tolterodine)?

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Last updated: April 16, 2025View editorial policy

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From the Research

Cystistat should be administered as a bladder instillation once weekly for the first month (four treatments), followed by monthly instillations for maintenance therapy, with each treatment consisting of a 50 mL solution containing 40 mg of sodium hyaluronate, as this regimen has been shown to be effective in reducing symptoms of interstitial cystitis and recurrent urinary tract infections, with minimal side effects and good compliance, as demonstrated in studies such as 1 and 2. The dosing regimen for Cystistat is typically initiated with weekly instillations for the first month, followed by monthly maintenance therapy.

  • The solution should be retained in the bladder for as long as possible, ideally at least 30 minutes before voiding.
  • Prior to instillation, patients should empty their bladder completely.
  • The treatment course may be continued for several months depending on symptom response.
  • Cystistat works by replenishing the glycosaminoglycan (GAG) layer of the bladder, which is often deficient in conditions like interstitial cystitis and recurrent urinary tract infections.
  • This protective layer helps prevent irritating substances in urine from penetrating the bladder wall and causing inflammation and pain.
  • Patients should be advised that multiple treatments are usually necessary before significant symptom improvement occurs, and the full benefit may take several weeks to develop, as noted in studies such as 1 and 2. The most recent and highest quality study, 3, although focused on new treatments for bladder pain syndrome/interstitial cystitis, supports the continued use of hyaluronic acid, the active ingredient in Cystistat, as a viable treatment option.
  • The study highlights the importance of combining therapies and phenotyping patients to improve treatment outcomes.
  • However, the study also notes that validation of these approaches is arduous due to the broad spectrum of BPS/IC phenotypes and the need for larger, longer-term studies.
  • Despite these challenges, the available evidence, including studies such as 1 and 2, supports the use of Cystistat as a safe and effective treatment for interstitial cystitis and recurrent urinary tract infections.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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