What are the side effects of Fesoterodine (Toviaz), an antimuscarinic medication?

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Last updated: April 28, 2025View editorial policy

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From the Guidelines

Fesoterodine is associated with several side effects, including dry mouth, constipation, abdominal pain, and headache, with a number needed to harm (NNH) of 7 [CI, 5 to 9] 1. The most common side effects of fesoterodine include:

  • Dry mouth
  • Constipation
  • Headache
  • Abdominal pain These side effects are due to the mechanism of action of fesoterodine, which blocks muscarinic receptors, reducing bladder muscle contractions, but also affecting other body systems with these receptors. Some patients may also experience:
  • Dizziness
  • Drowsiness
  • Blurred vision
  • Difficulty urinating
  • Stomach pain More serious but less common side effects include:
  • Severe allergic reactions
  • Confusion
  • Hallucinations
  • Eye pain
  • Signs of urinary retention Elderly patients may be more sensitive to these side effects, particularly confusion and constipation. The evidence shows that fesoterodine has a higher rate of adverse effects compared to placebo, with a relative risk of 1.4 [CI, 1.2 to 1.6] 1. The discontinuation rate due to adverse effects is higher for fesoterodine, with a NNH of 33 [CI, 18 to 102] 1. It is essential for patients to stay well-hydrated while taking this medication and to contact their healthcare provider if they experience severe or persistent side effects. The typical dosage of fesoterodine starts at 4 mg once daily and may be increased to 8 mg if needed, but dose adjustments may be necessary for patients with kidney or liver impairment to minimize side effects 1.

From the Research

Fesoterodine Side Effects

  • The most common adverse events during fesoterodine treatment are:
    • Dry mouth 2
    • Constipation 2, 3, 4, 5, 6
  • Other potential side effects of fesoterodine include:
    • Urinary retention 5
    • Dizziness 6
    • Urinary tract infection 6
    • Dry eyes 6
    • Dry skin 6
  • Fesoterodine has a similar safety profile to other antimuscarinic drugs, such as darifenacin, imidafenacin, oxybutynin, and solifenacin 6
  • However, tolterodine may have better safety outcomes for certain adverse events, including dry mouth and constipation 6

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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