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Tolterodine is an antimuscarinic agent with an action similar to atropine that is used to treat overactive bladder with urinary incontinence, urgency and frequency. Oral administration once or twice a day
At the date of the last update, we found no published data on its excretion in breast milk.
Its high plasma protein binding, large volume of distribution and moderately high molecular weight make its excretion in breast milk unlikely.
Its low oral bioavailability makes it difficult for it to pass into the infant's plasma from ingested breast milk, except in premature babies and the immediate neonatal period, when there may be greater intestinal permeability.
There are a few slow metabolisers (with CYP2D6 deficiency) in whom bioavailability increases to 66%.
Take the minimum dose and do not prolong treatment, as anticholinergics can reduce milk production (De Martino 1980, Bizarro 1980). Monitor the infant for anticholinergic symptoms (dry mouth, constipation, etc.).