What are side effects of anticholinergic drugs?

Anticholinergics such as darifenacin (Enablex), oxybutynin (Ditropan XL), solifenacin (VESIcare), tolterodine tartrate (Detrol LA), trospium (Sanctura XR) and fesoterodine (Toviaz) are available in an extended-release form that minimizes side effects. Some people taking the drugs experience side effects such as dry mouth and dry eyes, headache, constipation, and blurred vision. Some older users report memory problems, and the drugs may worsen dementia. Talk to your doctor if you experience side effects or don't get the results you expect. You may need to try more than one medication to discover which works best and causes the fewest side effects. About 80% of people are able to tolerate one of these drugs -- a big improvement over older anticholinergics.

The Food and Drug Administration (FDA) approved Oxytrol, a patch changed twice weekly to deliver a constant level of oxybutynin through the skin. The most common side effect is skin irritation at the site of the patch.

You should not use anticholinergics if you have narrow-angle glaucoma, myasthenia gravis, or severe ulcerative colitis. Men should not use the drugs to relieve symptoms in lieu of getting a proper prostate evaluation.
Audrey K. Chun, MD
Geriatric Medicine
Older adults are particularly susceptible to anticholinergic side effects and their consequences. Anticholinergics block the action of acetylcholine, a neurotransmitter that enervates the bladder, gastrointestinal tract, salivary glands, tear ducts and other bodily secretions.

Younger people mainly experience drying effects, blurred vision and constipation. As one gets older, it's more typical to experience constipation, a rapid heart rate, trouble urinating and a lack of sweating. Anticholinergics also can cause confusion and delirium even without any of the other side effects, and they can also affect cognition.

The risk is greater for older adults because they tend to have multiple medical conditions and take several medications, all of which may exacerbate how the body responds to anticholinergic drugs.

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