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Vol. 26, Issue 6, 528-535, June 1998
Department of Drug Metabolism, Pharmacia & Upjohn AB
Tolterodine is a new muscarinic receptor antagonist intended for
the treatment of urinary urge incontinence and other symptoms associated with an overactive bladder. The in vivo
metabolism of 14C-labeled tolterodine was
investigated in rats, mice, and dogs by analysis of blood and urine
samples, whereas in vitro metabolism studies were performed
by incubation of [14C]tolterodine with mouse,
rat, dog, and human liver microsomes in the presence of NADPH.
Tolterodine was extensively metabolized in vivo. Mice and
dogs showed similar metabolite patterns, which correlated well with
that observed in humans. In these species, tolterodine was metabolized
along two different pathways, with the more important being the
stepwise oxidation of the 5-methyl group to yield the 5-hydroxymethyl
metabolite of tolterodine and then, via the aldehyde, the
5-carboxylic acid metabolite. The other pathway involved dealkylation
of the nitrogen. In the subsequent phase II metabolism, tolterodine and
the metabolites were conjugated with glucuronic acid to various
degrees. Rats exhibited more extensive metabolism and a markedly
different metabolite pattern, with metabolites also being formed by
hydroxylation of the unsubstituted benzene ring. In addition, a gender
difference was observed, with male rats showing more extensive
metabolism than females. Incubation of
[14C]tolterodine with liver microsomes
yielded a total of five metabolites with rat liver microsomes and three
with mouse, dog, and human liver microsomes. The 5-hydroxymethyl
metabolite of tolterodine and N-dealkylated tolterodine
were major metabolites in all incubations, representing 83-99% of
total metabolism. Although the extent of metabolism varied among
species, the metabolic profiles were similar. However, rat liver
microsomes also formed metabolites hydroxylated in the unsubstituted
benzene ring. These results show that the metabolism of tolterodine in
mice and dogs corresponds to that observed in humans, whereas rats
exhibit a different metabolite pattern.