部分中文曲司氯铵处方资料（仅供参考）     
药品英文名
Trospium
药品别名
盐酸曲司氯铵、Trospium Hydrochloride、Sanctura
药物剂型
盐酸曲司氯铵片剂：20mg/片。20～25℃室温保存。
药理作用
本品为季铵盐化合物，具有抗胆碱作用和解痉作用。本品作用于胆碱能神经所支配效应器上的M受体，能拮抗乙酰胆碱对M受体的作用。其副交感神经阻滞作用可引起膀胱平滑肌的舒张，使膀胱容量增加。治疗剂量下，本品对烟碱受体作用微弱。
药动学
本品口服后吸收率不足10%，平均生物利用度9.6%。给药后5～6h血药浓度达峰值(Cmax)，给药剂量从20mg增加到40mg和60mg，Cmax分别增加3倍和4倍。药时曲线下面积(AUC)随剂量呈线性变化。高脂饮食可使本品的AUC和Cmax降低70%～80%。体外研究显示，0.5～50ng/ml浓度范围内，本品血浆蛋白结合率50%～85%，本品主要分布在血浆，口服20mg的表观分布容积为395L。本品可能通过水解作用与葡萄糖醛酸结合，代谢产物占排出物的40%。本品消除半衰期约20h，85.2%经粪便排出，5.8%经肾脏排出，肾脏排出物的60%为原形药物。本品的肾脏排泄主要经肾小管分泌，严重肾功能不全患者的AUC和Cmax分别提高4.5倍和2倍，半衰期延长至33h。肝功能轻度至中度异常患者的Cmax分别升高12%和63%。
适应证
本品用于膀胱过度刺激引起的尿频、尿急、尿失禁。
禁忌证
1.对本品及其中成分过敏者禁用。
2.尿潴留、胃潴留及未控制的闭角型青光眼患者禁用。
注意事项
1.儿童用药安全性尚未评价。
2.本品过量可引起严重抗胆碱作用，有过量后引起瞳孔散大和心动过速的病例。出现药物过量应采取对症治疗和支持治疗，并监测心电图。
3.慎用：
(1)由于尿潴留的可能，有明显膀胱尿道阻塞症状的患者使用时应谨慎。
(2)本品具有抗胆碱作用，能降低胃肠道动力，胃肠道阻塞性疾病患者有胃潴留的可能，使用时应谨慎。严重便秘、溃疡性结肠炎和重症肌无力患者慎用。
(3)中度至重度肝功能不全患者慎用。
(4)只有当可能的受益高于危险时，方可在严密监护下用于已控制的闭角型青光眼患者。
(5)本品生殖毒性分级为C，只有对母体的益处高于对胎儿的危险时方可用于孕妇。
(6)本品可经大鼠乳汁分泌，尚不知本品是否经人乳汁分泌，只有当可能的受益高于对新生儿的危险时方可用于哺乳期妇女。
不良反应
本品最常见的不良反应为便秘、口干。其他不良反应包括以下几方面。
1.消化系统：口干、便秘、腹痛加剧、便秘加重、消化不良、胃肠胀气、呕吐、味觉障碍、咽干、胃炎。
2.泌尿生殖系统：尿潴留。
3.神经系统：头痛、晕厥、幻觉、躁狂。
4.全身：无力、胸痛。
5.代谢及营养疾病：有血管神经性水肿的报道。
6.心血管系统：心动过速、心悸、室上性心动过速、高血压危象。
7.皮肤：皮肤干燥、渗出性多形性红斑、过敏反应。
8.其他：眼干、视力模糊、视觉异常、横纹肌溶解。
用法用量
口服，推荐剂量为每次20mg，2次/d，空腹服用或饭前1h服用。严重肾功能损伤患者(肌酐清除率＜30ml/min)，推荐剂量为20mg/d，睡前服用。75岁以上老年患者，起始剂量为20mg/d。
药物相应作用
1.本品从肾脏排出主要经肾小管分泌作用，与其他经肾小管分泌排泄的药物(如地高辛、普鲁卡因胺、双哌雄双酯、吗啡、万古霉素、二甲双胍及替诺福韦)同时使用，有可能引起二者血药浓度的提高，应对患者进行严密监护。
2.与混合性P450抑制剂西咪替丁合用，本品的Cmax和AUC增加。
3.本品为CYP2D6和CYP3A4抑制剂，与主要经CYP2D6代谢的治疗窗较窄的药物(如氟卡尼、硫利达嗪及三环类抗抑郁药)合用时应谨慎。本品可使丙咪嗪的Cmax和AUC增加。
4.与其他抗胆碱药合用，可能加剧口干、便秘、视力模糊及其他抗胆碱症状。
5.由于本品的胃肠道动力降低作用，本品可影响其他药物的胃肠道吸收。
Sanctura XR Description
Sanctura Xr 60mg is an antispasmodic and an antimuscarinic agent used to treat overactive bladder with symptoms such as incontinence, urgency, and frequency. Sanctura Xr 60mg may be used to treat other conditions as determined by your doctor.
Sanctura XR Directions
Follow the directions for taking Sanctura Xr 60mg provided by your doctor. An additional patient information leaflet is available with Sanctura Xr 60mg. Ask your doctor, nurse, or pharmacist any questions that you may have about this information. TAKE SANCTURA XR 60mg ON AN EMPTY STOMACH WITH WATER at least 1 hour before eating, preferably in the morning or as directed by your doctor. STORE SANCTURA XR 60mg at room temperature between 68 and 77 degrees F (20 and 25 degrees C) in a tightly-closed container, away from heat, moisture, and light. Brief storage between 59 and 86 degrees F (15 and 30 degrees C) is permitted. IF YOU MISS A DOSE OF SANCTURA XR 60mg, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. DO NOT TAKE 2 doses at once.
Sanctura XR Cautions
DO NOT TAKE SANCTURA XR 60mg if you have had an allergic reaction to it or are allergic to any ingredient in this product. Sanctura Xr 60mg may cause drowsiness or blurred vision. DO NOT DRIVE, OPERATE MACHINERY, OR DO ANYTHING ELSE THAT COULD BE DANGEROUS until you know how you react to Sanctura Xr 60mg. Using Sanctura Xr 60mg alone, with other medicines, or with alcohol may lessen your ability to drive or to perform other potentially dangerous tasks. DO NOT DRINK ALCOHOL WITHIN 2 HOURS before or after you take Sanctura Xr 60mg. DO NOT USE MEDICINES THAT MAY CAUSE DROWSINESS (eg, sleep aids, muscle relaxers) while you are using Sanctura Xr 60mg; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness. BEFORE YOU HAVE ANY MEDICAL OR DENTAL TREATMENTS, EMERGENCY CARE, OR SURGERY, tell the doctor or dentist that you are using Sanctura Xr 60mg. Sanctura Xr 60mg may cause dry mouth. To relieve dry mouth, suck on (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water or use a saliva substitute. Sanctura Xr 60mg may reduce your ability to sweat. DO NOT BECOME OVERHEATED in hot weather or during exercise or other activities since heatstroke may occur. BEFORE YOU BEGIN TAKING ANY NEW MEDICINE, either prescription or over-the-counter, check with your doctor or pharmacist. CAUTION IS ADVISED WHEN USING SANCTURA XR 60mg IN THE ELDERLY because they may be more sensitive to the effects of Sanctura Xr 60mg, especially dry mouth, constipation, stomach pain or upset, and trouble urinating. FOR WOMEN: IF YOU PLAN ON BECOMING PREGNANT, discuss with your doctor the benefits and risks of using Sanctura Xr 60mg during pregnancy. IT IS UNKNOWN IF SANCTURA XR 60mg IS EXCRETED in breast milk. IF YOU ARE OR WILL BE BREAST-FEEDING while you are using Sanctura Xr 60mg, check with your doctor or pharmacist to discuss the risks to your baby.
Sanctura XR Side Effects
SIDE EFFECTS that may occur while taking Sanctura Xr 60mg include constipation, dry mouth or eyes, gas, nasal dryness, nausea, or upset stomach. If they continue or are bothersome, check with your doctor. CONTACT YOUR DOCTOR AS SOON AS POSSIBLE if you experience difficulty urinating or vision changes. CONTACT YOUR DOCTOR IMMEDIATELY if you experience chest pain; dark urine; fainting; fast or irregular heartbeat; hallucinations; mental or mood changes; muscle pain or weakness; or red, swollen, peeling, or blistered skin. AN ALLERGIC REACTION to Sanctura Xr 60mg is unlikely, but seek immediate medical attention if it occurs. Symptoms of an allergic reaction include rash, itching, swelling, dizziness, or trouble breathing. If you notice other effects not listed above, contact your doctor, nurse, or pharmacist. This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your healthcare provider. Call your doctor for medical advice about side effects.