Indications: urinary frequency, urgency and incontinence and nocturnal enuresis, in bladder dysfunction, especially in the elderly; uninhibited vesical hyperactivity after bladder surgery, prostatectomy and in association with acute and chronic cystitis. neurogenic bladder instability, and nocturnal enuresis associated with overactive bladder

Cautions: pregnancy, children less than 5 years of age; ulcerative colitis, toxic megacolon autonomic neuropathy, severe heart disease, porphyria, renal or hepatic disease.

Contra-indications: ileostomy, colostomy; glaucoma, myasthenia gravis.

Side Effects: anticholinergic side effects may occur as dry mouth, blurred vision, decreased sweating, drowsiness, tachycardia, palpitations, urinary retention and constipation. Allergic skin reactions may occur.

Dizziness; less commonly anorexia, facial flushing; rarely night terrors; application site reactions with patches.

Dose: adults, by mouth initially 2.5–5mg 2–3 times daily increased if necessary to max. 5mg 4 times daily; elderly initially 2.5–3mg twice daily, increased to 5mg twice daily according to response and tolerance.

Child over 5 year, neurogenic bladder instability, 2.5mg - 3mg twice daily increased to 5mg twice daily; max. dose is 5mg 3times daily.

Nocturnal enuresis in child over 7 days, 2.5 - 3mg twice daily increased to 5mg 2-3 times daily (last dose before bedtime).

Pregnancy: avoid unless benefit outweighs risk.

Breast feeding: Present in milk- advise to avoid