Evaluation of fesoterodine fumarate for the treatment of an overactive bladder.

INTRODUCTION: Fesoterodine fumarate is an approved drug for overactive bladder. The aim of this study is to review the preclinical and most up to date clinical data on fesoterodine, with a special emphasis on its unique pharmacokinetic features and its implications on safety and tolerability in various patient populations. AREAS COVERED: In this review, the authors extensively reviewed available literature via PubMed search regarding fesoterodine, covering its mechanism of action, pharmacodynamics and pharmacokinetics, clinical efficacy, safety, and tolerability. EXPERT OPINION: Fesoterodine is an anti-muscarinic agent with a unique pharmacokinetic profile. It is a prodrug that is rapidly metabolized to its active form by nonspecific plasma esterases. Its metabolism is independent of the cytochrome P450 enzyme system. This along with its dual excretion pathways and minimal central nervous system penetration leads to less variability in drug exposure and allowance of administration in those with mild to moderate renal and hepatic insufficiency and in the geriatric population.