Fesoterodine

Oral health effects

• Severe xerostomia

  Strong anticholinergic activity makes dry mouth one of the most common and pronounced side effects.

  Mechanism: Muscarinic receptor blockade markedly reduces salivary secretion.

  Clinical management: Aggressive caries prevention, high-fluoride products, salivary substitutes, frequent recall; consider discussing alternatives with the prescriber.

• Angioedema of lips, tongue or face (rare)

  The label warns that angioedema of the face, lips, tongue and/or larynx has been reported, sometimes after the first dose; upper-airway swelling can be life-threatening. Frequency is not established (postmarketing/rare).

  Clinical management: Ask about any facial, lip or tongue swelling since starting the drug. Swelling of the tongue, floor of mouth or throat during an appointment is a medical emergency: stop treatment, keep the patient upright, call emergency services and monitor the airway.