TOLTERODINE is used for treating heart failure and slowing the heart rate in patients with chronic atrial fibrillation, a type of abnormal heart rhythm. It may also be used for other conditions as determined by your doctor.

Digitek is a digitalis glycoside. It works by increasing the force of contraction of the heart and slowing heart rate.

What should I tell my health care providers before I take this medicine?

They need to know if you have any of these conditions:

• beriberi heart disease
• certain types of heart rhythm problems, such as ventricular fibrillation
• allergies to medicines, foods, or other substances
• severe heart failure, inflammation of the heart, coronary artery disease, heart attack, heart block, extra heart beats (PVCs), and certain abnormal heart rhythms, or fainting due to a heart problem
• severe kidney, liver or lung problems, or thyroid problems
• low blood levels of calcium, magnesium, or potassium, or high blood levels of potassium or calcium
• pregnant or trying to get pregnant, breast-feeding

How should I use this medicine?

Take Digitek by mouth. Do not take it within 1 hour of food high in fiber. Do not take antacids containing aluminum or magnesium, cholestyramine, or colestipol within 2 to 4 hours of taking Digitek .

What if I miss a dose?

If you miss a dose, 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.

What may interact with this medicine?

• amiodarone, amphotericin B, anticholinergics, beta-blockers, bupivacaine, calcium, certain stimulants, cyclosporine, diltiazem, diphenoxylate, diuretics, indomethacin, itraconazole, macrolides, propafenone, quinidine, quinine, spironolactone, succinylcholine, tetracyclines, thioamines, verapamil
• acarbose, certain anticancer medicines, cholestyramine, colestipol, kaolin-pectin, metoclopramide, penicillamine, rifampin, sulfasalazine, thyroid hormones
• oral aminoglycosides
• Spironolactone

This list may not describe all possible interactions. Give your health care providers a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What side effects may I notice from this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue)
• blurred vision, yellow vision, or other vision changes
• fast, slow, or irregular heartbeat
• mood or mental changes, hallucinations
• severe or persistent nausea, vomiting, or stomach pain
• unusual tiredness or weakness

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• diarrhea
• nausea

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider.

What should I watch for while using this medicine?

It may take 2 or 3 months to notice the full benefit from this medicine.

You may need to limit your intake tea, coffee, caffeinated sodas, and alcohol. These drinks may make your symptoms worse.

You may get drowsy or dizzy. Do not drive, use machinery, or do anything that needs mental alertness until you know how this drug affects you. Do not stand or sit up quickly, especially if you are an older patient. This reduces the risk of dizzy or fainting spells.

Your mouth may get dry. Chewing sugarless gum or sucking hard candy, and drinking plenty of water may help. Contact your doctor if the problem does not go away or is severe.

This medicine may cause dry eyes and blurred vision. If you wear contact lenses you may feel some discomfort. Lubricating drops may help. See your eye doctor if the problem does not go away or is severe.

Avoid extreme heat. This medicine can cause you to sweat less than normal. Your body temperature could increase to dangerous levels, which may lead to heat stroke.

Where should I keep this medicine?

Store at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep out of the reach of children and away from pets.