Detrusitol SR 4mg prolonged release capsule.

After one year on a twice daily dosage of Detrusitol 2mg tablets, the University Malaya Medical Centre pharmacy has switched me back to the Detrusitol SR 4mg extended release capsules again. For unexplained reasons, the pharmacy stopped dispensing the SR 4mg.

Detrusitol in the prolonged release capsule form is more convenient as I need to take it only once daily. Unlike the previous SR capsules which were packed seven capsules to a blister strip, the current ones come loose in 30s to a small plastic container. The new capsules appear smaller in size too.

I have been taking Detrusitol either in 2mg tablets or 4mg prolonged release capsules since 2004 when I was diagnosed with chronic renal failure. This is to relax my overactive bladder and the frequent urge to urinate, and in turn, reduces the risk of a reflux of urine from the bladder back to the kidneys, which if left unchecked will cause further damage to them.

Wuan accompanied me to the University Malaya Medical Centre (UMMC) yesterday. It was for my scheduled check-up at the Spinal Rehabilitation Clinic. I had been anxious from the time we went there three weeks ago to have my blood drawn for renal profile, blood glucose test and lipid profile.

Blood test results for August 2010.

I had half-expected the serum creatinine to be higher than previous results. I have been going through a spell of lethargy that I thought could be due to be caused by my kidneys. It was a great relief when I saw that the serum creatinine was 288 umol/L. No doubt, it was very high due to kidney disease, it has stayed below 300 umol/L. That was all I had been hoping for.

Serum potassium was marginally higher at 5.4 mmol/L. Normal values should be between 3.6 to 5.2 mmol/L. I need to be aware of potassium-rich food that I have to cut down on. Serum urea had come down although still above the desired range, while sodium was hovering at previous levels. Fasting blood glucose looked good. Likewise, lipid profile. Saying that I am happy with the results is an understatement. I am ecstatic!

The lump in the scrotum has been bothering me again of late. Prior to the discovery of the lump, I stopped driving for a while because my legs were spasmodic. When the spasms struck, my legs would get in the way of the hand controls and steering wheel. The spasms went away about one week after I finished the antibiotics.

Its size has not reduced much after the two-week course of antibiotics. The spasms have returned. I believe there is a relation between the spasms and the lump. I was at the UMMC Rehabilitation Medicine Clinic for my scheduled three-month check-up yesterday. The doctor examined the lump and advised me to get a biopsy done. I am going back to SJMC soon to have the lump checked again by the urologist.

When I went to collect my supply of medication, the pharmacist changed my dosage of Detrusitol from the 2mg twice a day to one 4mg once daily prolonged-release capsule. I told him that I have had problems with the 4mg capsule as it caused problems with urination. He told me that was the only dosage the pharmacy has now and if I prefer the 2mg tablet I have to get it elsewhere. I decided to give the 4mg capsules a try again.

I cannot understand why the pharmacy prefers to dispense the 4mg capsules instead of the 2mg tablets. A one-month supply of Detrusitol SR 4mg capsules costs RM249 while the Detrusitol 2mg tablets costs only RM170 when I last bought them myself. Anyway, the instruction was that I should take one capsule at night. Based on my previous experience with Detrusitol SR, I decided to take the capsule in the morning instead. I had my first dose this morning and will be monitoring my bladder’s reaction in the coming days.