CAREFUL PATIENT MONITORING IS RECOMMENDED DURING CO-ADMINISTRATION OF DRUGS THAT ARE ELIMINATED BY ACTIVE TUBULAR SECRETION LIKE PROCAINAMIDE, PANCURONIUM, MORPHINE, VANCOMYCIN, METFORMIN & TENOFOVIR WITH TROSPIUM CHLORIDE SINCE IT INCREASES SERUM CONCENTRATION OF TROSPIUM CHLORIDE AND/OR THE COADMINISTERED DRUG DUE TO COMPETITION FOR THIS ELIMINATION PATHWAY.