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Overactive Bladder (cont.)

Overactive Bladder Medications

Patient Comments

The most common group of medications used to treat overactive bladder are the anticholinergic drugs. These medications work by diminishing the activity of and relaxing the detrusor muscle. As a group, they have similar side effects, including dry mouth, blurry vision, constipation, and confusion, especially in the elderly. These drugs for OAB are taken by prescription only and should be taken under the supervision of the prescribing doctor.

The following are anticholinergic medications used for OAB:

  • Oxybutynin (Ditropan) is taken two to three times a day. The extended-release form, Ditropan XL, can be taken once a day. There is also a patch form, Ditropan patch or oxybutynin (Oxytrol), which can be placed on the skin once or twice per week.
  • Tolterodine (Detrol) produces less dry mouth as a side effect and can be taken twice a day. The extended-release type, Detrol LA, is taken once a day.
  • Solifenacin (VESIcare) is also used once a day and is relatively new in this group of medications.
  • Darifenacin (Enablex) has the least confusion-type side effects and is recommended for the elderly with dementia. It is also taken once daily.
  • Fesoterodine fumarate (Toviaz) is a once a day medication.

A new class of medication called beta-3 adrenergic agonists may result in less dry mouth and constipation and anticholinergic medications:

  • Mirabegron (Myrbetriq) is a beta-3 adrenergic agonist indicated for the treatment of overactive bladder (OAB) with symptoms of urge urinary incontinence, urgency, and urinary frequency.

Occasionally antidepressant medications are used for treatment of overactive bladder. More specifically, duloxetine (Cymbalta) has shown some benefit in treating the urinary symptoms of overactive bladder, although it is currently not approved by the U.S. Food and Drug Administration (FDA) for this purpose.

Estrogen preparations, orally or vaginally, are sometimes used in postmenopausal women with incontinence.

Some of the newer therapies for overactive bladder include Botox injection into the detrusor muscle. This has been used with relative success in some people who otherwise have not responded to more traditional treatments for OAB. Botox has not been approved for this use by the FDA.

Herbal and natural remedies for overactive bladder have not been studied scientifically and even though they have been traditionally used for a long time, their effectiveness is greatly unknown. Some of the commonly used herbal therapies for overactive bladder are buchu (Barosma betulina), cleavers, corn silk, horsetail, saw palmetto, and gosha-jinki-gan. Despite availability of these natural and homeopathic therapies for overactive bladder, most experts discourage their use due to lack of scientific evidence and possible risks.

Medically Reviewed by a Doctor on 12/17/2015

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