6 Anticholinergic Medications to Treat Overactive Bladder

Written by Kristeen Cherney | Published on February 5, 2014
Medically Reviewed by George T. Krucik, MD, MBA on February 5, 2014

6 Medications for Overactive Bladder

Urinating frequently and leaking between bathroom visits may be signs that you have overactive bladder. According to the Mayo Clinic, overactive bladder may cause you to urinate at least eight times in a 24-hour period. You may also wake up frequently in the middle of the night to use the bathroom.

Overactive bladder can be embarrassing, but it can also affect your quality of life. Choosing the right medication can make all of the difference, so make sure you know your options.

How Bladder Medications Work

Medications, such as anticholinergics, can control overactive bladder (OAB) by relaxing bladder muscles. OAB drugs, which are most common in tablet form, also help prevent urine leaks by controlling bladder spasms.

Overactive bladder drugs can also come in extended-release pills, which don’t cause as many side effects, patches, and topical gels.

Oxybutynin

Oxybutynin is one type of anticholinergic drug for overactive bladder. It is available in four forms:

  • tablet  (Ditropan, Ditropan XL)
  • syrup
  • patch  (Oxytrol)
  • gel      (Gelnique)

All forms are taken on a daily basis, except for Gelnique, which is administered twice a week. Oxybutynin comes in immediate-release or extended-release formulas. Immediate-release versions may be taken up to three times a day in five mg doses.

Oxybutynin may be appealing if you’re looking for more flexibility in your medicine. It’s also available in both generic and brand name form.

Tolterodine

Tolterodine is another option for bladder control. Tolterodine is an active ingredient found in the brand-name drug Detrol and its extended-release version, Detrol LA. Like oxybutynin, this drug is available in various dosages, including one, two, and four milligrams.

The biggest difference between tolterodine and oxybutynin is that tolterodine only comes in immediate-release tablets or extended-release capsules. It does not come as a gel, patch, or syrup.

Fesoterodine

Fesoterodine is the active ingredient in the brand-name drug Toviaz. Fesoterodine is ideal if you specifically want an extended-release bladder control medication. If you are switching from an immediate-release drug because of its side effects, fesoterodine can also help.

Fesoterodine comes in a four mg tablet taken once a day. The drug may take a few weeks to start working, so don’t increase the dose on your own. In fact, you may not feel the full effect of fesoterodine for 12 weeks, according to Medline Plus.

Trospium

If you don’t respond to small doses of bladder control drugs, then your doctor may recommend trospium. Found in the brand-name drug Sanctura, trospium is a 20 mg tablet taken twice a day. It’s also available in an extended-release formula, Sanctura XR.

According to Consumer Reports, this is one of the most expensive bladder control medications available, based on a 2010 survey.

Darifenacin

Darifenacin treats both bladder spasms and muscle spasms within the urinary tract. It is the active ingredient in Enablex, and it comes in a 7.5 mg tablet. This is an extended-release tablet taken once a day.

If you don’t respond to the medication after two weeks, your doctor may increase your medication. If you feel the medication is not working, do not increase the dose on your own.

Solifenacin

Like darifenacin, solifenacin controls spasms in the bladder as well as the urinary tract. The main difference between darifenacin and solifenacin lies in the dose. Solifenacin comes in five mg tablets taken once a day.

Patients who need more bladder control medicine are usually switched to a different type. Solifenacin is available in the brand-name medication Vesicare.

Bladder Control Comes with Risks

Overactive bladder control medications carry the risk of side effects, which are more prominent in high dosage, extended-release medications. Side effects can include:

  • dry mouth
  • constipation
  • drowsiness
  • memory problems

Discuss these symptoms with your doctor–especially if they affect your quality of life. Seek medical care if you have changes in heart rate.

Medications Complement a Healthy Lifestyle

Overactive bladder medications can help, but they should also complement lifestyle changes. Kegel exercises, bladder training, and weight maintenance can all positively affect your OAB symptoms.

Other prescription medications can interact with bladder control medicine. For example, diuretics for high blood pressure and weight loss can place additional pressure on the bladder. Make sure you tell your doctor everything you take. 

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