Anticholinergic Medications for Overactive Bladder
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6 Anticholinergic Medications to Treat Overactive Bladder

Medications for overactive bladder

  1. Anticholinergic drugs relax your bladder muscles and prevent spasms in your urinary tract.
  2. These drugs can cause side effects, especially at high dosages.
  3. You take these medications daily to complement a healthy lifestyle and physical exercises for OAB.

If you urinate often and have leaks between bathroom visits, you may have signs of an overactive bladder (OAB). According to the Mayo Clinic, OAB may cause you to urinate at least eight times in a 24-hour period. If you wake up often in the middle of the night to use the bathroom, OAB may be the cause. There are other reasons you may need to use the bathroom overnight, though. For instance, many people need to use the bathroom overnight more often as they get older due to kidney changes that come with age.

If you do have OAB, it can affect your quality of life. Your doctor may suggest making changes to your lifestyle to control your symptoms. If changing your habits doesn’t work, medications may help. Choosing the right drug may make all of the difference, so know your options. Check out certain OAB medications called anticholinergics below.

How anticholinergic bladder medications work

Anticholinergic drugs are often prescribed to treat OAB. These drugs work by relaxing your bladder muscles. They also help prevent urine leaks by controlling bladder spasms.

Most of these drugs come as oral tablets or capsules. They also come in transdermal patches and topical gels. Most are only available as prescriptions, but the patch is available over the counter.

Anticholinergic drugs for OAB

Oxybutynin

Oxybutynin is an anticholinergic drug for overactive bladder. It’s available in the following forms:

  • oral tablet (Ditropan, Ditropan XL)
  • transdermal patch (Oxytrol)
  • topical gel (Gelnique)

You take this drug on a daily basis. It’s available in several strengths. The oral tablet comes in immediate-release or extended-release forms. Immediate-release drugs release into your body right away, and extended-release drugs release into your body slowly. You may need the take the immediate-release form up to three times per day.

Tolterodine

Tolterodine (Detrol, Detrol LA) is another drug for bladder control. It’s available in many strengths, including 1-mg and 2-mg tablets or 2-mg and 4-mg capsules. This drug only comes in immediate-release tablets or extended-release capsules.

This drug interacts with other medications, especially when it’s used at a higher dosage. Make sure you tell your doctor about all over-the-counter and prescription medications, supplements, and herbs you’re taking. This way, your doctor can watch out for dangerous drug interactions.

Fesoterodine

Fesoterodine (Toviaz) is an extended-release bladder control medication. If you’re switching from an immediate-release drug because of its side effects, fesoterodine may be a better choice for you. This is because extended-release forms of OAB drugs tend to cause fewer side effects than immediate-release versions. However, compared to other OAB medications, this drug may be more likely to interact with other drugs.

Fesoterodine comes in 4-mg and 8-mg oral tablets. You take it once per day. This drug may take a few weeks to start working. In fact, you may not feel the full effect of fesoterodine for 12 weeks.

Trospium

If you don’t respond to small doses of other bladder control drugs, your doctor may recommend trospium. This drug is available as a 20-mg immediate-release tablet that you take twice per day. It also comes as a 60-mg extended-release capsule that you take once per day. You shouldn’t consume any alcohol within two hours of taking the extended-release form. Drinking alcohol with this drug can cause increased drowsiness.

Darifenacin

Darifenacin (Enablex) treats both bladder spasms and muscle spasms within the urinary tract. It comes in an 7.5-mg and 15-mg extended-release tablet. You take it once per day.

If you don’t respond to this medication after two weeks, your doctor may increase your dosage. Do not increase your dosage on your own. If you think the drug is not working to control your symptoms, talk to your doctor.

Solifenacin

Like darifenacin, solifenacin (Vesicare) controls spasms in your bladder and urinary tract. The main difference between these drugs is the strengths they come in. Solifenacin comes in 5-mg and 10-mg tablets that you take once per day.

Bladder control comes with risks

These medications all carry the risk of side effects. Side effects may be more likely when you take any of these drugs at a high dosage. The side effects may be severe with extended-release forms of OAB medications.

Side effects can include:

  • dry mouth
  • constipation
  • drowsiness
  • memory problems
  • increased risk of falls, especially for seniors
Lifestyle changes
Due to side effects OAB drugs can cause, your doctor may suggest making changes to your lifestyle first to help your OAB. Kegel exercises, bladder training, and keeping a healthy weight can all help ease your symptoms. Ask your doctor what actions you can take to improve your bladder control.

These drugs can also cause changes to your heart rate. If you have heart rate changes, see your doctor right away.

Many drugs used to treat OAB can interact with other medications. Interactions may be more likely with OAB drugs when you take them at a high dosage. Make sure you tell your doctor about all over-the-counter and prescription medications, drugs, and herbs you’re taking. Your doctor will look out for interactions to help keep you safe.

Learn more: Lifestyle changes, other medications, and surgery for OAB »

Work with your doctor

Anticholinergic drugs can bring you relief from your OAB symptoms. Work with your doctor to find the medication that’s best for you. Keep in mind that if anticholinergic drugs aren’t a good choice for you, there are other medications for OAB. Talk to your doctor to see if an alternative drug will work for you.

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