What new medications treat overactive bladder?

Some of the medications used to treat overactive bladder include Detrol, Detrol LA, Ditropan, Ditropan XL, Enablex, Oxytrol, Sanctura, Sanctura XR, Myrbetriq and VESIcare. Toviaz is also used to treat overactive bladder symptoms.

If behavioral therapy for overactive bladder doesn’t work, doctors may also consider pharmacological treatment. This includes anticholinergic/antimuscarinics, antispasmodics, beta-3 agonists, sedatives and antidepressants. Six antimuscarinics are approved in the United States for use, including darifenicin, oxybutynin, solifenacin, tolterodine, trospium and festoterodine. All have similar efficacy, which is about 70% to 75% for decreasing urinary incontinence episodes. Side effects include dry mouth, constipation, blurry vision, stomach upset and impaired cognitive function. Although these are not common, they can be bothersome enough to stop use of the medication. The contraindications of this medicine are people with narrow angle glaucoma and those with impaired gastric emptying, or urinary retention.

The second class of medication that doctors use is a class of antidepressants. The most commonly used one in the United States is imipramine, which is a tricyclic antidepressant. It directly relaxes the bladder muscle and increases the storage capacity. It is also used for childhood bedwetting. It can improve bladder neck function; however, it can lead to dizziness and nausea or vomiting. This medication should not be used in people who are taking monoamine oxidase (MAO) inhibitors. The U.S. Food and Drug Administration (FDA) has also approved beta-3 adrenergic agonists, such as Mirabegron. The side effects are high blood pressure, nasopharyngitis, urinary tract infections, dry mouth and headache. As they can cause or elevate blood pressure, beta-3 adrenergic agonists should not be used in people with uncontrolled high blood pressure.