An Overview of Medicines to Treat Overactive Bladder

Overactive bladder and urinary incontinence have an increasing number of pharmacologic treatments

(RxWiki News) Having a sudden urge to urinate can strike women with overactive bladder (OAB) almost anytime. And while there are a number of lifestyle and muscular remedies, medications are taking a larger role in treating OAB.

Recently, Italian researchers reviewed international literature to assess the various medications currently available to treat women with urinary tract symptoms.

This review uncovered that various classes of medications and combination therapies were effective choices, but noted that more research is needed with female study participants.

"Visit your doctor if you are having urinary control issues."

Lucio M.A. Cipullo, of the Department of Gynecology and Obstetrics at the University of Salerno in Salerno, Italy, led this review that evaluated studies on lower urinary tract symptoms, including urge urinary incontinence (UUI) and overactive bladder.

A sudden involuntary contraction of the bladder wall muscle causes OAB, and symptoms include an urgent need to urinate, with or without loss of control. UUI is an involuntary loss of urine combined with a sudden sensation of urgency with or without bladder wall contractions.

Lifestyle changes, such as modifying the amount of liquids consumed, stimulation to strengthen the bladder muscles and surgery are all OAB treatment options. Increasingly, though, women have been turning to medication solutions, according to Cipullo’s team.

Several medications are currently available for the treatment of bladder voiding and storage disorders. Studies have found that the following medications were effective in treating incontinence:

These medications, which fall into a class called antimuscarinic drugs (also referred to as anticholinergic drugs), have the potential of causing serious side effects that can affect the heart, vascular system, respiratory system, GI and urinary tracts, eyes and cognitive function, according to the research team. 

In addition to medications designed to treat bladder disorders, other classes of medications are also being used effectively, including antidepressants [Cymbalta (duloxetine) and Tofranil  (imipramine)]; alpha blockers, beta blockers and cox inhibitors, used to treat heart disease and other conditions; toxins such as botox; and hormone (estrogen) medications.

Medications known as “PDE5-inhibitors,” which are used to treat erectile dysfunction and enlarged prostates in men, also have shown promise for treating bladder disorders in men, the researchers reported. These medications — Revatio and Viagra (sildenafil) or Adcirca and Cialis (tadalafil) — have been shown to offer significant bladder function improvements in lower urinary tract symptoms.

Combination therapies have also demonstrated effectiveness and are an emphasis of new research.

According to Cipullo and colleagues, Flomax (tamsulosin) plus Detrol (tolterodine) treatment might improve the quality of life in patients with difficulty voiding along with uncontrolled contraction of the bladder wall.

Combining PDE5-inhibitors such as Viagra and Cialis with alpha blockers — i.e., Xatral (alfuzosin) — proved to be more effective than using a single agent.

“Studies conducted so far are often pilot studies with a short follow-up,” the researchers wrote. “Moreover, large trials to test the efficacy and tolerability of such combination therapy are still lacking and no studies have yet been performed in women.”

"Before beginning treatment with any of the medications to treat OAB, be sure to inform your health care providers of all of the other medications you are taking, including over-the-counter supplements, even if you take them occasionally," Steve Leuck, PharmD, founder of AudibleRx, told dailyRx News. "Medications used to treat OAB have the potential for interacting with many other medications and your Community Pharmacist will be happy to check to see if what you are taking is safe to take with your OAB medication."

This review was published in a recent issue of European Journal of Obstetrics & Gynecology and Reproductive Biology.

No research funding information was provided, and the authors declared no conflicts of interest.

Review Date: 
January 17, 2014