Table 6. Pharmacotherapeutic Optionsa
Drug (Brand)
Typical Dose
Side Effects
Comments
Nervousness,
excitability,
restlessness,
weakness,
insomnia
Contraindications: MAOIs
Precautions: glaucoma,
diabetes, hyperthyroidism, heart
disease, hypertension
Stress Incontinence
α-Adrenergic agonists
Pseudoephedrine
15-30 mg tid
Sudafed®
Generics
Urge Incontinence
Botulinum toxin Ab
Botox®
Antimuscarinic
Darifenacin
Enablex®
Solifenacin
VESIcare®
Tolterodine
Detrol ®
Detrol LA®
Fesoterodine
Toviaz™
Oxybutinin
Ditropan®
Ditropan XL®
Gelnique® (10% gel)
Oxytrol ®
Transdermal System
Trospium
Sanctura®
Sanctura XR®
Anticholinergic
Hyoscyamine
Anaspaz®
Cystospaz®
Levsinex®
Generics
a
b
200 units
Urine infection, Cystoscopic intravesical
urine retention injection
7-15 mg daily
5-10 mg daily
2 mg bid
1 mg bid in
reduced renal or
hepatic function
2-4 mg daily
2 mg daily in
reduced renal or
hepatic function
4-8 mg daily
Common:
dry mouth,
constipation,
dyspepsia,
somnolence
Less common:
headache,
nausea,
abdominal
pain,
2.5-5 mg bid-tid xerophthalmia,
(max 20 mg daily) blurred vision
5-30 mg daily
Pruritus or
Apply daily to
erythema
dry skin
(specific to
3.9 mg patch
topicals)
q3-4d
20 mg bid
20 mg hs in renal
impairment
60 mg qAM
0.375 mg bid
Dry mouth,
headache,
constipation,
drowsiness,
blurred vision,
flushing
Contraindications: urinary or
gastric retention, uncontrolled
narrow-angle glaucoma
Precautions: hepatic or renal
impairment, bladder outflow
obstruction, GI obstructive
or mobility disorder,
controlled narrow-angle
glaucoma, myasthenia gravis,
renal insufficiency, hepatic
impairment
Contraindications: glaucoma,
obstructive uropathy, GI
obstructive or mobility disorder,
myasthenia gravis
Precautions: autonomic
neuropathy, hyperthyroidism,
hypertension, heart or renal disease
Start with lowest dose and titrate up in frail and elderly patients.
FDA approved for detrusor overactivity associated with neurologic conditions.
