OVERACTIVE BLADDER & URINARY INCONTINENCE TREATMENTS†
 
Generic & Class Brand & Company Formulation Strengths Dose Notes
ANTICHOLINERGIC
Imipramine HCl Tofranil
(Mallinckrodt)
tabs 10mg, 25mg, 50mg <6 years: not recommended.
≥6 years: initially 25mg daily 1 hour before bedtime; after 1 week, increase to 50mg for children 6–12 years, up to 75mg for those >12 years.
Attempt drug-free periods after gradual tapering of dose if drug response favorable.
Early night bedwetters: give 25mg in afternoon and repeat at bedtime.
Max 2.5mg/kg per day.
ANTISPASMODIC/ANTICHOLINERGIC
Darifenacin HBr Enablex
(Novartis)
ext-rel tabs 7.5mg, 15mg Children: not recommended.
Adults: Initially 7.5mg once daily; may increase to 15mg once daily after 2 weeks. Max 7.5mg once daily in moderate hepatic impairment or with potent CYP3A4 inhibitors (eg, ketoconazole, itraconazole, ritonavir, nelfinavir, clarithromycin, nefazadone).
Swallow whole with liquid.
Oxybutynin chloride Ditropan
(Ortho-McNeil)
scored tabs 5 mg <5yrs: not recommended.
≥5yrs: 5mg twice daily; max 15mg/day.
Adults: 5mg 2–3 times a day; max 20mg/day.
 
syrup 5mg/5mL
Ditropan XL
(Ortho-McNeil)
ext-rel tabs 5mg, 10mg, 15mg <6yrs: not recommended.
≥6yrs: Initially 5mg once daily; may increase in 5mg increments; max 20mg/day.
Adults: Initially 5mg or 10mg once daily; may increase weekly in 5mg increments; max 30mg/day.
Swallow whole. Take with fluid.
Gelnique
(Watson)
gel 100mg/g per sachet Children: not recommended.
Adults: Apply one sachet once daily to dry, intact skin. Rotate application sites.
Apply to abdomen, upper arms/shoulders, or thighs. Application should not be made to the same site on consecutive days.
Solifenacin succinate Vesicare
(Astellas)
tabs 5mg, 10mg Children: not recommended.
Adults: Initially 5mg once daily; if well tolerated, may increase to 10mg once daily. Severe renal impairment (CrCl<30mL/min), moderate hepatic impairment, or concomitant potent CYP3A4 inhibitors (eg, ketoconazole): max 5mg once daily.
Swallow whole with liquids.
Trospium chloride Sanctura
(Allergan)
tabs 20mg Children: not recommended.
Adults: 20mg twice daily. ≥75yrs: 20mg once daily if twice daily dose not tolerated. Severe renal impairment (CrCl<30mL/min): 20mg once daily at bedtime.
Take on empty stomach.
Sanctura XR
(Allergan)
ext-rel caps 60mg Children: not recommended.
Adults: 60mg daily in the AM. Severe renal impairment (CrCl<30mL/min): not recommended.
Take on empty stomach.
MUSCARINIC ANTAGONIST
Fesoterodine fumarate Toviaz
(Pfizer)
ext-rel tabs 4mg, 8mg Children: not recommended.
Adults: Initially 4mg once daily; if well tolerated, may increase to 8mg once daily. Severe renal impairment (CrCl<30mL/min) or concomitant potent CYP3A4 inhibitors (eg, ketoconazole): max 4mg once daily.
Swallow whole with liquids.
Tolterodine tartrate Detrol
(Pfizer)
tabs 1mg, 2mg Children: not recommended.
Adults: 2mg twice daily; may decrease to 1mg twice daily. Concomitant CYP3A4 inhibitors, or significant renal or hepatic dysfunction: 1mg twice daily.
 
Detrol LA
(Pfizer)
ext-rel caps 2mg, 4mg Children: not recommended.
Adults: 4mg once daily; may decrease to 2mg once daily. Concomitant CYP3A4 inhibitors, or significant renal or hepatic dysfunction: 2mg once daily.
Swallow whole.
VASOPRESSIN (SYNTHETIC)
Desmopressin acetate DDAVP
(sanofi aventis)
scored tabs 0.1mg, 0.2mg <6yrs: not recommended.
6–17yrs: initially 0.2mg once daily at bedtime; individualize; max 0.6mg.
When switching to tabs give 1st oral dose 24hrs after last intranasal dose.
DDAVP NASAL SPRAY
(sanofi aventis)
nasal spray 10micrograms/spray <6yrs: not recommended.
≥6yrs: initially 20micrograms (2 sprays) or 0.2mL soln intranasally at bedtime. Usual range 10–40micrograms/day at bedtime. Give ½ total dose in each nostril.
Adults: 10–40 micrograms intranasally at bedtime.
Use rhinal tube for doses <10micrograms.
DDAVP RHINAL TUBE
(sanofi aventis)
intranasal soln 10micrograms/0.1mL  
NOTES

caps=capsules; tabs=tablets; ext-rel=extended release; soln=solution

†Not an inclusive list. Please see drug monographs or visit www.eMPR.com

(Rev. 7/2009)