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Overactive Bladder & Urinary Incontinence Treatments

June 05, 2009

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OAB & UI treatments (download)

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.
Imipramine HCl	Tofranil (Mallinckrodt)	tabs	10mg, 25mg, 50mg	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.
	Ditropan (Ortho-McNeil)	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.
Trospium chloride	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.
Tolterodine tartrate	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)

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