Pharmacologic management of overactive bladder

Sum Lam^1,2, Olga Hilas^1,3

¹St. John’s University, College of Pharmacy and Allied Health Professions, Department of Clinical Pharmacy Practice, Queens, New York, USA; ²Division of Geriatric Medicine, Winthrop University Hospital, Mineola, New York, USA; ³Department of Pharmacy, New York-Presbyterian Hospital, Weill Cornell Medical Center, New York, New York, USA

Abstract: Overactive bladder (OAB) is a prevalent and costly condition that can affect any age group. Typical symptoms include urinary urgency, frequency, incontinence and nocturia. OAB occurs as a result of abnormal contractions of the bladder detrusor muscle caused by the stimulation of certain muscarinic receptors. Therefore, antimuscarinic agents have long been considered the mainstay of pharmacologic treatment for OAB. Currently, there are five such agents approved for the management of OAB in the United States: oxybutynin, tolterodine, trospium, solifenacin and darifenacin. This article summarizes the efficacy, contraindications, precautions, dosing and common side effects of these agents. All available clinical trials on trospium, solifenacin and darifenacin were reviewed to determine its place in therapy.

Keywords: overactive bladder, urinary incontinence, pharmacologic management, antimuscarinic agents, anticholinergics