Overactive Bladder & Urinary Incontinence Treatments

OVERACTIVE BLADDER &
URINARY INCONTINENCE TREATMENTS
Generic Brand Form Strength Dose
ANTICHOLINERGIC
imipramine HCl Tofranil tabs 10mg, 25mg, 50mg <6yrs: Not established.
≥6yrs: Initially 25mg daily 1hr before bedtime; after 1wk, increase to 50mg for children 6−12yrs, up to 75mg for those >12yrs.
Early night bedwetters: Give 25mg in afternoon and repeat at bedtime.
Max 2.5mg/kg per day.
ANTISPASMODIC/ANTICHOLINERGIC
darifenacin HBr Enablex ext-rel tabs 7.5mg, 15mg Children: Not recommended.
Adults: Initially 7.5mg once daily; may increase to 15mg once daily after 2wks. Max 7.5mg once daily in moderate hepatic impairment or with potent CYP3A4 inhibitors (eg, ketoconazole, itraconazole, ritonavir, nelfinavir, clarithromycin, nefazadone).
oxybutynin chloride 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
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.
Gelnique 
10%
gel 1g/
 
sachet
Children: Not established.
Adults: Apply one sachet once daily to dry, intact skin. Rotate application sites.
oxybutynin transdermal system Oxytrol patch 3.9mg/
 
day
Children: Not established.
Adults: Apply 1 patch twice weekly (every 3−4 days) to clean, dry area on the abdomen, hip or buttock. Rotate application sites.
solifenacin succinate Vesicare tabs 5mg, 10mg Children: Not established.
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.
trospium chloride Sanctura tabs 20mg Children: Not established.
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.
Sanctura XR ext-rel caps 60mg Children: Not established.
Adults: 60mg daily in the AM. Severe renal impairment (CrCl<30mL/min): not recommended.
MUSCARINIC ANTAGONIST
fesoterodine fumarate Toviaz ext-rel tabs 4mg, 8mg Children: Not recommended.
Adults: 4mg once daily; max 8mg once daily. Severe renal insufficiency (CrCl<30mL/min) or concomitant potent CYP3A4 inhibitors (eg, ketoconazole, itraconazole, clarithromycin): max 4mg/day.
tolterodine tartrate Detrol tabs 1mg, 2mg Children: Not established.
Adults: 2mg twice daily; may decrease to 1mg twice daily. Concomitant CYP3A4 inhibitors, or significant renal or hepatic dysfunction: 1mg twice daily.
Detrol LA ext-rel caps 2mg, 4mg Children: Not established.
Adults: 4mg once daily; may decrease to 2mg once daily. Concomitant CYP3A4 inhibitors, or significant renal or hepatic dysfunction: 2mg once daily.
NEUROMUSCULAR BLOCKER
onabotuli-
numtoxin A
Botox vacuum-dried pwd; for intra-
detrusor inj after reconsti-
tution and dilution
50 U/vial, 100 U/vial, 200 U/vial <18yrs: Not established.
Adults: See full labeling. Should be administered and managed by experienced physicians. Give prophylactic antibiotics 1−3 days pre‑treatment, during, and 1−3 days post‑treatment. Discontinue anti-platelet therapy ≥3 days before procedure. May premedicate with local or general anesthetic. Max dose: 100 Units/treatment; give 20 injections of 0.5mL each into the detrusor muscle via a flexible or rigid cystoscope, avoiding the trigone. May consider re‑treatment after effect of the previous injection diminishes but no sooner than 12wks. Max cumulative dose: 400 Units in a 3‑month interval.
VASOPRESSIN (SYNTHETIC)
desmo-
pressin acetate
DDAVP scored tabs 0.1mg, 0.2mg <6yrs: Not recommended.
≥6yrs: Initially 0.2mg once daily at bedtime; individualize; max 0.6mg.
NOTES

Not an inclusive list of medications and/or official indications. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling.

(Rev. 7/2016)

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