Overactive Bladder & Urinary Incontinence Treatments

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OVERACTIVE BLADDER &
URINARY INCONTINENCE TREATMENTS
Generic Brand Strength Form Dose
ANTICHOLINERGIC
imipramine HCl Tofranil 10mg, 25mg, 50mg tabs <6yrs: Not established.
≥6yrs: Childhood enuresis: Initially 25mg daily 1hr before bedtime; after 1wk, increase to 50mg for children 6−12yrs, up to 75mg if >12yrs.
Early night bedwetters: Give 25mg in afternoon and repeat at bedtime. Max 2.5mg/kg/day.
ANTISPASMODIC/ANTICHOLINERGIC
oxybutynin chloride 5 mg scored tabs <5yrs: Not recommended.
≥5yrs: 5mg twice daily; max 15mg/day
Adults: 5mg 2−3 times a day; max 20mg/day
5mg/
 
5mL
syrup
Ditropan 
XL
5mg, 10mg, 15mg ext-rel tabs <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%
1g/
 
sachet
gel Children: Not established.
Adults: Apply one sachet once daily to dry, intact skin. Rotate application sites.
oxybutynin transdermal system Oxytrol 3.9mg/
 
day
patch 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.
BETA-3 ADRENERGIC AGONIST
mirabegron Myrbetriq 25mg, 50mg ext-rel tabs Children: Not established.
Adults: Initially 25mg once daily; may increase to 50mg once daily as needed or tolerated. Severe renal impairment or moderate hepatic impairment: max 25mg once daily.
MUSCARINIC ANTAGONIST
darifenacin HBr Enablex 7.5mg, 15mg ext-rel tabs Children: Not established.
Adults: Initially 7.5mg once daily; may increase to 15mg once daily after 2wks. Moderate hepatic impairment (Child-Pugh B), concomitant potent CYP3A4 inhibitors: max 7.5mg once daily.
fesoterodine fumarate Toviaz 4mg, 8mg ext-rel tabs Children: Not established.
Adults: 4mg once daily; may increase to max 8mg once daily. Severe renal impairment (CrCl <30mL/min) or concomitant potent CYP3A4 inhibitors: max 4mg/day.
solifenacin succinate Vesicare 5mg, 10mg tabs 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.
tolterodine tartrate Detrol 1mg, 2mg tabs 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 2mg, 4mg ext-rel caps 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.
trospium chloride 20mg tabs 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.
60mg ext-rel caps Children: Not established.
Adults: 60mg daily in the AM. Severe renal impairment (CrCl<30mL/min): not recommended.
NEUROMUSCULAR BLOCKER
onabotuli-
numtoxin A
Botox 50 U/vial, 100 U/vial, 200 U/vial vacuum-dried pwd; for intra-
detrusor inj after reconsti-
tution and dilution
<18yrs: Not established.
Adults: 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. See full labeling.
VASOPRESSIN (SYNTHETIC)
desmo-
pressin acetate
DDAVP 0.1mg, 0.2mg scored tabs <6yrs: Not recommended.
≥6yrs: Nocturnal enuresis: individualize. Initially 0.2mg once daily at bedtime; max 0.6mg.
Noctiva 0.83mcg, 1.66mcg nasal spray Children: Not established.
Adults:
<50yrs: not studied. Nocturnal polyuria: <65yrs (without increased risk of hyponatremia): 1 spray (1.66mcg) in either nostril ~30mins before bedtime. ≥65yrs (or <65yrs with increased risk of hyponatremia): initially 1 spray (0.83mcg) in either nostril ~30mins before bedtime; may increase to 1.66mcg after ≥7 days, if needed, provided the serum sodium has remained normal.
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. 10/2018)

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