7.4.2 Drugs for urinary frequency, enuresis, and incontinence


First line drugs Second line drugs Specialist drugs Secondary care drugs

Notes:

  • Accurate assessment and diagnosis of the cause of incontinence  is vital for treatment success. Non-drug treatments have an important  role in management.
  • Desmopressin (refer to Section 6.5.2) is licensed for nocturnal enuresis.    
  • Tricyclic antidepressants may also be used to treat nocturnal enuresis.
  • Do not use flavoxate, propantheline and imipramine for the treatment of UI or OAB in women. [2006]
  • Do not offer oxybutynin (immediate release) to frail older women. [new 2013]
  • Offer one of the following choices first to women with OAB or mixed UI:
  • oxybutynin (immediate release), or

  • tolterodine (immediate release), or

  • darifenacin (once daily preparation). [new 2013]

 

Oxybutynin

  • Tablets 2.5mg, 3mg, 5mg

Notes: Oxybutynin standard release is the first choice drug therapy. Patients may experience anticholinergic side effects. Therefore the minimum effective dose should be used. However, many patients referred to secondary care on low doses respond well to higher doses so GPs should consider increasing the dose of oxybutynin to 5mg TDS before referral.      

Tolterodine

  • Tablets 1mg, 2mg

 

Darifenacin

  • Tablets m/r 7.5mg, 15mg  

Tolterodine

  • Capsules m/r 4mg      

Trospium

  • Tablets 20mg      

 

Mirabegron

See Milton Keynes pathway: Pharmacotherapy for the Management of LUTS in Males and Females

 

Return to Chapter: 7. Obstetrics, Gynaecology and Urinary–tract Disorders

Last updated by: Annie Bolton on 01-10-2014 11:58