Overactive Bladder: Summary of affordable alternatives
The five prescription drugs used to treat overactive bladder are only modestly effective and have side effects that can limit their usefulness. Overactive bladder is characterized by the strong urge to urinate, often frequently and sometimes accompanied by leakage.
People with only mild symptoms should try non-drug measures first, such as lifestyle changes and learning Kegel exercises to strengthen pelvic muscles.
People with more severe symptoms also benefit from such measures but may get added symptom relief from taking a medicine. The drugs work better in tandem with non-drug measures than on their own.
None of the five drugs - oxybutynin (Ditropan, Ditropan XL and Oxytrol, a skin patch); tolterodine (Detrol, Detrol LA); trospium (Sanctura); solifenacin (Vesicare); and darifenacin (Enablex) – is any more effective than the others. However, they differ is the side effects they cause and their cost. Side effects include dry mouth, constipation, and mental confusion.
In studies, Ditropan XL, Detrol LA, Oxytrol, Sanctura, Vesicare, and Enablex have caused fewer side effects.
Taking effectiveness, side effects, safety, dosing convenience, and cost into account, we have chosen the following as Consumer Reports Best Buy Drugs to treat overactive bladder – if your doctor and you have concluded a drug is worth trying:
- Tolterodine (Detrol) – two pills per day
- Tolterodine extended release (Detrol LA) – one pill per day
- Trospium (Santura) – one pill per day
- Oxybutynin patch (Oxytrol) – two patches per week
All these medicines cost quite a bit more than generic oxybutynin, the only generic now available to treat overactive bladder. Their choice as Best Buys is justified by their lower risk of side effects. Tolterodine could soon become available as a generic drug.
Some people tolerate the side effects of generic oxybutynin well. If you have no health insurance or drug coverage, we'd advise trying that first.
Overactive Bladder Drugs: Cost Comparison and Best Buy Drugs
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| Recommendations: Bladder Drugs | |||||
| CR Best Buy | Generic Name and Dose | Brand Name(s)1 | Frequency of Use (Per Day)2 | Average Monthly Cost3 | Compare Prices |
| Oxybutyin 5mg | Ditropan | Two | $77 |  |
|
| Oxybutyin 5mg | Generic | Two | $20 | |
|
| Oxybutyin 5mg | Ditropan | Three | $116 | |
|
| Oxybutyin 5mg | Generic | Three | $30 | |
|
| Oxybutyin extended release 5mg | Ditropan XL | One | $127 | |
|
| Oxybutyin extended release 10mg | Ditropan XL | One | $126 | |
|
| Oxybutyin extended release 15mg | Ditropan XL | One | $133 | |
|
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Oxybutyin skin patch 3.9mg/24hrs | Oxytrol | See note4 | $114 - $226 | |
|
Tolterodine 1mg | Detrol | Two | $143 | |
|
Tolterodine 2mg | Detrol | Two | $144 | |
|
Tolterodine extended release 2mg | Detrol LA | One | $121 | |
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Tolterodine extended release 4mg | Detrol LA | One | $121 | |
|
Trospium 20mg | Sanctura | One | $65 | |
| Trospium 20mg | Sanctura | Two | $130 | |
|
| Solifenacin 5mg | Vesicare | One | $124 | |
|
| Solifenacin10mg | Vesicare | One | $126 | |
|
| Darifenacin 7.5mg | Enablex | One | $121 | |
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| Darifenacin 15mg | Enablex | One | $121 | |
|
(1) “Generic�? means the price given is for the generic version.
(2) As commonly or typically prescribed.
(3) Prices reflect nationwide retail average for September 2006, rounded to the nearest dollar. Prices are derived by Consumer Reports Best Buy Drugs from data provided by Wolters Kluwer Health, Pharmaceutical Audit Suite.
(4) The manufacturer’s recommendation is to change the patch every three to four days but some people may need a new patch every other day to get a meaningful benefit. The price variation reflects that variable use.
(2) As commonly or typically prescribed.
(3) Prices reflect nationwide retail average for September 2006, rounded to the nearest dollar. Prices are derived by Consumer Reports Best Buy Drugs from data provided by Wolters Kluwer Health, Pharmaceutical Audit Suite.
(4) The manufacturer’s recommendation is to change the patch every three to four days but some people may need a new patch every other day to get a meaningful benefit. The price variation reflects that variable use.
