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Overactive Bladder: Summary of Recommendations
If you're going to the bathroom too frequently, it doesn't necessarily mean you need a medication. Lifestyle changes and bladder training exercises can often provide relief without the need for a drug, so you should try those first.

Pharmaceutical companies don't want you to know that, however. They've spent millions on advertising (nearly $127 million last year alone) in an attempt to persuade you that you need one of their drugs that is intended to treat a condition called overactive bladder.

There are six different overactive bladder drugs that have been turned into at least a dozen separate products—darifenacin (Enablex), fesoterodine (Toviaz), oxybutynin (generic, Ditropan, Ditropan XL, a skin patch called Oxytrol, and a topical gel called Gelnique), solifenacin (Vesicare), tolterodine (Detrol, Detrol LA), and trospium (Sanctura, Sanctura XR). They are only moderately effective and can cause serious side effects, including dry mouth, constipation, blurred vision, and dizziness.

In addition to the side effects, these drugs are expensive, with some costing more than $200 per month. So before you shell out big bucks for any of these drugs, look beyond the slick ads and first consider whether you need a medication at all.

Overactive bladder is characterized by sudden urges to urinate, having to go more than eight to 10 times per day, and episodes of incontinence or urine leakage. If you have symptoms of overactive bladder, it is important to see your primary care physician or general internist to get an accurate diagnosis, because there are several other bladder and incontinence disorders that are treated differently, but which are sometimes confused with overactive bladder.

If your overactive bladder symptoms are relatively mild and don't interfere with your daily activities, most doctors recommend you first try lifestyle changes, such as cutting back on caffeinated and alcoholic beverages and drinking less before bedtime, along with bladder-training exercises, including Kegel exercises to strengthen the pelvic muscle that help control urination. These can often relieve your symptoms enough that a drug isn't necessary.

 
  Our Best Buy Pick

But if your frequent trips to the bathroom are interfering with your life—for example, some people are reluctant to leave the house and go someplace new for fear they'll be unable to find a bathroom when they need one—or you're having accidents, then it may be time to see your doctor to determine if a medication might help. Our Best Buy Drugs report gives you the information you need to choose the right one. Taking effectiveness, side effects, safety, dosing convenience, and cost into account, we chose as our Best Buy selections:
  • Tolterodine (Detrol)
  • Tolterodine extended-release (Detrol LA)

Both Detrol and Detrol LA have a low rate of side effects, and Detrol LA offers the convenience of only having to take it once a day. If price is an issue for you or you do not have health insurance, we recommend trying generic oxybutynin (in tablet form). This is the least expensive of all the overactive bladder medications, costing just $10 to $15 for a month's supply. But it did not meet our criteria for a Best Buy selection because it has the highest rate of some side effects, including severe dry mouth, and constipation. However, many people tolerate the drug well and are not bothered by these side effects. So if it works for you, it may be an option to consider.
Overactive-Bladder Drugs: Price Comparison
CR Best Buy
Generic Name and Dose Brand Name(s)1 Frequency of Use Per Day2 Average Monthly Cost3 Compare Prices
  Oxybutynin 5 mg Ditropan Two $82
  Oxybutynin 5 mg Generic Two $10
  Oxybutynin 5 mg Ditropan Three $123
  Oxybutynin 5 mg Generic Three $15
  Oxybutynin extended-release
5 mg
Ditropan XL One $155
  Oxybutynin extended-release
5 mg
Generic One $104
  Oxybutynin extended-release
10 mg
Ditropan XL One $150
  Oxybutynin extended-release
10 mg
Generic One $105
  Oxybutynin extended-release
15 mg
Ditropan XL One $154
  Oxybutynin extended-release
15 mg
Generic One $107
  Oxybutynin skin patch
3.9 mg/24 hrs
Oxytrol See note4 $195-$260
  Oxybutynin topical gel 10% Gelnique Apply once daily $179
best buy Tolterodine 1 mg Detrol Two $214
best buy Tolterodine 2 mg Detrol Two $220
best buy Tolterodine extended-release
2 mg
Detrol LA One $184
best buy Tolterodine extended-release
4 mg
Detrol LA One $169
  Trospium 20 mg Sanctura Two $220
  Trospium 60 mg Sanctura XR One $179
  Solifenacin 5 mg Vesicare One $189
  Solifenacin 10 mg Vesicare One $189
  Darifenacin 7.5 mg Enablex One $181
  Darifenacin 15 mg Enablex One $182
  Fesoterodine 4 mg Toviaz One $174
  Fesoterodine 8 mg Toviaz One $172
1. "Generic" means the price given is for the generic version.

2. As typically prescribed.

3. Prices reflect nationwide retail average for March 2010, rounded to the nearest dollar. Prices are derived by Consumer Reports Health Best Buy Drugs from data provided by Wolters Kluwer Pharma Solutions®. Wolters Kluwer is not involved in our analysis or recommendations.

4. The manufacturer's recommendation is to change the patch every three to four days. The price range reflects that variable use.