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.