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Going to the bathroom too often? Try lifestyle changes before medication

Consumer Reports News: August 24, 2010 06:08 AM

If your bladder seems to work overtime and you’re headed to the bathroom more often than you’d like, it can be annoying but it doesn’t necessarily mean you need medication (or that you even have a medical problem at all). Yet, if you’ve seen ads about this on TV or in magazines, you might think otherwise. Pharmaceutical companies spend millions on adver-tising to convince you that you need one of their drugs intended to treat a condition called “overactive bladder.” But the truth, as detailed in our latest Best Buy Drugs report, is that lifestyle changes and bladder-training exercises can often provide relief without the need for a drug.

Why? Drugs for overactive bladder—such as darifenacin (Enablex), fesoterodine (Toviaz), oxybutynin (generic, Ditropan, Ditropan XL, Oxytrol, Gelnique), solifenacin (Vesicare), tolterodine (Detrol, Detrol LA), and trospium (Sanctura, Sanctura XR)—are only moderately effective. And they can cause notable side effects, including dry mouth, constipation, blurred vision, and dizziness.

Even so, heavy advertising has helped boost sales into the hundreds of millions of dollars for some of these drugs. Pharmaceutical companies spent a whopping $126.9 million on advertising last year for five of these drugs—Detrol, Detrol LA, Enablex, Toviaz, and Vesicare, according to Kantar Media. One drug, Toviaz, accounted for almost half of that, with $56.5 million in advertising, or more than double the $22.7 million the drug racked up in U.S. sales during the same year, according to IMS Health. ( See our AdWatch here that breaks down a Toviaz TV commercial.)

The advertising seems to work: The top three overactive bladder drugs—Detrol LA, Vesicare, and Enablex—had combined sales of more than $1.6 billion last year. It’s not a total surprise when you consider that in general, one-fifth (20 percent) of consumers currently taking a prescription drug asked their doctor for medication they learned about from an ad-vertisement. And of those people, a majority (59 percent) said their doctor wrote a prescrip-tion for the requested drug, according to a new national survey by the Consumer Reports National Research Center. About half of the respondents also said they thought doctors reached too often for the prescription pad before considering alternate treatments.

At the same time, drug manufacturers spend billions—more than $6.6 billion last year alone, according to IMS Health—in promotions to physicians and other health-care professionals.

The public is wary of the amount of influence pharmaceutical companies may have over doctors’ prescribing habits. In the survey, 81 percent of the respondents said their greatest concern was the rewards given by pharmaceutical companies to doctors who write a lot of prescriptions for a company’s drugs. Sixty-one percent voiced concern about doctors re-ceiving payments from pharmaceutical companies to speak at industry conferences. And 58 percent were concerned about big drug companies buying meals for doctors and their staffs.

And in the end, its consumers (and their insurance companies) who foot the bill for these financial outlays to doctors in the form of high-priced brand-name medication. Certain overactive bladder drugs, for example, are expensive, with some costing more than $200 a 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 10 times a day, and episodes of incontinence (urine leakage). If you have these symptoms, it’s important to see a doctor to get an accurate diagnosis, because there are several other bladder and incontinence conditions that are treated differently but sometimes confused with overactive bladder.

If your symptoms are relatively mild and don’t interfere with your daily activities, you should try cutting back on caffeinated and alcoholic beverages, drink less before bedtime, and learn bladder-training exercises, including Kegel exercises, to strengthen the pelvic muscles that help control urination. This can often relieve your symptoms enough so that a drug isn’t necessary.

For more detailed information, check out our free Best Buy Drugs report on drugs to treat overactive bladder.

Steve Mitchell, associate editor, Consumer Reports Health Best Buy Drugs

Aaron Bailey

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