Tab. VI.

Selected medications used for therapy of overactive bladder and their effects on various body systems/organs [7]

Anticholinergics
Medication	Dosage and administration	Muscarinic receptor affinity					Main side effects
		M1	M2	M3	M4	M5	Dry mouth	Consti-pation	Cognitive	Other
Oxybutynin IR	2.5-5 mg bid/tid	+	+	+	+	+	+++	++	++
Oxybutynin ER	5-30 mg/day	+	+	+	+	+	++	++	++
Oxybutynin patch	1 patch/twice weekly (3.9 mg/day) Rotate application site	+	+	+	+	+	+	+	No effect	Skin irritation
Oxybutynin gel	1 g/skin/daily(abdomen, thighs or upper body) Rotate application site and cover with clothing to avoid transfer	+	+	+	+	+	+	+	No effect
Solifenacin	5-10 mg/day				+		+	+	No effect
Darifenacin	7.5-15 mg/day				+		+	+/++	No effect
Fesoterodine	4-8 mg/day	+	+	+		+	+	+	No effect
Propiverine IR	15 mg/bid	+	+	+	+	+	+	++	Limited data
Propiverine ER	30 mg/day	+	+	+	+	+	+	++	Limited data
Tolterodine IR	1-2 mg/bid	+	+	+		+	+	+	No effect	Prolonged Qt interval(dose > 8 g/day)
Tolterodine ER	2-4 mg/day	+	+	+		+	+	+	No effect
Trospium	IR: 20 mg/bid ER: 60 mg/day	+	+	+	+	+	++	+	No effect
Non-antimuscarinic treatment for overactive bladder
Medication	Dosage and administration		Mechanism/site of action				Main side effects
Mirabegron	25-50 mg/day		β3-adrenergic receptor antagonist				Low incidence: Hypertension Tachycardia Headache Urinary tract infections Constipation or diarrhea Nasopharyngitis
Botulinum toxin A	100-200 U (idiopathic OAB) 200-300 U (neurogenic OAB)		Presynaptic motor neuron				Urinary retention Clean intermittent catheterization (occasionally) Hematuria Urinary tract infections
Tricyclic antidepressant	Starting dose: Imipramine 10 mg/bid Amitryptiline 10-20 mg/day		Multiple receptors in CNS Direct action on detrusor muscle				Anticholinergic like side effects (dry mouth, blurred vision, constipation, urinary retention) Tremor Arrhythmia Nausea
Desmopressin	0.1-0.2 mg/day		Renal collecting ducts Aquaporin-2-mediated				Hyponatremia Cardiac failure Hypertension