Lancashire and South Cumbria
Formulary
 
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7 Obstetrics, Gynaecology, and urinary-tract disorders
07-04-02 Urinary incontinence

Urinary incontinence should be categorised at the initial clinical assessment and initial treatment should be started on this basis. During the clinical assessment seek to identify relevant predisposing and precipitating factors and other diagnoses that may require referral for additional investigation and treatment.

Patient’s diagnosed with overactive bladder who are suitable for treatment in primary care should receive non-pharmacological treatment as the first line option.

Anticholinergic medicines can cause problematic adverse effects, especially in those using other medicines that affect total anticholinergic load.


Solifenacin
Formulary

Tablets 5mg, 10mg

Urinary frequency, urgency, and incontinence.

First line pharmacological therapy for urinary frequency, urgency, incontinence in women.


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Tolterodine
Formulary

Tablets 1mg, 2mg, Modified-release capsules 4mg

Urinary frequency, urgency, and incontinence.


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Trospium
Formulary

Tablets 20mg, Modified-release capsules 60mg

Urinary frequency, urgency, and incontinence.


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Mirabegron Betmiga®
Formulary

Modified-release tablets 25mg, 50mg

Urinary frequency, urgency, and incontinence.

Link  MHRA: Mirabegron (Betmiga▼): risk of severe hypertension and associated cerebrovascular and cardiac events
Link  NICE TA290: Mirabegron for treating symptoms of overactive bladder

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Oxybutynin
Formulary

Tablets 2.5mg, 5mg
Liquid 2.5mg/5mL
M/R tablets 5mg, 10mg

Urinary frequency, urgency, and incontinence.


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Darifenacin
Formulary

Modified-release tablets 7.5mg, 15mg

Urinary frequency, urgency, and incontinence.


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Duloxetine Yentreve®
Formulary

Capsules 20mg, 40mg

Moderate to severe stress urinary incontinence.

 There can be variation in the licensing of different medicines containing the same drug therefore prescribe by brand name.

Link  MHRA: Duloxetine: marketed as Cymbalta▼ and Yentreve▼ for different disorders
Link  MHRA: SSRI/SNRI antidepressant medicines: small increased risk of postpartum haemorrhage when used in the month before delivery

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Fesoterodine
Formulary

Modified-release tablets 4mg, 8mg

Urinary frequency, urgency, and incontinence.

 


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Vibegron
Formulary
Link  NICE TA999: Vibegron for treating symptoms of overactive bladder syndrome

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Oxybutynin
Formulary

Transdermal patches 3.9mg/24h 

Urinary frequency, urgency & incontinence.

Restricted to use in patients who are unable to take/tolerate oral anticholinergics, in line with LSCMMG guidance.


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