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. |
|
Mirabegron Betmiga® |
Formulary
|
Modified-release tablets 25mg, 50mg Urinary frequency, urgency, and incontinence. |
MHRA: Mirabegron (Betmiga▼): risk of severe hypertension and associated cerebrovascular and cardiac events NICE TA290: Mirabegron for treating symptoms of overactive bladder |
|
Oxybutynin |
Formulary
|
Tablets 2.5mg, 5mg Urinary frequency, urgency, and incontinence. |
|
Darifenacin |
Formulary
|
Modified-release tablets 7.5mg, 15mg Urinary frequency, urgency, and incontinence. |
|
Duloxetine Yentreve® |
Formulary
|
Capsules 20mg, 40mg There can be variation in the licensing of different medicines containing the same drug therefore prescribe by brand name. |
MHRA: Duloxetine: marketed as Cymbalta▼ and Yentreve▼ for different disorders MHRA: SSRI/SNRI antidepressant medicines: small increased risk of postpartum haemorrhage when used in the month before delivery |
|
Fesoterodine |
Formulary
|
Modified-release tablets 4mg, 8mg Urinary frequency, urgency, and incontinence.
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Vibegron |
Formulary
|
NICE TA999: Vibegron for treating symptoms of overactive bladder syndrome |
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