A New Class of Drug
For decades, urge incontinence has been treated with drugs known as anticholinergics, which block nerves that cause muscle spasms in the bladder. However, these drugs come with side effects (dry mouth and constipation) so severe that 70 percent of women stop taking the medications within a year. In 2012 the FDA approved Myrbetriq, a new category of drug that works on a different set of nerves and doesn’t trigger the same side effects, notes Daniel S. Elliott, MD, of the department of female urology at Mayo Clinic. Patients may not see results for several weeks after starting the daily pills. Myrbetriq may raise blood pressure and may not be the right choice for those who suffer from uncontrolled hypertension.
Shots of this toxin have been used off-label to treat overactive bladder for a decade, but only in the past year did the FDA give its official seal of approval to the practice. “Botox relaxes bladder muscles, which prevents abnormal contractions and
allows for more urine to remain stored in the bladder,” says Courtenay Moore, MD, a urologist at the Cleveland Clinic.
But the Botox effect wears off: Patients need injections every six to eight months. Possible side effects include urinary tract infections. Elliott says Botox is typically reserved for people who haven’t had success with other treatment options or can’t tolerate the side effects of medications.
An OTC Patch
Last year the FDA approved Oxytrol for Women, an OTC patch formulated from the anticholinergic drug oxybutynin. The patch delivers medicine directly into the bloodstream via the skin. “Because the drug bypasses the liver, it has fewer side effects than the oral medications,” says Elliott.
Each patch is worn continuously for four days, so it could irritate people with sensitive skin. The medicine should cause a noticeable improvement within three months, possibly sooner.
Related: How I Solved My Bladder Problems