Who Cannot Take Medicines For Urinary Urgency And Incontinence
In general, most people are able to take these medicines however, there are some people who are unable to take these medicines.
Duloxetine should not be taken by people who have severe kidney or liver problems, uncontrolled high blood pressure, or are taking certain medicines – for example, antidepressants called monoamine-oxidase inhibitors.
Antimuscarinics should not be taken by people with:
- Myasthenia gravis. This is a condition where muscles become easily tired and weak.
- Severe bladder problems or urinary retention .
- Severe inflammation of the gut .
- Blockage of the gut.
- A condition of the eye, known as uncontrolled angle-closure glaucoma.
For a full list of people who cannot take these medicines, see the leaflet that came with your medicines.
Anticholinergic Drugs For Oab
The largest class of drugs used to treat OAB is anticholinergic drugs. They work by blocking a chemical in your body called acetylcholine. This chemical sends a message to your bladder to contract. By blocking this chemical, these drugs reduce the contractions that cause you to release urine. In studies that compared the drugs, all anticholinergics worked in treating OAB.
Anticholinergics are sold under different brand names. Some are also available as generic drugs. These medications include:
All of these drugs except for Oxytrol come as either tablets or capsules that you take by mouth. Oxytrol is available as a skin patch.
The most common side effects of anticholinergic drugs include:
- dry mouth
- blurry vision
Seniors have the greatest risk of side effects from these drugs. These medications may also cause drowsiness and an increased risk of falls in seniors. Oxybutynin may cause more side effects than the other drugs in this class. However, taking oxybutynin in its extended-release form may reduce some of the side effects. Anticholinergics may also worsen dementia symptoms and should be used with caution in people with this disease.
Weighing Benefits And Risks
The review does not make recommendations about the use of these drugs.
“It turns out that it’s as important to sit down with your doctor and look at the side effect pattern of the pills as it is the direct effects,” Kane says, “because for the most part, a number of them basically have about the same effectiveness, but they have different patterns of side effects.”
The new study is published in the Annals of Internal Medicine. It was funded by the federal Agency for Healthcare Research and Quality.
“This is a very important and well-done study,” says Patricia Goode, MD, a professor of medicine in the Center for Aging at the University of Alabama at Birmingham.
Goode says in an email that studies comparing the benefits and drawbacks of similar drugs are rare, “so this type of study, providing all of the best effectiveness data in one place, will be very useful.”
But she says the research may also be a little misleading since it masks the small degrees of improvement many women see on the drugs.
“Improvement alone can improve quality of life — for example, going from diapers to pads, or no longer having accidents that overflow pads and cause embarrassment,” she says. “Both frequency and volume decreases are important.”
But she says that for women who are able, Kegel exercises and lifestyle changes that include drinking less caffeine and watching fluid intake are likely to have bigger impacts on the condition.
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What To Do In Case You Take Too Much Gemtesa
If you think youve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use their online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.
When you get Gemtesa from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. This date is typically 1 year from the date when they dispensed the medication.
The expiration date helps guarantee that the medication is effective during this time. The of the Food and Drug Administration is to avoid using expired medications. If you have unused medication, and its expiration date has passed, talk with your pharmacist about whether you might still be able to use it.
Which Medicine Is Usually Prescribed
As discussed above, duloxetine is prescribed for stress incontinence.
For people with urge incontinence, oxybutinin is normally prescribed first. If you have too many side-effects with this medicine, your doctor may choose a different antimuscarinic such as darifenacin, fesoterodine, propiverine, solifenacin, tolterodine, or trospium. Your doctor may also choose a slow-release preparation of oxybutinin or an oxybutinin skin patch to help lessen side-effects.
Propiverine is sometimes chosen if you have urinary urgency but you do not have urinary incontinence.
You may be prescribed mirabegron if you are unable to take an antimuscarinic.
Other medicines that are used less often are oestrogen applied to the vagina and desmopressin. These medicines are usually prescribed on the advice of a specialist doctor. Oestrogen applied to the vagina may be chosen for women who have gone through the menopause and desmopressin is considered if you are passing urine frequently at night and you are younger than 65 years of age.
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Overcoming Barriers To Treatment
Dr. Slopnick says there are a number of reasons why people with overactive bladder problems dont explore all treatment options.
Most of the time, its two or three years before people are diagnosed or even have treatment, she says. Then, after patients try multiple medications without success, they may lose hope for an effective treatment and give up.
But theres no reason to prolong treatment thats not working, she says.
She suggests talking to a urologist after your first failed attempt at treatment with medication. The main point is that if youre having bothersome symptoms, talk to your doctor about them, she says.
Manufacturer Information And Claims About Urivarx For Women
UriVarx for Women is a product of Innovus Pharma Company. It is a United States of America-based company with its Headquarters situated in San Diego.
It is a rising pharmaceutical company involved in over-the-counter consumer products, commercialization, licensing, and development of safe and effective non-prescription medicine and consumer care products.
The products are designed to improve elderly womens bladder and urinary health. The manufacturer claims that the bladder control product is a potent blend of all-natural ingredients that target tissues surrounding the bladder and urinary tract to help restore normal urination patterns and control.
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Beta Agonists For Bladder Problems
This class of medication, mirabegron , works by relaxing the bladder muscle during the storage phase, thus increasing the capacity of bladder to hold more urine. They can be used for the treatment of overactive bladder . Mirabegron is the first drug in this category.
- How beta-agonist drugs work: They work by relaxing the bladder muscles and reducing bladder overactivity.
- Who should not use this medication: Individuals with the following conditions should not use mirabegron or a similar class of drugs:
- Allergy to this drug
- Advanced kidney disease
Botox Injection For Bladder Problems
Botox injection has recently been approved by the Food and Drug Administration for the treatment of overactive bladder for patients who have failed to respond to standard therapy with anticholinergic medications.
Overactive bladder is a type of urinary incontinence caused by overactivity of the muscles in the bladder, causing frequent squeezing of the bladder and, thus, frequent urge to urinate. Botox can be injected into the bladder directly through a cystoscope .
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Begin By Talking To Your Doctor
What should you do if youre experiencing bladder problems? First, speak up. People often dont bring up issues of incontinence with their clinical providers, either due to embarrassment or because they feel there are no available options that can helpor that surgery may be the only option, says Tomas Griebling, M.D., professor of urology and senior associate dean for medical education at the University of Kansas School of Medicine. But the symptoms can almost always be eased, Hochman says.
So start by working with a general practitioner, who can determine whether there may be an underlying cause for your symptoms. Urgency, incontinence, and urinary frequency can be caused by urinary tract infections or kidney stonesor, in men, a prostate infection or prostate enlargement. Medication you take to treat other conditions, such as anxiety, depression, high blood pressure, insomnia, and pain, can also lead to bladder leaks.
Your doctor might ask you to keep a diary of how often you urinate, when you have leaks, and how much liquid you consume. That will help define the problem and pinpoint the triggers.
How Can I Manage Incontinence At Home
Incontinence can be uncomfortable and disruptive. It can cause sleeping problems, make you feel ashamed or angry, or affect your daily life in other ways. In addition to working with your health care team to find the best treatment, there are things you can do at home to help make incontinence better or more comfortable.
Limit how much you drink, especially coffee and alcohol. Avoid foods that can irritate the bladder, including dairy products, citrus fruits, sugar, chocolate, soda, tea, and vinegar.
Go to the bathroom right before bedtime and any vigorous activity.
Wear an absorbent pad inside your underwear or disposable incontinence underwear.
Maintain a healthy weight. Extra weight can put pressure on the bladder and muscles that support it.
Go to the bathroom regularly each day. Do not wait too long or put off going.
Quit smoking. Nicotine can irritate the bladder. It can also make you cough and leak urine.
Do Kegel exercises. Ask your health care team about doing Kegel exercises at home. They can make your bladder stronger. To do Kegel exercises, first tighten the muscles you use to stop the flow of urine. Then, relax those muscles. Repeat the exercise several times. During this exercise, relax the muscles in your belly, buttocks, and thigh.
Finally, it can help to find support. Talk with your health care team or join a support group for people with bladder problems. It can help you feel better to know that other people are also dealing with incontinence.
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What Are The Symptoms Of Bladder Control Problems
Signs and symptoms of urinary incontinence can include
- leaking urine during everyday activities, such as lifting, bending, coughing, or exercising
- being unable to hold in urine after feeling a sudden, strong urge to urinate
- leaking urine without any warning or urge
- being unable to reach a toilet in time
- wetting your bed during sleep
- leaking during sexual activity
Medications For Treating Incontinence
There are several medications used to treat incontinence. The main types of incontinence that respond to drug treatment are stress and urge incontinence.
Some of the medication used for stress incontinence include:
- Oestrogens are used to re-vitalise the urethral tissue structures enabling a better seal or closure.
- Alpha-adrenergic agonists. These drugs are used to contract the muscles around the bladder neck and urethra. This forms a tighter seal that keeps urine from leaking under pressure.
The medications used for urge incontinence or over-active bladder syndrome include:
All of these drugs should be used in conjunction with bladder training and pelvic floor exercises. The combination of these techniques provides the best option for managing the bladder spasms that cause urge incontinence and strengthening urethral resistance in stress incontinence. Each of these incontinence medications affects people differently. You should consult your doctor to determine the best treatment for you.
* International not-for-profit organisation preparing, maintaining and promoting the accessibility of systematic reviews of the effects of health care.
Kimberly-Clark Australia makes no warranties or representations regarding the completeness or accuracy of the information. This information should be used only as a guide and should not be relied upon as a substitute for professional medical or other health professional advice.
Other urinary incontinence causes
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What Should I Know About Storage And Disposal Of This Medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light, excess heat and moisture .
It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location â one that is up and away and out of their sight and reach.
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.
Could Your Overactive Bladder Be Something Else
Urgency, incontinence, and urinary frequency can all be caused by having urinary tract infections , kidney stones, prostate infection or enlargement, or could be from medicine you take to treat other conditions, such as high blood pressure. The first question your doctor might ask if youre having urinary problems is what medicines youre taking. If they dont ask, be sure to bring it up.
Other conditions can cause symptoms similar to those of overactive bladder, tooespecially the need to make frequent bathroom trips. These include bladder cancer, diabetes, heart disease, and neurologic disorders, such as multiple sclerosis, Parkinsons disease, spinal cord injuries, and strokes.
Other conditions can also cause urine leakage. For example, stress incontinenceleaking urine when you cough, sneeze, run, jump, or even laughis sometimes confused with overactive bladder. Its caused by a weakness of the muscles that help keep the bladder closed. Some people have a combination of overactive bladder and stress incontinence.
Another bladder disorder called overflow incontinence can have symptoms similar to overactive bladder. This condition is usually caused by an inability to empty the bladder, due to an obstruction or a problem with the muscles that contract the bladder. So much urine builds up in the bladder that it starts leaking out.
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What If I Forget To Take It
If you forget to take your medicine, take it as soon as you remember unless the next dose is due in less than 6 hours. In this case skip the missed dose and take your next one at the usual time.
Do not take a double dose to make up for a missed dose.
If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
How Is Urinary Incontinence Diagnosed
Talk with your health care team if you have a problem controlling your bladder. They will work with you to figure out the reason. They may recommend you writing down some details about your urination, including when you urinate, how often you urinate, and how much liquid is released. This is called a “voiding diary.” Your health care provider may also give you the following tests:
Tests on a sample of your urine to look for an infection or other problems.
A test where you cough as hard as you can when your bladder is full.
Tests to measure pressure in your bladder.
Tests to measure how well your urine is flowing.
An ultrasound. This uses sound waves to create a picture of your bladder and the other body parts that control urine.
A cystoscopy. This test uses a small, lighted tube to look inside your bladder.
An X-ray of your bladder.
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Other Options For Overactive Bladder
If medications arent working for you, talk to your doctor or a urologist about other approaches. They range from injections to implants, and each approach has pros and cons. Here are three of the most common alternatives:
1. Onabotulinum toxinA
Botox® is well-known for smoothing wrinkles, but onabotulinum toxinA injections can also benefit your bladder.
Injecting the drug directly into bladder muscles helps to calm the bladder and prevent urinary urgency and related leakage, says Dr. Slopnick.
The big advantages are that injections are done in the office and are usually only required two or three times a year. Side effects like dry mouth and constipation arent an issue. However, there are other possible side effects, Dr. Slopnick points out. About 6% of patients have a hard time urinating and require intermittent self-catheterization until the Botox starts to wear off. Also, about 20% develop urinary tract infections.
2. Sacral neuromodulation
This treatment uses a device that works like a pacemaker for your bladder. The device is placed in two stages, so you can test drive it first to see if it works for you. The first stage is either done in the office with local anesthesia or under sedation. Your doctor will insert a thin wire lead into your back to stimulate your bladder nerve roots.
You do a two-week test stimulation with a temporary battery, explains Dr. Slopnick. And if you have 50% improvement in your symptoms then you go on to full implantation.