Urinary Incontinence Drug Summary

• CV effects (QT prolongation, ventricular tachycardia); GI effects (thirst, dry mouth, constipation, paralytic ileus, hepatic dysfunction); Other effects (acute glaucoma, urinary retention, hallucination/delirium)

• Must be taken after breakfast and evening meal
• Contraindicated in patients with urinary retention, occluded pyloric region, paralytic ileus, decreased GI motility, angle closure glaucoma, myasthenia gravis, severe heart disease
• Use with caution in patients with arrhythmia, hepatic and renal impairment, dementia, cognitive dysfunction, Parkinson symptoms, cerebrovascular symptoms, cerebrovascular disorder, ulcerative colitis, hyperthyroidism

• GI effects (nausea/vomiting, diarrhea, enterospasms); Ophthalmologic effect (miosis); CV effect (bradycardia); Respiratory effect (bronchospasm); Other effects (increased salivation and lacrimation, sweating, muscle spasms and tremor, muscle weakness, difficulty in swallowing)

• Take the whole dose on an empty stomach, 30 minutes before breakfast
• Contraindicated in patients with severe vagotonia or dominance of the parasympathetic part of the autonomic nervous system

• Irritation or itching at application site, breast discomfort or pain

• Use with caution in patients with leiomyoma, endometrial hyperplasia, first-degree hereditary for breast cancer, HTN, DM, severe liver disorders, severe headache, SLE, epilepsy, asthma, otosclerosis, thromboembolic disorders
• Avoid in patients with known or suspected breast cancer, estrogen-dependent tumors, undiagnosed vaginal bleeding, untreated endometrial hyperplasia, thrombosis, thromboembolism, acute liver disease, porphyria
• Discontinue use if jaundice or liver function deterioration, significant increase in BP or new onset of migraine-type headache occurs

• Injection site reactions (pain, tenderness and/or bruising); Dermatologic effects (rarely skin rash, pruritus); Other effects (fever, flu, facial paresis, neck pain)

• Contraindicated in patients with myasthenia gravis, Eaton-Lambert syndrome, acute UTI and urinary retention who are not routinely doing clean intermittent self-catheterization
• Use with caution in patients at risk of angle-closure glaucoma, amyotrophic lateral sclerosis, pregnant, children <12 years old and elderly

• GI effects (nausea, abdominal pain); CNS effects (muscular weakness, myalgia, intracranial hypertension); Other effects (exanthematous or urticarial skin rashes)

• Use with caution in patients with impaired renal or hepatic function, CNS damage, convulsion; strong sunlight exposure
• Avoid in lactating patients

• CNS effects (insomnia, fatigue, headache, dizziness, tremor); GI effects (dry mouth, constipation, nausea, anorexia, decreased appetite); Ophthalmologic effect (blurred vision); Other effects (increased sweating, hyponatremia has been reported rarely; suicidal ideation can occur)

• Avoid in women with hepatic dysfunction
• Use with caution in patients a history of mania, bipolar disorder and/or seizures, in combination with antidepressants, in patients with increased intraocular pressure or those at risk for acute narrow-angle glaucoma
• Taper slowly at discontinuation of therapy

• Tachycardia, UTI
• Uncommon: CV effects (palpitations, atrial fibrillation); GI effects (dyspepsia, gastritis, increased liver enzymes); Other effects (rash, pruritus, joint swelling)

• Use with caution in patients with severe renal impairment or end-stage renal disease, severe or moderate hepatic impairment, severe uncontrolled hypertension, history of QT prolongation or taking drugs known to prolong QT interval

Adverse Reactions

• GI effects (constipation, nausea, xerostomia, diarrhea); Respiratory effects (nasopharyngitis, upper respiratory tract infection [URTI]); Other effects (hot flash, increased PVRV, urinary retention)

Special Instructions

• Contraindicated in patients with severe hepatic impairment and end-stage renal disease
• Use with caution in patients with bladder outlet obstruction and use of concomitant muscarinic drugs

Adverse Reactions

• CNS effects (nervousness, vertigo, fatigue, headache, confusion); CV effects (tachycardia, palpitation); GI effects (dry mouth and throat, abdominal pain, constipation); Ophthalmologic effects (blurred vision, increased intraocular pressure); Other effects (dysuria, hypersensitivity reactions, hyperpyrexia, eosinophilia, leukopenia)

Special Instructions

• Contraindicated in patients with pyloric or duodenal obstruction, intestinal lesions or ileus, achalasia, GI hemorrhage, obstructive uropathies of the lower urinary tract, myasthenia gravis, severe ulcerative colitis, toxic megacolon, glaucoma
• Use with caution in the elderly and in patients with coronary artery disease, congestive heart failure, arrhythmias, autonomic neuropathy, hepatic and renal impairment

Adverse Reactions

• GI effects (dry mouth, constipation, abdominal pain, diarrhea); Ophthalmologic effects (blurred vision, dry eyes); CNS effects (drowsiness, headache); CV effects (palpitations, arrhythmias, tachycardia); GU effects (urinary retention, dysuria); Other effects (angioedema, skin reactions)

Special Instructions

• Avoid in patients with urinary or gastric retention, uncontrolled narrow-angle glaucoma and in patients at risk for these conditions
• Use with caution in patients with GI obstructive disorders, severe constipation, ulcerative colitis, myasthenia gravis, controlled narrow-angle glaucoma; in patients with significant bladder outflow obstruction

Darifenacin

• Avoid in patients with severe hepatic impairment; use with caution if moderate impairment

Fesoterodine

• Use with caution in patients with renal and hepatic impairment, concomitant use of CYP3A4 inhibitors

Propiverine

• Monitor hepatic enzymes during long-term therapy

Solifenacin

• Avoid in patients with severe renal dysfunction or in those with moderate-severe liver disease

Trospium

• Use with caution in patients with moderate-severe hepatic impairment
• Use with caution in patients with renal impairment

• CV effects (bradycardia, supine and sitting hypertension); Other effects (paresthesia and pruritus mainly of the scalp, chills, urinary urgency, retention and frequency)

• Monitor BP, slowing of heart rate may occur
• Use with caution in patients with urinary retention, orthostatic hypotension, diabetes, renal and hepatic impairment; concomitant use with other vasoconstrictor drugs
• Avoid in patients with increased BP, severe organic heart disease, pheochromocytoma, thyrotoxicosis