Drugs used to treat overactive bladder are only modestly effective. And, the side effects can be so bothersome that you stop taking them. If you suffer from mild symptoms, first consider trying other things besides drugs. For example, cut back on caffeinated beverages, and for several weeks try Kegel exercises to strengthen your pelvic muscles, which help control urination, and see if those provide enough relief. People with more severe symptoms can also benefit from those steps, but might experience added relief from also taking medication.
For this report, we evaluated the medications: darifenacin (Enablex); fesoterodine (Toviaz); mirabegron (Myrbetriq); oxybutynin (Ditropan XL, a skin patch called Oxytrol, a topical gel called Gelnique, and generic); solifenacin (Vesicare); tolterodine (Detrol and generic, Detrol LA); and trospium (Sanctura, Sanctura XR and generic).
Our analysis found that none of those drugs are clearly more effective than the others. But they do differ in cost and the side effects they cause, which include: constipation, drowsiness, dry mouth, blurry vision, and dizziness. Studies have found that Ditropan XL, Detrol LA, Oxytrol, Sanctura, Vesicare, and Enablex may cause fewer side effects.
Taking effectiveness, side effects, and cost into account, we have chosen the following as a Consumer Reports Best Buy Drug if you and your doctor conclude that a drug is worth trying.
■ Generic tolterodine
This medicine costs quite a bit more than generic oxybutynin if you are paying out of pocket. We chose it as a Best Buy because it has a lower risk of side effects. But some people tolerate the side effects of generic oxybutynin tablets well. So if your insurance does not cover medications, you might consider trying oxybutynin first as it is significantly less expensive.
Another option is tolterodine extended-release (Detrol LA). But since this medication is not available as a generic, it may cost more depending on your insurance coverage. But it offers the convenience of one-a-day dosing and a lower risk of side effects than oxybutynin.