Antimuscarinic Medications for Overactive Bladder

Abstract

Strong clinical evidence supports antimuscarinics (AMs) as a primary treatment for overactive bladder (OAB). They regulate bladder contractions by controlling muscarinic receptors, especially M3. Quaternary amines, like trospium, are less likely to pass the blood-brain barrier than tertiary amines, such as oxybutynin, which can cause central adverse effects, including dry mouth. Better bladder selectivity is the main goal of more recent medications like darifenacin and solifenacin in order to minimize adverse effects. Propantheline and flavoxate are examples of older medications that are no longer in use because of their variable efficacy or negative side effects. By lowering systemic adverse effects, more recent medications such as imidafenacin and tarafenacin have the potential to increase patient adherence. To improve therapy effectiveness, researchers are also looking into combination medicines using β3-adrenergic agonists. Despite its effectiveness, AMs might have negative side effects.