The seven prescription drugs used to treat overactive bladder are only modestly effective and have side effects that can limit their usefulness. If you have mild symptoms, first try lifestyle changes (for example, cutting back on caffeinated beverages) and other nondrug steps, such as Kegel exercises to strengthen pelvic muscles that help control urination, to 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.
There are seven drugs for overactive bladder: 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. However, they do differ in cost and the side effects they cause, including: 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, safety, and cost into account, we have chosen the following as a Consumer Reports Best Buy Drug to treat overactive bladder 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. Our choice of it as a Best Buy is justified by its lower risk of side effects. However, 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 since it is significantly less expensive.
Another option is tolterodine extended-release (Detrol LA). However, 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
