Department of Pharmacology and Pharmacotherapy, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

To review evidence and regulatory dosing recommendations for muscarinic receptor antagonists used in the treatment of overactive bladder symptom complex (darifenacin, fesoterodine, oxybutynin, propiverine, solifenacin, tolterodine, trospium) in special patient populations.

Growing evidence demonstrates effects of renal impairment, hepatic impairment, genetics and/or comedications on the pharmacokinetics of muscarinic antagonists. They may cause greater exposure in the respective population, which may translate into greater risks for side effects. These possible risks lead to drug-specific regulatory dosing recommendations or even contraindications in certain patient populations.

Physicians should be aware of pharmacokinetic alterations in special patient populations and possible associated risks. The evidence-based choice of a muscarinic antagonist in such patients should be guided by its specific pharmacokinetic profile.

Written by:
Witte LP, Mulder WM, de la Rosette JJ, Michel MC.   Are you the author?

Reference:
Curr Opin Urol. 2009 Jan;19(1):13-9.

PubMed Abstract
PMID:19057211

UroToday.com Overactive Bladder (OAB) Section

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