From the Guidelines
The best medications for managing bladder spasms include anticholinergics such as oxybutynin (5-10mg daily), solifenacin (5-10mg daily), tolterodine (2-4mg daily), and darifenacin (7.5-15mg daily), as well as beta-3 adrenergic agonists like mirabegron (25-50mg daily). These medications work by blocking receptors that trigger bladder contractions or by relaxing the bladder muscle directly, and have been shown to be effective in reducing symptoms of bladder spasms 1.
Medication Options
- Anticholinergics: oxybutynin (5-10mg daily), solifenacin (5-10mg daily), tolterodine (2-4mg daily), and darifenacin (7.5-15mg daily)
- Beta-3 adrenergic agonists: mirabegron (25-50mg daily)
Potential Side Effects
- Anticholinergics: dry mouth, constipation, and blurred vision
- Mirabegron: may increase blood pressure
Lifestyle Modifications
- Timed voiding
- Reducing caffeine and alcohol intake
- Pelvic floor exercises
- Adequate hydration
Additional Treatment Options
- Muscle relaxants like baclofen (10-25mg three times daily) or diazepam (2-10mg daily) can be used short-term for immediate relief
- Further evaluation by a urologist may be necessary to rule out underlying conditions if symptoms persist despite medication 1.
From the FDA Drug Label
Mirabegron extended-release tablets are a beta-3 adrenergic agonist indicated for the treatment of: Overactive bladder (OAB) in adult patients with symptoms of urge urinary incontinence, urgency, and urinary frequency.
The recommended starting dose of mirabegron extended-release tablets is 25 mg orally once daily. After 4 to 8 weeks, the mirabegron extended-release tablets dose may be increased to 50 mg orally once daily.
The best medication for managing bladder spasms is mirabegron, which is a beta-3 adrenergic agonist. It is indicated for the treatment of overactive bladder (OAB) in adult patients with symptoms of urge urinary incontinence, urgency, and urinary frequency. The recommended starting dose is 25 mg orally once daily, which can be increased to 50 mg orally once daily after 4 to 8 weeks. 2
From the Research
Medications for Bladder Spasms
The following medications are commonly used to manage bladder spasms:
- Anticholinergic drugs, such as oxybutynin, tolterodine, solifenacin, and fesoterodine, which help relax the bladder muscle and increase bladder capacity 3, 4
- Beta-3 adrenergic agonists, such as mirabegron and vibegron, which help relax the bladder muscle and increase bladder capacity 5
Comparison of Medications
Studies have compared the efficacy of different anticholinergic drugs:
- Tolterodine versus oxybutynin: Tolterodine had fewer withdrawals due to adverse events and less risk of dry mouth 3
- Solifenacin versus tolterodine: Solifenacin had better efficacy and less risk of dry mouth 3
- Fesoterodine versus extended release tolterodine: Fesoterodine had superior efficacy but higher risk of withdrawal due to adverse events and dry mouth 3
Non-Pharmacological Therapies
Non-pharmacological therapies, such as bladder training and pelvic floor muscle training, can also be effective in managing bladder spasms:
- Bladder training: Can be used alone or in combination with anticholinergic drugs 6
- Electrical stimulation: May be effective in patients who are refractory to anticholinergic therapy 6
Treatment Approach
A stepwise approach to treatment is recommended, starting with behavioral therapy, followed by pharmacologic treatment, and then third-line therapies such as onabotulinumtoxinA and sacral nerve stimulation 7