From the Guidelines
For bladder spasms, oxybutynin is the recommended medication, given its efficacy in treating detrusor overactivity in patients with neurogenic bladder, as noted in a study published in The Journal of Urology 1. When considering medication for bladder spasms on an as-needed basis, it's crucial to weigh the benefits and potential side effects. Oxybutynin, an antimuscarinic medication, is specifically indicated for the treatment of detrusor overactivity, which can cause bladder spasms.
- The dosage of oxybutynin can be tailored to the patient's needs, but a common starting point is 5 mg taken orally when symptoms occur, with a maximum of 2-3 doses per day.
- It's essential to monitor for side effects such as dry mouth, constipation, and blurred vision, and to advise patients to avoid alcohol, which can exacerbate these side effects.
- Patients should also be encouraged to maintain good hydration throughout the day but might consider reducing fluid intake in the evening to minimize nighttime symptoms.
- For patients experiencing frequent bladder spasms, a scheduled dosing regimen rather than an as-needed approach might offer better symptom control.
- Certain patient populations, such as those with glaucoma, urinary retention, or specific gastrointestinal conditions, should exercise caution when using oxybutynin and discuss alternative treatments with their healthcare provider, as indicated by the study on design and methodological considerations for the treatment of neurogenic bladder 1.
From the FDA Drug Label
Oxybutynin chloride exerts a direct antispasmodic effect on smooth muscle and inhibits the muscarinic action of acetylcholine on smooth muscle. Oxybutynin chloride relaxes bladder smooth muscle In patients with conditions characterized by involuntary bladder contractions, cystometric studies have demonstrated that oxybutynin chloride increases bladder (vesical) capacity, diminishes the frequency of uninhibited contractions of the detrusor muscle, and delays the initial desire to void Oxybutynin chloride thus decreases urgency and the frequency of both incontinent episodes and voluntary urination.
Medication for bladder spasms: Oxybutynin (PO) can be used to treat bladder spasms.
- Mechanism of action: Oxybutynin chloride exerts a direct antispasmodic effect on smooth muscle and inhibits the muscarinic action of acetylcholine on smooth muscle.
- Clinical effects: Oxybutynin chloride relaxes bladder smooth muscle, increases bladder capacity, diminishes the frequency of uninhibited contractions of the detrusor muscle, and delays the initial desire to void.
- Dosage: The dosage of oxybutynin chloride for pediatric patients 5 years of age and older is not explicitly stated in the provided text for prn use, however, the total daily dose ranging from 5 mg to 15 mg was used in a study for pediatric patients with detrusor overactivity associated with a neurological condition 2. 2
From the Research
Medication for Bladder Spasms
- Medications such as oxybutynin have been used to treat bladder spasms, with studies showing its effectiveness in managing reflex neurovesical dysfunction, enuresis, and bladder spasm 3.
- Mirabegron, a beta-3 adrenoreceptor agonist, has been proposed as an alternative treatment for overactive bladder symptoms, including bladder spasms, with a favorable adverse effects profile compared to antimuscarinics 4, 5, 6.
- The use of antispasmodic therapy, such as oxybutynin, has been documented in the treatment of bladder spasms following ambulatory urologic procedures 7.
- Prophylaxis with belladonna and opium suppositories (B&O) was not significantly associated with a lower rate of bladder spasms in patients undergoing ambulatory urologic procedures 7.
Treatment Options
- Oxybutynin is a tertiary amine with anticholinergic and direct muscular antispasmodic effects, making it effective in treating bladder spasms 3.
- Mirabegron offers a new alternative for treating overactive bladder in patients who do not tolerate or are not appropriate for antimuscarinics, with a similar efficacy profile to first-line antimuscarinics 4, 5, 6.
- Combination therapy of mirabegron and other pharmacotherapy has proven to be efficient in controlling overactive bladder symptoms without inducing serious add-on adverse effects 5.