Formulary
Urinary incontinence should be categorised at the initial clinical assessment and initial treatment should be started on this basis. During the clinical assessment seek to identify relevant predisposing and precipitating factors and other diagnoses that may require referral for additional investigation and treatment.
Patient’s diagnosed with overactive bladder who are suitable for treatment in primary care should receive non-pharmacological treatment as the first line option.
Anticholinergic medicines can cause problematic adverse effects, especially in those using other medicines that affect total anticholinergic load.
| Solifenacin |
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Formulary
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Tablets 5mg, 10mg Urinary frequency, urgency, and incontinence. First line pharmacological therapy for urinary frequency, urgency, incontinence in women. |
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| Tolterodine |
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Formulary
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Tablets 1mg, 2mg, Modified-release capsules 4mg Urinary frequency, urgency, and incontinence. |
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| Trospium |
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Formulary
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Tablets 20mg, Modified-release capsules 60mg Urinary frequency, urgency, and incontinence. |
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| Mirabegron Betmiga® |
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Formulary
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Modified-release tablets 25mg, 50mg Urinary frequency, urgency, and incontinence. |
 MHRA: Mirabegron (Betmiga▼): risk of severe hypertension and associated cerebrovascular and cardiac events NICE TA290: Mirabegron for treating symptoms of overactive bladder |
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| Oxybutynin |
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Formulary
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Tablets 2.5mg, 5mg Urinary frequency, urgency, and incontinence. |
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| Darifenacin |
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Formulary
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Modified-release tablets 7.5mg, 15mg Urinary frequency, urgency, and incontinence. |
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| Duloxetine Yentreve® |
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Formulary
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Capsules 20mg, 40mg There can be variation in the licensing of different medicines containing the same drug therefore prescribe by brand name. |
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MHRA: Duloxetine: marketed as Cymbalta▼ and Yentreve▼ for different disorders MHRA: SSRI/SNRI antidepressant medicines: small increased risk of postpartum haemorrhage when used in the month before delivery |
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| Fesoterodine |
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Formulary
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Modified-release tablets 4mg, 8mg Urinary frequency, urgency, and incontinence.
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| Vaginal devices for female urinary stress incontinence Diveen®, Contiform®, Efemia® |
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Formulary
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Pelvic floor dysfunction: prevention and non-surgical management
For women who are unable to perform an effective pelvic floor muscle contraction, consider supplementing pelvic floor muscle training with biofeedback techniques, electrical stimulation or vaginal cones.
Consider a trial of intravaginal devices for women with urinary incontinence, only if other non-surgical options have been unsuccessful.
The product should only be initiated by a specialist pelvic health physiotherapist or specialist nurses and only continue if evidence of continued benefit.
 Routine management of female urinary stress incontinence. |
 LSCMMG Vaginal devices for female urinary stress incontinence NICE NG123 Urinary incontinence and pelvic organ prolapse in women: management NICE NG210 Pelvic floor dysfunction: prevention and non-surgical management |
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| Vibegron |
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Formulary
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NICE TA999: Vibegron for treating symptoms of overactive bladder syndrome |
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Links
- FSRH Clinical Guideline: Contraceptive Choices for Young People
- FSRH: Standards & Guidance
- FSRH: UK Medical Eligibility Criteria for Contraceptive Use (UKMEC)
- LSCMMG Vaginal devices for female urinary stress incontinence
- LSCMMG: Erectile Dysfunction Guideline
- LSCMMG: Overactive bladder in female adults
- LSCMMG: Overactive bladder in female adults
- MHRA: Duloxetine: marketed as Cymbalta▼ and Yentreve▼ for different disorders
- MHRA: Medicines with teratogenic potential: what is effective contraception and how often is pregnancy testing needed?
- MHRA: Mirabegron (Betmiga▼): risk of severe hypertension and associated cerebrovascular and cardiac events
- MHRA: SSRI/SNRI antidepressant medicines: small increased risk of postpartum haemorrhage when used in the month before delivery
- NICE CG30: Long-acting reversible contraception
- NICE CG97: Lower urinary tract symptoms in men: management
- NICE NG123 Urinary incontinence and pelvic organ prolapse in women: management
- NICE NG123: Urinary incontinence and pelvic organ prolapse in women: management
- NICE NG133: Hypertension in pregnancy: diagnosis and management
- NICE NG194: Postnatal care
- NICE NG210 Pelvic floor dysfunction: prevention and non-surgical management
- NICE NG210: Pelvic floor dysfunction: prevention and non-surgical management
- NICE NG3: Diabetes in pregnancy: management from preconception to the postnatal period
- NICE NG88: Heavy menstrual bleeding: assessment and management
- NICE TA290: Mirabegron for treating symptoms of overactive bladder
- NICE TA999: Vibegron for treating symptoms of overactive bladder syndrome
- NICE: TA290 - Mirabegron for overactive bladder
- Vaginal devices for female urinary stress incontinence