Dumfries & Galloway Health Board
Prescribing Support Team

Review of antimuscarinics in urinary frequency, urgency and urge incontinence

Posted: 6 Jul 17 Edited: 8 Aug 18
Audits Obstetrics, Gynaecology & Urinary Tract Disorders

Patients who suffer from detrusor muscle over-activity and urge incontinence may benefit from anti-muscarinic therapy in addition to pelvic floor exercises, bladder retraining and lifestyle interventions. Previous SIGN guidance in this therapeutic area (SIGN 79) was withdrawn in 2015 which means that the most recent UK based national clinical guideline is NICE CG171 (first published in 2013 and updated in 2015). This guideline recommends that antimuscarinic therapy be reviewed four weeks following its commencement to assess the extent of any therapeutic benefit and the degree of any adverse effects. Medication should be continued where a satisfactory therapeutic response has been achieved whilst in those instances where adverse effects have proved to be problematic, an alternative antimuscarinic should be tried. In the event of treatment being continued, review of ongoing need should take place annually in those aged under 75 years and every 6 months in those aged over 75 years.