Which medications in the drug class Anticholinergic Drugs are used in the treatment of Bladder Dysfunction?

Updated: Jan 04, 2019
  • Author: Gregory T Carter, MD, MS; Chief Editor: Elizabeth A Moberg-Wolff, MD  more...
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Anticholinergic Drugs

Anticholinergic drugs inhibit the binding of acetylcholine to the cholinergic receptor, thereby suppressing involuntary bladder contraction of any etiology. In addition, they increase the volume of the first involuntary bladder contraction, decrease the amplitude of the involuntary bladder contraction, and may increase bladder capacity.


Propantheline is used for its anticholinergic effect and is given to control symptoms of urinary incontinence secondary to uninhibited bladder contractions related to upper motor neuron lesions.

Oxybutynin (Ditropan XL, Gelnique, Oxytrol)

Oxybutynin is a commonly used drug in patients with bladder disorders and is known for its anticholinergic-antispasmodic effects. It has a smooth muscle–relaxing effect distal to the cholinergic receptor site. It is also available in a long-acting form for once-daily dosing.

Tolterodine tartrate (Detrol, Detrol LA)

Tolterodine tartrate is a competitive muscarinic receptor antagonist for overactive bladder; however, it differs from other anticholinergic types in that it has selectivity for the urinary bladder over the salivary glands. It exhibits a high specificity for muscarinic receptors and has minimal activity or affinity for other neurotransmitter receptors and other potential targets (eg, calcium channels).

Trospium (Sanctura, Sanctura XR)

Trospium is a quaternary ammonium compound that elicits antispasmodic and antimuscarinic effects. It antagonizes the acetylcholine effect on muscarinic receptors. Its parasympathetic effect reduces smooth muscle tone in the bladder. Trospium is indicated for overactive bladder with symptoms of urinary incontinence, urgency, and frequency.

Solifenacin succinate (VESIcare)

Solifenacin succinate elicits competitive muscarinic receptor antagonism, which results in an anticholinergic effect and inhibition of bladder smooth muscle contraction. It is indicated for overactive bladder with symptoms of urgency, frequency, and urge incontinence.

Darifenacin (Enablex)

Darifenacin is an extended-release product that elicits competitive muscarinic receptor antagonism and reduces bladder smooth muscle contractions. It has high affinity for the M3 receptors involved in bladder and GI smooth muscle contraction, saliva production, and iris sphincter function. Darifenacin is indicated for overactive bladder with symptoms of urge incontinence, urgency, and frequency. It should be swallowed whole; it should not be chewed, divided, or crushed.

Fesoterodine (Toviaz)

Fesoterodine is a competitive muscarinic receptor antagonist. Its antagonistic effect results in decreased bladder smooth muscle contractions. Fesoterodine is indicated for symptoms of overactive bladder (eg, urinary urge incontinence, urgency, and frequency). It is available as 4- or 8-mg extended-release tablet.

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