Klin Farmakol Farm. 2025;39(1):44-51 | DOI: 10.36290/far.2025.016

Drug-drug interactions of drugs for treatment of overactive bladder

Michal Prokeš, Josef Suchopár
DrugAgency, a. s. Praha

The consumption of drugs used for the treatment of overactive bladder (OAB) in the Czech Republic has increased significantly over the past 10 years, and the number of potential drug interactions of these drugs is undoubtedly also increasing. This review article summarizes the current knowledge on this issue in order to provide treating physicians with the information necessary for optimal pharmacotherapy of OAB, which includes individual selection of drugs with regard to the patient's condition and drugs that are being used for other diseases.

Keywords: drug-drug interaction, anticholinergics, adrenergic β3 receptors agonists.

Accepted: April 15, 2025; Published: April 29, 2025  Show citation

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Prokeš M, Suchopár J. Drug-drug interactions of drugs for treatment of overactive bladder. Klin Farmakol Farm. 2025;39(1):44-51. doi: 10.36290/far.2025.016.
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    References

    1. Broďák M. Léčiva používaná k terapii dysfunkcí dolních močových cest, in: Suchopár J et al. Compendium. Léčiva používaná v podmínkách ČR. 2018:677-690.
    2. Oefelein MG.Safety and tolerability profiles of anticholinergic agents used for the treatment of overactive bladder. Drug Saf 2011;34(9):733-754. Go to original source... Go to PubMed...
    3. Prokeš M, Suchopár J. Anticholinergní léčiva a kumulace jejich nežádoucích účinků u seniorů. Med. Praxi. 2020;17(3): 182-189. Go to original source...
    4. Boustani MA, Campbell NL, Munger S, et al. Impact of anti­cholinregics: a review and practical application. Aging Health. 2008;4(3):311-320. Go to original source...
    5. Richardson K, Fox C, Maidment I, et al. Anticholinergic drugs and risk of dementia: case-control study. BMJ. 2018;361:k1315. Go to original source... Go to PubMed...
    6. Kay G, Crook T, Rekeda L, et al. Differential effects of the anti­muscarinic agents darifenacin and oxybutynin ER on memory in older subjects. Eur Urol 2006;50(2):317-326. Go to original source... Go to PubMed...
    7. Coupland CA, Trevor-Hill, Dening T, et al. Anticholinergic drug exposure and the risk of dementia. A nestad case-control study. JAMA Intern Med. 2019;179(8):1084-1093. Go to original source... Go to PubMed...
    8. Rube TE, Scorcheville A, Londos E, et al. Development of the Swedish anticholinergic burden scale (Swe-ABS). Drugs. 2023;83(4):315-340. Go to original source... Go to PubMed...
    9. Bishara D, Perera G, Harwood D, et al. Centrally Acting Anticholinergic Drugs Used for Urinary Conditions Associated with Worse Outcomes in Dementia. J Am Med Dir Assoc. 2021;22(12):2547-2552. Go to original source... Go to PubMed...
    10. Matta R, Gomes T, Juurlink D, et al. Receipt of Overactive Bladder Drugs and Incident Dementia: A Population-based Case-control Study. Eur Urol Focus. 2022;8(5):1433-1440. Go to original source... Go to PubMed...
    11. Özmen N, Yiginer Ö, Ün H, Bicakci B. Frequently occurring torsades de pointes attacks in an old patient on solifenacin therapy and management strategy. Anatol J Cardiol. 2015;15(4):342-3. Go to original source... Go to PubMed...
    12. Asajima H, Sekiguchi Y, Matsushima S, et al. QT prolongation and torsade de pointes associated with solifenacin in an 81-year-old woman. Br J Clin Pharmacol. 2008;66(6):896-897. Go to original source... Go to PubMed...
    13. DrugBank®. DB06702 [Internet]. [cited 2025 Feb 26]. Available from: https://go.drugbank.com/drugs/(vstup 26.2.2025).
    14. Woosley RL, Heise CW, Gallo T, et al. QTdrugs List [Internet]. CredibleMeds®; Tucson, AZ, AZCERT; Available from: www.CredibleMeds.org [cited 2025 Feb 25].
    15. Suchopár J, et al. Lékové interakce v urologii - na co si dát pozor. Urol. Praxi. 2020;21(2):80-86. Go to original source...
    16. Hussain RM, Hartigan-Go K, Thomas SH, Ford GA. Effect of oxybutynin on the QTc interval in elderly patients with urinary incontinence. Br J Clin Pharmacol. 1996;41(1):73-75. Go to original source... Go to PubMed...
    17. Serra DB, Affrime MB, Bedigian MP, et al. QT and QTc interval with standard and supratherapeutic doses of darifenacin, a muscarinic M3 selective receptor antagonist for the treatment of overactive bladder. J Clin Pharmacol. 2005;45(9):1038-1047. Go to original source... Go to PubMed...
    18. Breuel HP, Mürtz G, Bondy S, et al. Safety and tolerance of trospium chloride in the high dose range. Arzneimittelforschung. 1993;43(4):461-464.
    19. Donath F, Braeter M, Feustel C. The influence of propiverine hydrochloride on cardiac repolarization in healthy women and cardiac male patients. Int J Clin Pharmacol Ther. 2011;49(6):353-365. Go to original source... Go to PubMed...
    20. Suchopár J, et al. Léky prodlužující QT interval, in: Suchopár J, et al: Lékové interakce. Obecné aspekty lékových interakcí, první díl B. DrugAgency® a. s. 2023:725-750.
    21. Lukkari E, Juhakoski A, Aranko K, Neuvonen PJ. Itraconazole moderately increases serum concentrations of oxybutynin but does not affect those of the active metabolite. Eur J Clin Pharmacol. 1997;52(5):403-406. Go to original source... Go to PubMed...
    22. Swart PJ, Krauwinkel WJJ, Smulders RA, et al. Pharmacokinetic effect of ketoconazole on solifenacin in healthy volunteers. Basic Clin Pharmacol Toxicol 2006;99(1):33-36. Go to original source... Go to PubMed...
    23. Abebe BT, Weiss M, Modess C, et al. Effects of the P-Glycoprotein Inhibitor Clarithromycin on the Pharmacokinetics of Intravenous and Oral Trospium Chloride: A 4-Way Crossover Drug-Drug Interaction Study in Healthy Subjects. J Clin Pharmacol. 2019;59(10):1319-1330. Go to original source... Go to PubMed...
    24. Astellas Pharma US, Inc. Vesicare® (solifenacin) - Full prescribing information [Internet]. 2020 May [cited 2025 Feb 25]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/021518s017lbl.pdf.
    25. AbbVie Inc. Enablex® (darifenacin) - Full prescribing information [Internet]. 2021 Jul [cited 2025 Feb 25. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/021513s017lbl.pdf a Clinical Pharmacology Biopharmaceutics Review https://www.accessdata.fda.gov/drugsatfda_docs/nda/2004/21-513_Enablex_biopharmr.pdf.
    26. Malhotra B, Sachse R, Wood N. Evaluation of drug-drug interactions with fesoterodine. Eur J Clin Pharmacol. 2009;65(6):551-560. Go to original source... Go to PubMed...
    27. Salahudeen MS, Duffull SB, Nishtala PS. Anticholinergic burden quantified by anticholinergic risk scales and adverse outcomes in older people: a systematic review. BMC Geriatr. 2015;15:31. https://bmcgeriatr.biomedcentral.com/ articles/10.1186/s12877-015-0029-9. Go to original source... Go to PubMed...
    28. Rosa GM, Ferrero S, Nitti VW, et al. Cardiovascular Safety of β3-adrenoceptor Agonists for the Treatment of Patients with Overactive Bladder Syndrome. Eur Urol. 2016;69(2):311-323. Go to original source... Go to PubMed...
    29. Park JS, Choi SB, Jang WS, et al. Risks of Dementia After Treatment with an Anticholinergic, Beta-3 Agonist, or Combination of Both for an Overactive Bladder: A Korean National Cohort Study. Eur Urol Focus. 2024;10(2):306-314. Go to original source... Go to PubMed...
    30. Malik M, van Gelderen EM, Lee JH, et al. Proarrhythmic safety of repeat doses of mirabegron in healthy subjects: a randomized, double-blind, placebo-, and active-controlled thorough QT study. Clin Pharmacol Ther. 2012;92(6):696-706. Go to original source... Go to PubMed...
    31. Yamaguchi O, Kakizaki H, Homma Y, et al. Safety and efficacy of mirabegron as 'add-on' therapy in patients with overactive bladder treated with solifenacin: a post-marketing, open-label study in Japan (MILAI study). BJU Int. 2015;116(4):612-622. Go to original source... Go to PubMed...
    32. Katoh T, Igawa Y, Yamaguchi O, et al. Cardiovascular safety of antimuscarinic add-on therapy in patients with overactive bladder who had a suboptimal response to mirabegron monotherapy: A post hoc analysis from the Japanese MILAI II study. Low Urin Tract Symptoms. 2020;12(1):68-80. Go to original source... Go to PubMed...
    33. Lee J, Moy S, Meijer J, et al. Role of cytochrome p450 isoenzymes 3A and 2D6 in the in vivo metabolism of mirabegron, a β3-adrenoceptor agonist. Clin Drug Investig. 2013;33(6): 429-440. Go to original source... Go to PubMed...
    34. Konishi K, Minematsu T, Nagasaka Y, Tabata K. Physiologically-based pharmacokinetic modeling for mirabegron: a multi-elimination pathway mediated by cytochrome P450 3A4, uridine 5'-diphosphate-glucuronosyltransferase 2B7, and butyrylcholinesterase. Xenobiotica. 2019;49(8): 912-921. Go to original source... Go to PubMed...
    35. Konishi K, Minematsu T, Nagasaka Y, Tabata K. Application of a physiologically based pharmacokinetic model for the prediction of mirabegron plasma concentrations in a population with severe renal impairment. Biopharm Drug Dispos. 2019;40(5-6):176-187. Go to original source... Go to PubMed...
    36. Krauwinkel W, et al. The effect of mirabegron, a potent and selective β3-adrenoceptor agonist, on the pharmacokinetics of CYP2D6 substrates desipramine and metoprolol. Eur J Drug Metab Pharmacokinet. 2014;39(1):43-52. Go to original source... Go to PubMed...
    37. Groen-Wijnberg M, van Dijk J, Krauwinkel W, et al. Pharmacokinetic Interactions Between Mirabegron and Metformin, Warfarin, Digoxin or Combined Oral Contraceptives. Eur J Drug Metab Pharmacokinet. 2017;42(3):417-429. Go to original source... Go to PubMed...
    38. Lin J, Goosen TC, Tse S, et al. Physiologically Based Pharmacokinetic Modeling Suggests Limited Drug-Drug Interaction for Fesoterodine When Coadministered With Mirabegron. J Clin Pharmacol. 2019;59(11):1505-1518. Go to original source... Go to PubMed...
    39. U. S. Food and Drug Administration. Gemtesa® (vibegron) - clinical pharmacology and biopharmaceutics review(s) [Internet]. Urovant; 2020 Dec [cited 2025 Feb 25]. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2020/213006Orig1s000ClinPharmR.pdf.
    40. Ritchey ME, Wang J, Young JC, et al. CYP2D6 Substrate Dispensing Among Patients Dispensed Mirabegron: An Administrative Claims Analysis. Drugs Real World Outcomes. 2023;10(1):119-129. Go to original source... Go to PubMed...
    41. Welk B, McArthur E. Increased risk of dementia among patients with overactive bladder treated with an anticholinergic medication compared to a beta-3 agonist: a population-based cohort study. BJU Int. 2020;126(1):183-190. Go to original source... Go to PubMed...
    42. Okita Y, Shimomura Y, Komukai S, et al. Risks of Dementia Associated With Anticholinergic Medication Compared to Beta-3 Agonist Among Older Patients With Overactive Bladder in Japan: The LIFE Study. Int J Geriatr Psychiatry. 2025;40(1):e70036. Go to original source... Go to PubMed...
    43. Trbovich M, Romo T, Polk M, et al. The treatment of neurogenic lower urinary tract dysfunction in persons with spinal cord injury: An open label, pilot study of anticholinergic agent vs. mirabegron to evaluate cognitive impact and efficacy. Spinal Cord Ser Cases. 2021;7(1):50. Go to original source... Go to PubMed...

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