An Issue of Urgency

If you feel chained to the toilet because you "need to go" frequently, you may have what GPs call an 'overactive bladder'. This is a common condition where no cause can be found for repeated and uncontrolled bladder contractions. Or you may have 'urge incontinence' where the main symptom is the sudden urge to urinate and the involuntary loss of urine at inappropriate times.

Many people suffer from these problems, but for various reasons they have never discussed them with their doctor. These problems can be treated successfully and life can get back to normal, but the first step is to speak to your doctor.

A combination of bladder training and medication can be very successful. With bladder training the aim is to slowly stretch the bladder so that it can hold larger and larger volumes of urine. In time, the bladder muscle should become less overactive and you will become more in control.

Doctors will usually start a patient on Oxybutynin and then Solifenacin (Vesicare®) if oxybutynin is not well tolerated. However many patients will suffer from dry mouth or other side effects with these drugs. The good news is that there is now another option with fewer adverse effects^1,2,3,4 that has become fully funded with a Special Authority, which means that there is no cost to the patient (apart from the initial visit to the doctor). This new option is called Arrow-Tolterodine and it is well tolerated. This is important news if you experience constipation, as Tolterodine has shown significantly lower incidence of constipation compared to Solifenacin (Vesicare*).

Arrow-Tolterodine is used to treat symptoms of an overactive bladder including:

• Urinary frequency and urgency
• Urge incontinence

Arrow-Tolterodine binds to receptors in the bladder. It controls the release of urine by significantly reducing spasms, relaxing the smooth muscle in the bladder wall and increasing storage volume. The full effect of the treatment can be expected within 4 weeks.

If you are being treated for overactive bladder or urge incontinence and would like to find out if Arrow-Tolterodine is better tolerated or works better, ask your doctor if Arrow-Tolterodine is right for you. Free samples are available from many doctors.

**Under Special Authority where the patient has overactive bladder and a documented intolerance of oxybutynin. *Vesicare is a registered trademark of Astellas Pharma International.

For more information, click here.

References:

1. Abrams P, Freeman R, Anderstrom C, Mattiasson A. Tolterodine, a new antimuscarinic agent: as effective but better tolerated than oxybutynin in patients with an overactive bladder. Br J Urol 1998; 81:801-810.

2. Appell RA: Clinical efficacy and safety of tolterodine in the treatment of overactive bladder: A pooled analysis. Urology 1997; 50(6A Suppl):90-96

3. Chapple C, Khullar V, Gabriel Z, Dooley JA. The effects of antimuscarinic treatments in overactive bladder: A systematic review and meta-analysis. Eur Urol 2005; 48:5-26.

4. NZMJ 19 May 2006, Vol 119 No 1234 Pg 31.

Arrow-Tolterodine is a Prescription Medicine for the treatment of symptoms of overactive bladder such as urinary frequency, urgency or incontinence. Check that this medicine is right for you. Medicines have benefits and risks. Do not use if you are unable to pass urine, have uncontrolled narrow-angle glaucoma or are breast feeding. Caution in patients with impaired kidney and liver function and with a condition myasthenia gravis. May affect heart rhythm and ability to drive and use machines. Use in pregnancy if benefits outweigh the risks. Possible adverse effects are dry mouth, dyspepsia, reduced tears, headache, constipation/ diarrhoea, dizziness/vertigo, abdominal pain, fatigue, drowsiness, wind, dry skin, reflux, increased heart rate, and water retention at the extremities. Use only as directed. If symptoms persist or you have side effects see your doctor. Check the Consumer Medicine Information (CMI) for full details at www.medsafe.govt.nz Contains 1mg and 2mg of Tolterodine. Fully funded with Special Authority. Actavis New Zealand Ltd, Auckland.

TAPS Approval Number NA 6532