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Thread: Bladder med alternatives?

  1. #1
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    Bladder med alternatives?

    I've been on oxybutynin (Ditropan) for years and it works really well. I can go about a year between botox injections. However, the side effects are just not worth it anymore. I have pretty bad short term memory loss, struggle to find words I'm thinking of, issues with comprehension, etc. I recently switched to Myrbetriq and the side effects went away. But it doesn't work as well for the bladder issues, so I have to do botox after only three months. I'm looking for another alternative that works well but without the mental side effects. I've also tried Trospium (Sanctura) in the past with little luck. My urologist suggested trying Vesicare next, but I would appreciate any suggestions. Thanks in advance.

  2. #2
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    Wait. You do Botox but still need oxybutynin? I'm planning to do Botox in order to get off oxybutynin!
    T3 complete since Sept 2015.

  3. #3
    Senior Member Oddity's Avatar
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    I don't need meds with Botox. No meds and no Botox I hold ~300-400cc before I have issues. With Botox I can hold twice that, or more sometimes. On 15mg Ditropan 2x a day I only held ~500-600, and was cognitively debilitated by the side effects. I'd say get Botox more often. I need it 2x a year, 300 units each time, for full effect. Once every 8-10 months if I let it wear off entirely. (It also takes a week or so to fully kick in)
    "I have great faith in fools; self-confidence my friends call it." - Edgar Allen Poe

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  4. #4
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    Quote Originally Posted by Mize View Post
    Wait. You do Botox but still need oxybutynin? I'm planning to do Botox in order to get off oxybutynin!
    Yes, for me at least taking medication extends the time between botox injections. If I go with no meds and just botox, it only lasts a few months. It may be different for others though, so hopefully it works for you.

  5. #5
    Unfortunately, nearly all the anticholenergics have the same side effects of dry mouth, dry eyes, and constipation. For some, this lso includes cognitive side effects. Sanctura has the least amount of cognitive effects, but you have already tried that. Everyone is different in how they respond to the traditional anticholenergics, so it may be worth a trial on solifenacin (Vesicare) to see how you do with it. Have you also been tried on tolterodine (Detrol), darifenacin (Enablex), flavoxate (Urispas), or fesoterodine (Toviaz)? Some people can do a lower dose of Ditropan if they also combine it with another anticholenergic like hyoscyamine (Levsinex).

    Also, it is well known that for some people, each repeated course of treatment with Botox can be less and less effective, and last less time than the previous course.

    Brad, do you do intermittent cath? Have you tried intravesicular Ditropan (where you instill a solution of Ditropan into your bladder at the end of your cath a couple times a day)? This is not done a lot, but may be an option for those who cannot tolerate the side effects of the oral use of anticholenergics.

    (KLD)
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  6. #6
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    Quote Originally Posted by SCI-Nurse View Post
    Unfortunately, nearly all the anticholenergics have the same side effects of dry mouth, dry eyes, and constipation. For some, this lso includes cognitive side effects. Sanctura has the least amount of cognitive effects, but you have already tried that. Everyone is different in how they respond to the traditional anticholenergics, so it may be worth a trial on solifenacin (Vesicare) to see how you do with it. Have you also been tried on tolterodine (Detrol), darifenacin (Enablex), flavoxate (Urispas), or fesoterodine (Toviaz)? Some people can do a lower dose of Ditropan if they also combine it with another anticholenergic like hyoscyamine (Levsinex).

    Also, it is well known that for some people, each repeated course of treatment with Botox can be less and less effective, and last less time than the previous course.

    Brad, do you do intermittent cath? Have you tried intravesicular Ditropan (where you instill a solution of Ditropan into your bladder at the end of your cath a couple times a day)? This is not done a lot, but may be an option for those who cannot tolerate the side effects of the oral use of anticholenergics.

    (KLD)
    I have not tried those other medications that you mentioned. I do intermittent cath, but have never heard of intravesicular ditropan. I'll give the Vesicare a shot since they just gave me a month of samples and if the side effects are the same, then I'll move on to the things you listed. Thanks

  7. #7

    Any update Brad?

    Wondering how Vesicare worked out for you?



    Quote Originally Posted by Brad09 View Post
    I have not tried those other medications that you mentioned. I do intermittent cath, but have never heard of intravesicular ditropan. I'll give the Vesicare a shot since they just gave me a month of samples and if the side effects are the same, then I'll move on to the things you listed. Thanks

  8. #8
    For what it's worth, I was able to reduce spasms by getting rid of kidney stones. No meds needed.

  9. #9
    Quote Originally Posted by August West View Post
    For what it's worth, I was able to reduce spasms by getting rid of kidney stones. No meds needed.
    I think I’m going to have to look into that if my spasms starts acting up again. I had really bad spasms and pain one night to the point that i was raiding my medicine cabinet to see if I had an old opioid prescription left over. The next morning my urine was red tinged with blood clots in it. Pretty sure I had been passing a stone through my ureter that night. Hasn’t happened again so I’ll ignore it until it acts up, but I guess I should get it checked out if it recurrs.

  10. #10
    Constipation with anticholinergics occurs because of the lack of water in the bowels and increasing stool softeners such as docusate to max dose (600 mg twice a day -slowly increase may help.Also Mirgabetron an be taken with the anticholinergics as it is in a different class.

    CWO
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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