Detrol vs. Ditropan...bladder spasticity

Chris Chappell · 11-06-2003, 12:10 PM

Question for the nurses...

I take 4mg daily of Detrol LA. Lately I've had some increased bladder spasticity issues.

Elimiating the obvious (UTI) could it be that 4mg isn't enough? That my body has "leveled off" and doesn't respond the same to the 4mg?

Is 4mg normal, low, high in terms of dosage?

Should I consider switching maybe to Ditropan? If so, why?

Thanks.

marmalady · 11-06-2003, 01:23 PM

Just a lay person's guess here - it may be that the 'sustained release' dose of the Detrol isn't enough to keep you going. Matt was tried on Detrol, and it just didn't work for him; he apparently needs the every 6-8 hour dose from the Ditropan.

_____________
Tough times don't last - tough people do.

Chris Chappell · 11-06-2003, 02:46 PM

Jackie, thanks, and if you don't mind me asking, how much (mg) is in each (6-8hr) dose?

I'm usually ok for 24hrs but just this past week I'm having spasticity issues about every 5-6 hrs?

Btw, how much (detrol or ditropan) is ok to take in a 24hr period? And is there a major difference between the two?

Sorry for all the questions but I'm running low on options, not to mention supplies -

SCI-Nurse · 11-06-2003, 02:47 PM

Chris -- Have you spoken to your urologist, rehab MD or general practitioner about the increase in bladder spasms? I assume you are kicking off more. I would rule out the UTI first. I would give your doctor/nurse a call and get this done before discussing a medication change. How long have you been on the Detrol LA? When is the last time you had a CMG done? PLG

Chris Chappell · 11-06-2003, 02:57 PM

PLG, yes I've spoken to my GP about this. He's not much of a help though...kinda relys on me to tell him what I need.

Yes, I had a CMG in June. All was well and in normal ranges. I don't know what "kicking off more" means? Output?

I've been on Detrol LA since injury - roughly 3 1/2 yrs.

I'm also going to have a SP change tomorrow, even though its only been two weeks. Maybe there was some contamination last time -

Probably a loaded question, but, what causes / triggers bladder spasms - generally? Sometimes I have them when I'm pushing/racing my chair really hard? That's not the case this week?

Btw, diet hasn't changed either.

Curt Leatherbee · 11-06-2003, 03:15 PM

Perhaps the Sp Tube is causing some irratation to the bladder therefore the increased Spasticity?

"Life is about how you
respond to not only the
challenges you're dealt but
the challenges you seek...If
you have no goals, no
mountains to climb, your
soul dies".~Liz Fordred

SCI-Nurse · 11-06-2003, 05:45 PM

Chris-- Thanks for the update. I was referring to reflexive voiding when I mentioned "kick off voiding". How do you know you are having spasms? Is there pain or discomfort? Additional or less output? What other symptoms? When you go to have your SP tube changed tomorrow are you going to ask for a urinalysis/screen to be done as well to make sure you don't have a UTI? Bladder spasms can be caused by an irritation within the bladder wall such as with an infection or if you have a high pressure bladder or some dysynergia with the sphincters. I will ask KLD to get back to you on this one since I rarely work with SP tubes in my setting. Maybe she can shed more light on this for you. In the meantime, good luck tomorrow. Are you going to the GP's office to get this done, or your urologist? PLG

marmalady · 11-06-2003, 06:13 PM

Chis, Matt takes 5 mg every 8 hours of Ditropan; he was on 5 every 6 hours, and was able about two years ago to cut it back a little.

But everyone's different. Is your urologist an SCI urologist? If not, is there someone at Craig you could consult about this?

_____________
Tough times don't last - tough people do.

jpw · 11-07-2003, 02:38 PM

Hi. I IC when necessary (enough sensation to know when to go) so not sure if my experience will be helpful or not. I found that Detrol just doesn't work for me. I tried it at the max dose (can't remember exactly what that was) and no luck. Had to pee all the time. I do ditropan, 10mg 2x a day. This is the max ditropan dose I believe. It works pretty well and keeps the spacticity manageable. Ditropan XL didn't work either. I am about to try the ditropan patch.

JP

Spazway · 11-14-2003, 02:21 PM

I was on Ditropan for 16 years. I took 5 mg, 4 times a day and it finally stopped working. All it did was dry out my mouth (I felt like I had a mouth full of cotton all the time). Two years ago my urologist put me on Detrol, 2mg, 2 times a day. At first it didn't work so he increased my dosage to 4mg, 2 times a day and then I had a cystoscopy/lithotripsy to remove bladder stones. Following that, he dropped me back down to 2mg, twice a day and it's worked wonders. I no longer have the dry mouth (or not as dry), it doesn't make me nearly as drowsy as Ditropan, and I'm more continent now than I was while on Ditropan.

He is able who thinks he is able. - Buddha

11-06-2003, 12:10 PM	#1
Chris Chappell Senior Member Join Date: Jul 2001 Location: Denver, CO Posts: 6,609	Detrol vs. Ditropan...bladder spasticity Question for the nurses... I take 4mg daily of Detrol LA. Lately I've had some increased bladder spasticity issues. Elimiating the obvious (UTI) could it be that 4mg isn't enough? That my body has "leveled off" and doesn't respond the same to the 4mg? Is 4mg normal, low, high in terms of dosage? Should I consider switching maybe to Ditropan? If so, why? Thanks.

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11-06-2003, 01:23 PM	#2
marmalady Senior Member Join Date: Aug 2001 Posts: 3,940	Just a lay person's guess here - it may be that the 'sustained release' dose of the Detrol isn't enough to keep you going. Matt was tried on Detrol, and it just didn't work for him; he apparently needs the every 6-8 hour dose from the Ditropan. _____________ Tough times don't last - tough people do.

11-06-2003, 02:46 PM	#3
Chris Chappell Senior Member Join Date: Jul 2001 Location: Denver, CO Posts: 6,609	Jackie, thanks, and if you don't mind me asking, how much (mg) is in each (6-8hr) dose? I'm usually ok for 24hrs but just this past week I'm having spasticity issues about every 5-6 hrs? Btw, how much (detrol or ditropan) is ok to take in a 24hr period? And is there a major difference between the two? Sorry for all the questions but I'm running low on options, not to mention supplies -

11-06-2003, 02:47 PM	#4
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 30,233	Chris -- Have you spoken to your urologist, rehab MD or general practitioner about the increase in bladder spasms? I assume you are kicking off more. I would rule out the UTI first. I would give your doctor/nurse a call and get this done before discussing a medication change. How long have you been on the Detrol LA? When is the last time you had a CMG done? PLG

11-06-2003, 02:57 PM	#5
Chris Chappell Senior Member Join Date: Jul 2001 Location: Denver, CO Posts: 6,609	PLG, yes I've spoken to my GP about this. He's not much of a help though...kinda relys on me to tell him what I need. Yes, I had a CMG in June. All was well and in normal ranges. I don't know what "kicking off more" means? Output? I've been on Detrol LA since injury - roughly 3 1/2 yrs. I'm also going to have a SP change tomorrow, even though its only been two weeks. Maybe there was some contamination last time - Probably a loaded question, but, what causes / triggers bladder spasms - generally? Sometimes I have them when I'm pushing/racing my chair really hard? That's not the case this week? Btw, diet hasn't changed either.

11-06-2003, 03:15 PM	#6
Curt Leatherbee Moderator Join Date: Jul 2001 Location: Florida Posts: 7,201	Perhaps the Sp Tube is causing some irratation to the bladder therefore the increased Spasticity? "Life is about how you respond to not only the challenges you're dealt but the challenges you seek...If you have no goals, no mountains to climb, your soul dies".~Liz Fordred

11-06-2003, 05:45 PM	#7
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 30,233	Chris-- Thanks for the update. I was referring to reflexive voiding when I mentioned "kick off voiding". How do you know you are having spasms? Is there pain or discomfort? Additional or less output? What other symptoms? When you go to have your SP tube changed tomorrow are you going to ask for a urinalysis/screen to be done as well to make sure you don't have a UTI? Bladder spasms can be caused by an irritation within the bladder wall such as with an infection or if you have a high pressure bladder or some dysynergia with the sphincters. I will ask KLD to get back to you on this one since I rarely work with SP tubes in my setting. Maybe she can shed more light on this for you. In the meantime, good luck tomorrow. Are you going to the GP's office to get this done, or your urologist? PLG

11-06-2003, 06:13 PM	#8
marmalady Senior Member Join Date: Aug 2001 Posts: 3,940	Chis, Matt takes 5 mg every 8 hours of Ditropan; he was on 5 every 6 hours, and was able about two years ago to cut it back a little. But everyone's different. Is your urologist an SCI urologist? If not, is there someone at Craig you could consult about this? _____________ Tough times don't last - tough people do.

11-07-2003, 02:38 PM	#9
jpw Senior Member Join Date: Oct 2001 Location: Eagle River, AK, USA Posts: 155	Hi. I IC when necessary (enough sensation to know when to go) so not sure if my experience will be helpful or not. I found that Detrol just doesn't work for me. I tried it at the max dose (can't remember exactly what that was) and no luck. Had to pee all the time. I do ditropan, 10mg 2x a day. This is the max ditropan dose I believe. It works pretty well and keeps the spacticity manageable. Ditropan XL didn't work either. I am about to try the ditropan patch. JP

11-14-2003, 02:21 PM	#10
Spazway Senior Member Join Date: Sep 2003 Location: Canada Posts: 175	I was on Ditropan for 16 years. I took 5 mg, 4 times a day and it finally stopped working. All it did was dry out my mouth (I felt like I had a mouth full of cotton all the time). Two years ago my urologist put me on Detrol, 2mg, 2 times a day. At first it didn't work so he increased my dosage to 4mg, 2 times a day and then I had a cystoscopy/lithotripsy to remove bladder stones. Following that, he dropped me back down to 2mg, twice a day and it's worked wonders. I no longer have the dry mouth (or not as dry), it doesn't make me nearly as drowsy as Ditropan, and I'm more continent now than I was while on Ditropan. He is able who thinks he is able. - Buddha