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Treatment area: Irritable bladder

Overactive bladder: medically reviewed and treated

With an overactive bladder, the bladder suddenly and intensely signals its need, often at night, and sometimes urine is leaked. Here you will find prescription tablets for the symptoms of an overactive bladder, and a doctor will review your questionnaire to determine if treatment is suitable for you.

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Ratgeber lesenRead the guideLire le guideGids lezen
  • online questionnaire
  • Medical examination
  • Discreet Shipping
  • Money back if not suitable

BehandlungsoptionenTreatment optionsOptions de traitementBehandelopties

Tablets for overactive bladder

All medications are prescription-only and intended for adults with overactive bladder. After making your selection, you will complete a medical questionnaire, and a doctor will then decide whether a treatment is suitable for you.

Selbst einschätzenAssess it yourselfFaire le point vous-mêmeZelf inschatten

Which medication might be suitable?

  1. 1 If you prefer to take it only once a day Mirabegron (Betmiga) as a sustained-release tablet and solifenacin (Vesicare) as a film-coated tablet are taken once daily, while oxybutynin is usually taken several times a day. The doctor will decide which medication is suitable.
  2. 2 If you have high blood pressure or don't know your current blood pressure Mirabegron can increase blood pressure and is not suitable for patients with very high, uncontrolled blood pressure. A current blood pressure reading in the questionnaire will facilitate the assessment. The doctor will decide.
  3. 3 In cases of advanced age, memory problems, narrow-angle glaucoma, or myasthenia gravis Anticholinergics can cause confusion and drowsiness and are not suitable for patients with narrow-angle glaucoma or myasthenia gravis. Mirabegron works via a different mechanism. Please provide all information in the questionnaire; the doctor will decide.
  4. 4 If you have already taken medication for an overactive bladder In the questionnaire, please specify which medication was used and how effective and tolerable it was. Taking multiple bladder medications simultaneously increases the risk of urinary retention, and any changes should be made only as directed by your doctor. The doctor will make the final decision.

Diese Hinweise helfen bei der Orientierung und ersetzen keine ärztliche Beratung. Ob und welche Behandlung für Sie geeignet ist, entscheidet der Arzt anhand Ihres Fragebogens.This guidance helps you get your bearings and does not replace medical advice. Whether a treatment is suitable for you, and which one, is decided by the doctor on the basis of your questionnaire.Ces indications vous aident à vous orienter et ne remplacent pas un avis médical. C’est le médecin qui décide, sur la base de votre questionnaire, si un traitement vous convient et lequel.Deze aanwijzingen helpen u op weg en vervangen geen medisch advies. Of en welke behandeling voor u geschikt is, bepaalt de arts aan de hand van uw vragenlijst.

Anticholinergics

Oxybutynin and solifenacin inhibit muscarinic receptors in the bladder muscle and differ, among other things, in how often they are taken per day.

Oxybutynin RezeptpflichtigPrescription onlySur ordonnanceUitsluitend op recept

Oxybutynin

Anticholinergic tablet for frequent urination and urge incontinence in overactive bladder.

WirkeintrittOnsetDélai d’actionWerkingsaanvang
Peak blood levels after approximately 0,5 to 1 hour
FormFormFormeVorm
Tablets

So wirkt es:How it works:Mode d’action :Zo werkt het: Oxybutynin blocks muscarinic receptors in the bladder muscle and also has an antispasmodic effect. The bladder muscle contracts less frequently involuntarily, the bladder stores more urine, and the urge to urinate decreases.

Das kann für Sie passenThis may suit youCela peut vous convenirDit kan bij u passen
  • If an overactive bladder with frequent or strong urges to urinate has been medically diagnosed
  • If a urinary tract infection and problems emptying the bladder have been ruled out
  • If there is no narrow-angle glaucoma and no myasthenia gravis
Anwendung & wichtige HinweiseUse & important informationUtilisation et informations importantesGebruik en belangrijke aandachtspunten

Anwendung:Use:Utilisation :Gebruik: Tablets of 5 mg, usually taken two to three times daily with plenty of liquid, with a maximum dose of 20 mg per day. Elderly people usually start with a lower dose.

Verfügbare Stärken:Available strengths:Dosages disponibles :Beschikbare sterktes: 5 mg

Not suitable for patients with narrow-angle glaucoma, urinary retention, myasthenia gravis, strictures or obstructions in the gastrointestinal tract, severe ulcerative colitis, or tachyarrhythmia. Elderly people are particularly susceptible to confusion and drowsiness.

abfromà partir devanaf 37,97 € Endpreis, inkl. ärztlicher PrüfungFinal price, incl. medical reviewPrix final, évaluation médicale incluseEindprijs, incl. medische beoordeling
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Solifenacin RezeptpflichtigPrescription onlySur ordonnanceUitsluitend op recept

Vesicare (Solifenacin)

Antimuscarinic film-coated tablet, taken once daily to treat urinary urgency and urge incontinence in overactive bladder.

WirkeintrittOnsetDélai d’actionWerkingsaanvang
First effects often within 1 week
FormFormFormeVorm
Film-coated tablets

So wirkt es:How it works:Mode d’action :Zo werkt het: Solifenacin blocks muscarinic receptors in the bladder muscle. This reduces involuntary contractions of the bladder muscle, allowing the bladder to store more urine, and decreasing urinary urgency and frequency of trips to the toilet.

Das kann für Sie passenThis may suit youCela peut vous convenirDit kan bij u passen
  • If an overactive bladder with urinary urgency or urge incontinence has been medically diagnosed
  • If a urinary tract infection and urinary retention have been ruled out
  • Provided there is no narrow-angle glaucoma, no myasthenia gravis, and no severe liver disease.
Anwendung & wichtige HinweiseUse & important informationUtilisation et informations importantesGebruik en belangrijke aandachtspunten

Anwendung:Use:Utilisation :Gebruik: One film-coated tablet once daily, usually starting with 5 mg, increasing to 10 mg if necessary. The effect can be assessed after at least 4 weeks.

Verfügbare Stärken:Available strengths:Dosages disponibles :Beschikbare sterktes: 5 mg · 10 mg

Not suitable for patients with urinary retention, narrow-angle glaucoma, myasthenia gravis, severe gastrointestinal disease, dialysis, or severe liver disease. Do not exceed 5 mg when used with strong CYP3A4 inhibitors.

abfromà partir devanaf 52,32 € Endpreis, inkl. ärztlicher PrüfungFinal price, incl. medical reviewPrix final, évaluation médicale incluseEindprijs, incl. medische beoordeling
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Beta-3 agonists

Mirabegron relaxes the bladder muscle via beta-3 receptors and does not have an anticholinergic effect.

Mirabegron RezeptpflichtigPrescription onlySur ordonnanceUitsluitend op recept

Betmiga (Mirabegron)

Delayed-release tablet containing mirabegron for overactive bladder with urgency, frequent urination or urge incontinence.

WirkeintrittOnsetDélai d’actionWerkingsaanvang
Detectable in studies after 4 weeks
WirkdauerDurationDurée d’actionWerkingsduur
Extended-release tablet for once-daily use
FormFormFormeVorm
Extended-Release Tablets

So wirkt es:How it works:Mode d’action :Zo werkt het: Mirabegron activates beta-3 receptors in the bladder muscle and relaxes it as the bladder fills. This allows the bladder to hold more urine, and can reduce urgency and frequency of urination.

Das kann für Sie passenThis may suit youCela peut vous convenirDit kan bij u passen
  • When sudden urge to urinate, frequent urination, or urge incontinence are the main symptoms
  • If the blood pressure is known and can be checked regularly
  • If a urinary tract infection has been ruled out as the cause
Anwendung & wichtige HinweiseUse & important informationUtilisation et informations importantesGebruik en belangrijke aandachtspunten

Anwendung:Use:Utilisation :Gebruik: One prolonged-release tablet once daily, swallowed whole with liquid, with or without food.

Verfügbare Stärken:Available strengths:Dosages disponibles :Beschikbare sterktes: 25 mg · 50 mg

Not for use in cases of severe, uncontrolled hypertension above 180/110 mmHg. Mirabegron can increase blood pressure, therefore it should be measured before starting treatment and regularly thereafter.

abfromà partir devanaf 75,11 € Endpreis, inkl. ärztlicher PrüfungFinal price, incl. medical reviewPrix final, évaluation médicale incluseEindprijs, incl. medische beoordeling
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RatgeberGuideGuideGids

What you should know about overactive bladder

An overactive bladder is common and nothing to be ashamed of. Tablets can relieve urinary urgency and urinary incontinence, but they do not replace the investigation of other underlying causes.

What is an overactive bladder?

In an overactive bladder, the bladder muscle contracts involuntarily, even though the bladder is not yet full. Typical symptoms include:

  • sudden, strong urge to urinate that can hardly be postponed
  • Frequent urination during the day and at night
  • Urine loss when you feel the urge to urinate (urge incontinence)

Stress incontinence, in which urine is lost when coughing, sneezing, or lifting, is distinct from this. The cause of an overactive bladder often remains unclear; sometimes neurological disorders such as multiple sclerosis are the underlying cause. A urinary tract infection or an obstruction, such as one caused by an enlarged prostate, should be ruled out before treatment.

What treatments are there?

The first steps usually involve bladder training, pelvic floor exercises, and adjusting fluid intake. If that's not enough, tablets can relax the bladder muscle.

  • Anticholinergics: Oxybutynin and solifenacin (Vesicare) inhibit muscarinic receptors in the bladder muscle.
  • Beta-3 agonist: Mirabegron (Betmiga) relaxes the bladder muscle via beta-3 receptors.

The tablets alleviate the symptoms but do not eliminate the cause. Whether treatment is effective is usually assessed after about four weeks. These medications are not intended for use in cases of pure stress incontinence.

Side effects and cautions

Anticholinergics such as oxybutynin and solifenacin often cause dry mouth, constipation, and blurred vision. Older people are more sensitive and may experience confusion or drowsiness. Oxybutynin also reduces sweating, which can lead to overheating in hot weather.

Mirabegron can increase blood pressure and accelerate the heartbeat. It is not suitable for patients with very high, uncontrolled blood pressure above 180/110 mmHg. If an irregular heartbeat occurs, discontinue use and seek urgent medical advice.

Taking multiple bladder medications at the same time increases the risk of being unable to empty the bladder.

Warning signs: When immediate help is needed

Urgency to urinate and urine loss can also have other causes. Seek immediate medical attention if:

  • Fever, chills or flank pain
  • Full, painful bladder, unable to urinate (urinary retention)
  • sudden eye pain with red eye or deterioration of vision

Call emergency services immediately on 112 (Switzerland: 144) if you experience new numbness in the genital or buttocks area, weakness in the legs or loss of bowel control. The same applies to swelling of the face, tongue, or throat accompanied by shortness of breath. Visible blood in the urine should be promptly examined by a doctor.

Take action yourself

Training the bladder

Besides medication, simple everyday measures can help the bladder get used to longer intervals between urination. A good starting point is keeping a bladder diary for a few days. Note when and how much you drink, how often you go to the toilet, and when you experience urine leakage. This will also make it easier to assess the effectiveness of the treatment later on.

  • Bladder training: gradually delay going to the toilet by a few minutes when you feel the urge to urinate.
  • Drink plenty of fluids throughout the day and reduce your intake of coffee, black tea and alcohol, especially in the evening.
  • Pelvic floor exercises, ideally with guidance from a physiotherapist.

Drinking less to avoid the urge to urinate often has the opposite effect, as insufficient fluid intake frequently increases the urge and promotes urinary tract infections. For dry mouth while taking anticholinergics, small sips of water or sugar-free chewing gum can help. More on urinary tract infections: Cystitis.

Zu den BehandlungsoptionenView treatment optionsVoir les options de traitementNaar de behandelopties

AblaufHow it worksDéroulementWerkwijze

In vier Schritten zur BehandlungFour steps to your treatmentEn quatre étapes vers votre traitementIn vier stappen naar uw behandeling

Ärztlich geprüft, diskret und ohne Wartezimmer.Reviewed by a doctor, discreet and without a waiting room.Examiné par un médecin, discret et sans salle d’attente.Door een arts beoordeeld, discreet en zonder wachtkamer.

  1. 1Behandlung wählenChoose a treatmentChoisir un traitementBehandeling kiezenWählen Sie Ihr Anliegen und das gewünschte Präparat oder stellen Sie eine allgemeine Anfrage.Choose your concern and the medicine you want, or send a general request.Choisissez votre problème et le médicament souhaité, ou envoyez une demande générale.Kies uw klacht en het gewenste middel, of stuur een algemene aanvraag.
  2. 2Fragebogen ausfüllenFill in the questionnaireRemplir le questionnaireVragenlijst invullenDie medizinischen Fragen beantworten Sie online, vertraulich und in Ruhe.You answer the medical questions online, confidentially and at your own pace.Vous répondez aux questions médicales en ligne, en toute confidentialité et à votre rythme.U beantwoordt de medische vragen online, vertrouwelijk en in alle rust.
  3. 3Ärztliche PrüfungMedical reviewÉvaluation médicaleMedische beoordelingEin zugelassener Arzt prüft Ihre Angaben. Ist die Behandlung nicht geeignet, erhalten Sie Ihr Geld zurück.A licensed doctor reviews your answers. If the treatment is not suitable, you get your money back.Un médecin agréé examine vos réponses. Si le traitement ne convient pas, vous êtes remboursé.Een bevoegde arts beoordeelt uw gegevens. Is de behandeling niet geschikt, dan krijgt u uw geld terug.
  4. 4Diskreter VersandDiscreet deliveryLivraison discrèteDiscrete verzendingNach Ausstellung des Rezepts versendet eine EU-Partnerapotheke Ihr Arzneimittel meist innerhalb eines Werktages.Once the prescription has been issued, an EU partner pharmacy usually sends your medicine within one working day.Une fois l’ordonnance établie, une pharmacie partenaire de l’UE expédie votre médicament généralement sous un jour ouvré.Na het uitschrijven van het recept verstuurt een EU-partnerapotheek uw geneesmiddel meestal binnen één werkdag.

Häufige FragenFrequently asked questionsQuestions fréquentesVeelgestelde vragen

Questions about overactive bladder

Haben Sie eine andere Frage? Unsere Ärzte und unser Service-Team helfen Ihnen gerne weiter.Have another question? Our doctors and our service team will be glad to help.Vous avez une autre question ? Nos médecins et notre équipe de service vous aident volontiers.Heeft u een andere vraag? Onze artsen en ons serviceteam helpen u graag verder.

Frage an einen ArztAsk a doctorPoser une question à un médecinVraag stellen aan een arts
Do I need a prescription for medication for an overactive bladder?

Yes. Oxybutynin, solifenacin (Vesicare), and mirabegron (Betmiga) are prescription medications. A doctor will review your questionnaire to determine if your symptoms are consistent with an overactive bladder and if a medication is suitable for you. Therefore, please provide complete information about any pre-existing medical conditions, your blood pressure, all medications you are taking, and whether you are pregnant or breastfeeding.

With solifenacin, initial improvement is often seen within a week; with mirabegron, the effect was measurable after four weeks in studies. Whether a treatment is effective is usually assessed after about four weeks. If no improvement has occurred by then, discuss further steps with your doctor instead of stopping the medication on your own.

They are not designed for that. Urine loss when coughing, sneezing, laughing, or lifting without a sudden urge to urinate is called stress incontinence and is usually related to a weakened pelvic floor. In this case, pelvic floor exercises and consultation at a local doctor's office are particularly important. In a mixed form with both urge and stress incontinence, the doctor will assess whether treating the urge component is appropriate.

Both relax the bladder muscle, but via different receptors. Anticholinergics such as oxybutynin and solifenacin often cause dry mouth and constipation and can trigger confusion in older people. Mirabegron is not anticholinergic, but it can increase blood pressure, which is therefore monitored regularly. Your doctor will decide which medication is best suited to your pre-existing conditions and current medications.

In that case, no prescription will be issued and you will receive a full refund of all payments made. For new or unclear bladder problems, blood in the urine, or difficulty emptying the bladder, we recommend an examination at a local medical practice, such as your general practitioner, a urologist, or a gynecologist. If you experience warning signs such as urinary retention, seek medical help immediately.

Medizinische ExpertiseMedical expertiseExpertise médicaleMedische expertise

Jede Anfrage in ärztlichen HändenEvery request in a doctor’s handsChaque demande entre des mains médicalesElke aanvraag in medische handen

Dr. Viktor Simunovic
Medizinischer GutachterMedical assessorMédecin évaluateurMedisch beoordelaarDr. Viktor SimunovicAllgemeinmedizin & digitale GesundheitGeneral medicine & digital healthMédecine générale et santé numériqueHuisartsgeneeskunde en digitale zorg
Dr. Codruta Anca Pandalache
Medizinische GutachterinMedical assessorMédecin évaluatriceMedisch beoordelaarDr. Codruta Anca PandalacheReproduktionsmedizin & FrauengesundheitReproductive medicine & women’s healthMédecine de la reproduction et santé des femmesVoortplantingsgeneeskunde en vrouwengezondheid
Lernen Sie unsere Ärzte kennenMeet our doctorsFaites connaissance avec nos médecinsMaak kennis met onze artsenHintergrund, Erfahrung und FachgebieteBackground, experience and specialismsParcours, expérience et spécialitésAchtergrond, ervaring en vakgebieden

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Irritable bladder: medically reviewed and treated

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