Overactive Bladder in Children Medication

Updated: Mar 30, 2021
  • Author: Pamela I Ellsworth, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Medication Summary

Although pharmacologic therapy is one of the mainstays in the treatment of adult overactive bladder (OAB) and the management of neurogenic detrusor overactivity, its role in the treatment of idiopathic OAB in children is less well defined.

Anticholinergic agents are often used in children with OAB when behavioral therapy has failed or as an adjunct to behavioral therapy. The most commonly used anticholinergics in children are oxybutynin (78%) and tolterodine (17%). [51]

Immediate-release (IR) oxybutynin tablets and syrup and tolterodine are approved by the US Food & Drug Administration (FDA) for children age 5 years and older, and extended-release (ER) oxybutynin tablets are FDA-approved for children age 6 years and older since they must be ingested whole. No other antimuscarinics have been FDA-approved for use in children under 18 years of age and no antimuscarinic drugs have been approved for children under 5 years of age. [52]  

Mirabegron, a beta3 agonist, gained FDA approval for NDO in children aged 3 years and older. [41]  

Trospium chloride (Sanctura), an agent used in adults, has been used in a small series of children, with doses varying from 10-25 mg/d, divided bid. Other anticholinergic agents used in adult patients with OAB include solifenacin (Vesicare) and darifenacin (Enablex).


Anticholinergic Agents

Class Summary

Anticholinergic agents inhibit the binding of acetylcholine to the cholinergic receptor, thereby suppressing involuntary bladder contraction of any etiology. In addition, they increase the volume of the first involuntary bladder contraction, decrease the amplitude of the involuntary bladder contraction, and may increase bladder capacity.

Oxybutynin (Ditropan, Ditropan XL, Oxytrol, Gelnique)

Oxybutynin inhibits the action of acetylcholine on smooth muscle and has a direct antispasmodic effect on smooth muscles, increasing bladder capacity and decreasing uninhibited contractions.


Beta3 Agonists

Class Summary

Beta-3 adrenergic receptor agonists causes relaxation of the detrusor smooth muscle of the urinary bladder and increases bladder capacity. 

Mirabegron (Myrbetriq)

Indicated for neurogenic detrusor overactivity (NDO) in children aged 3 years and older.