Urinary Dysfunction and MS 6 of 6

Summary 

In addition to being uncomfortable and embarrassing, the bladder symptoms of MS can have a significant impact a person's long-term health.  The impact of these symptoms can be limited by reporting urinary symptoms promptly to your health-care provider.  Based on the information you give, your provider can do the testing necessary to diagnose the underlying problem and recommend the appropriate medications and management strategies.  The treatment interventions described here are more effective the earlier they are implemented – before the problems have become severe.  They can help you manage your symptoms, and prevent unnecessary, potentially dangerous complications, so you can pursue your daily activities with comfort and confidence.  

Appendix 1 –

1.    My Medications List  Keep this list current, and bring it with you when you visit your regular doctor and see any new doctor. 

2.    Your name ____________________________________

3.    Date _________________________________________

4.    Prescription Drugs

·     Drug Name

·     How much?

·     How often?

5.    Non-prescription Drugs

·     Drug Name

·     How much?

·     How often?

6.    Herbal and Alternative Products, Vitamins, Dietary Supplements Drug

·     Name

·     How much?

·     How often?

Appendix 2 –

Drug Information

1.    Chemical Name: baclofen (bak-loe-fen)

·     Brand Name: Lioresal® (U.S.  and Canada)

·     Generic Available: Yes (U.S.  and Canada)

·     Description:

·     Baclofen acts on the central nervous system to relieve spasms, cramping, and tightness of muscles caused by spasticity in multiple sclerosis.  It is usually administered orally in pill form.  An intrathecal delivery system is available for those individuals with significant spasticity who cannot tolerate a sufficiently high dose of the oral form of the medication.  The intrathecal system delivers the medication via a surgically implanted pump directly into the fluid surrounding the spinal cord.  It is important with this medication to introduce a small dose and build slowly to a therapeutic level.  Building the dose up slowly will help to minimize side effects.  

2.    Chemical Name: ciprofloxacin (sip-roe-FLOX-a-sin)

·     Brand Name: Cipro® (U.S.  and Canada)

·     Generic Available: Yes

·     Description:

·     Ciprofloxacin is one of a group of antibiotics (fluoroquinolones) used to kill bacterial infections in many parts of the body.  It is used in multiple sclerosis primarily to treat urinary tract infections.  Cipro administered with tizanidine (used for spasticity) results in higher concentrations of tizanidine in the blood, which could lead to clinically significant adverse events such as increased sedation. 

3.    Chemical Name: darifenacin (dar-i-fen-a-sin)

·     Brand Name: Enablex® (U.S.  and Canada)

·     Generic Available: No

·     Description:

·     Darifenacin is an extended-release antispasmodic/ antimuscarinic medication that works by relaxing the bladder muscles to prevent urgent, frequent, or uncontrolled urination. 

4.    Chemical Name: desmopressin (des-moe-press-in) acetate

·     Brand Name: DDAVP Nasal Spray® (U.S.  and Canada)

·     Generic Available: Yes

·     Description:

·     Desmopressin acetate is a hormone used as a nasal spray.  The hormone works on the kidneys to control frequent urination.  

5.    Chemical Name: imipramine (im-ip-ra-meen)

·     Brand Name: Tofranil® (U.S.  and Canada)

·     Generic Available: Yes (U.S.  and Canada)

·     Description:

·     Imipramine is a tricyclic antidepressant used to treat mental depression.  Its primary use in multiple sclerosis is to treat bladder symptoms, including urinary frequency and incontinence.  Imipramine is also prescribed occasionally for the management of neurologic pain in MS.

6.    Chemical Name: oxybutynin (ox-i-byoo-ti-nin)

·     Brand Name: Ditropan® (U.S.  and Canada)

·     Generic Available: Yes (U.S.)

·     Description:

·     Oxybutynin is an antispasmodic/anticholinergic that helps decrease muscle spasms of the bladder and the frequent urge to urinate caused by these spasms. 

7.    Chemical Name: oxybutynin (ox-i-byoo-ti-nin) chloride -extended release

·     Brand Name: Ditropan XL® (U.S.  and Canada)/Uromax

·     Generic Available: No

·     Description:

·     This form of oxybutynin is an extended-release antispasmodic/anticholinergic that is formulated to help decrease muscle spasms of the bladder and the frequent urge to urinate caused by these spasms.  

8.    Chemical Name: oxybutynin (ox-i-byoo-ti-nin)-transdermal

·     Brand Name: Oxytrol® (U.S.  and Canada)

·     Generic Available:

·     No Description:

·     This form of oxybutynin, which is delivered via a skin patch, is an antispasmodic/anticholinergic medication that helps decrease muscle spasms of the bladder and the frequent urge to urinate caused by these spasms. 

9.    Chemical Name: prazosin (pra-zoe-sin)

·     Brand Name: Brand name not available. 

·     Generic Available: Yes (U.S.  and Canada)

·     Description:

·     Prazosin belongs to the general class of medicines called anti-hypertensives, which are used to treat high blood pressure.  It is used in MS help promote the flow of urine through the sphincter. 

10.  Chemical Name: propantheline (pro-pan-the-leen) bromide

·     Brand Name: Pro-Banthine (U.S.  only)

·     Generic Available: Yes (U.S.  only)

·     Description:

·     Propantheline is one of a group of antispasmodic/anticholinergic medications used to relieve cramps or spasms of the stomach, intestines, and bladder.  Propantheline is used in the management of neurogenic bladder symptoms to control urination.  

11.  Chemical Name: solifenacin succinate (sol-i-FEN-ah-sin SUC-sin-ate)

·     Brand Name: Vesicare® (U.S.  and Canada)

·     Generic Available: No

·     Description:

·     Solifenacin succinate is an antimuscarinic medication that is used to treat an overactive bladder causing symptoms of frequency, urgency, and/or urge incontinence.  In MS, overactive bladder is seen in failure to store and combined failure to store/failure to empty types of dysfunction. 

12.  Chemical Name: tamsulosin (tam-soo-loh-sin)

·     Brand Name: Flomax® (U.S.)

·     Generic Available: Yes

·     Description:

·     Tamsulosin is generally used to treat the signs and symptoms of benign enlargement of the prostate.  It helps to relax the muscles in the prostate and bladder, and is used in MS to promote the flow of urine. 

13.  Chemical Name: terazosin (ter-ay-zoe-sin)

·     Brand Name: Hytrin® (U.S.  and Canada)

·     Generic Available: Yes

·     Description:

·     Terazosin belongs to the general class of medicines called anti-hypertensives, which are used to treat high blood pressure.  It also helps relax the muscles of the prostate and the bladder.  In MS, it is used to help promote the flow of urine through the sphincter.  

14.  Chemical Name: tizanidine (tye-zan-i-deen) hydrochloride

·     Brand Name: Zanaflex® (U.S.  and Canada)

·     Generic Available: Yes

·     Description:

·     Tizanidine is used in multiple sclerosis to treat the increased muscle tone associated with spasticity.  While it does not provide a cure for the problems, it is designed to relieve the spasms, cramping, and tightness of muscles. 

15.  Chemical Name: tolterodine (tole-tare-oh-deen)

·     Brand Name: Detrol® (U.S.  and Canada)

·     Generic Available: No

·     Description:

·     Tolterodine is an antimuscarinic that is used to treat bladder spasms causing urinary frequency, urgency, or urge incontinence. 

16.  Chemical Name: tolterodine (tole-tare-oh-deen) tartrate

·     Brand Name: Detrol LA® (U.S.  and Canada)

·     Generic Available: No

·     Description:

·     Detrol LA (long acting) is an antimuscarinic agent used to treat overactive bladder with symptoms of urgency, frequency, and/or urge incontinence.  This problem occurs in failure to store and combined failure to store/failure to empty types of dysfunction.  It differs from Detrol in that Detrol LA can usually be taken as a single daily dose.   

Compliments of:

Multiple Sclerosis Society of Canada: