Data from 12-week , r and omised , double-blind , placebo-controlled trials of tolterodine extended release ( ER ) , oxybutynin and solifenacin show that combined antimuscarinic+α-blocker treatment is generally more effective than monotherapy or placebo in men with OAB symptoms .
The efficacy and safety  of tolterodine ER+α-blocker treatment was not affected by prostate size or prostate-specific antigen ( PSA ) level .
In men meeting entry criteria for OAB and benign prostatic obstruction trials  , tolterodine ER alone was effective selectively in men with prostate size or PSA level below study medians .
Post hoc analyses from double-blind , placebo-controlled trials and prospect i ve studies of fesoterodine , oxybutynin , propiverine , solifenacin and tolterodine also suggest that antimuscarinics are generally safe and efficacious in men .
A retrospective data base study found that risk of AUR in men was the highest in the first month of treatment and decreased considerably thereafter .
Antimuscarinics , alone or with an α-blocker , appear to be efficacious and safe in many men with predominant OAB symptoms or persistent OAB symptoms despite α-blocker or 5-α-reductase inhibitor treatment .
Despite potential benefits , primary care clinicians may avoid using antimuscarinics in men with overactive bladder ( OAB ) symptoms because of safety concerns .
Symptom-specific efficacy of tolterodine extended release in patients with overactive bladder: the IMPACT trial.
We evaluated the efficacy of tolterodine extended release ( ER ) for patients ' most bothersome overactive bladder ( OAB ) symptom in a primary care setting . Patients with OAB symptoms for > or=3 months received tolterodine ER  ( 4 mg q.d . ) for 12 weeks . Among incontinent patients ( n = 772 ) , the most bothersome OAB symptoms were daytime frequency ( 28 % ) , urgency urinary incontinence ( UUI ; 27 % ) , nocturnal frequency ( 26 % ) and urgency ( 19 % ) ; among continent patients ( n = 91 ) , they were daytime frequency ( 47 % ) , nocturnal frequency ( 42 % ) and urgency ( 10 % ) . Sixty-nine per cent of patients had one or more comorbid conditions . By week 12 , there were significant reductions in patients ' most bothersome symptom : -80 % for UUI , -78 % for urgency episodes , -40 % for nocturnal frequency and -30 % for daytime frequency ( p < 0.0001 ) . The most common adverse events were dry mouth ( 10 % ) and constipation ( 4 % ) . In primary care practice , bothersome OAB symptoms can be effectively and safely treated with tolterodine ER , even in patients with comorbid conditions
Data from 12-week , r and omised , double-blind , placebo-controlled trials of tolterodine extended release ( ER ) , oxybutynin and solifenacin show that combined antimuscarinic+α-blocker treatment is generally more effective than monotherapy or placebo in men with OAB symptoms .
The efficacy and safety  of tolterodine ER+α-blocker treatment was not affected by prostate size or prostate-specific antigen ( PSA ) level .
In men meeting entry criteria for OAB and benign prostatic obstruction trials  , tolterodine ER alone was effective selectively in men with prostate size or PSA level below study medians .
Post hoc analyses from double-blind , placebo-controlled trials and prospect i ve studies of fesoterodine , oxybutynin , propiverine , solifenacin and tolterodine also suggest that antimuscarinics are generally safe and efficacious in men .
A retrospective data base study found that risk of AUR in men was the highest in the first month of treatment and decreased considerably thereafter .
Antimuscarinics , alone or with an α-blocker , appear to be efficacious and safe in many men with predominant OAB symptoms or persistent OAB symptoms despite α-blocker or 5-α-reductase inhibitor treatment .
Despite potential benefits , primary care clinicians may avoid using antimuscarinics in men with overactive bladder ( OAB ) symptoms because of safety concerns .