Darifenacin (Oral Route)

Darifenacin is a prescription-strength medication marketed under the name Enablex that works on the muscles of the bladder to prevent them from causing incontinence in patients who have an overactive bladder.

Overview:

For patients who are suffering from a socially embarrassing condition such as incontinence, the orally administered drug Darifenacin can provide much-needed relief in both a medical and interpersonal sense of the word. This prescription medication functions by acting on the muscles of the bladder to increase control over the frequent need to urinate that is experienced by many older adults. It is very useful for this purpose, but the decision regarding whether or not to use this medication should be made with care. There are certain common interactions with existing conditions that can make the use of this drug potentially dangerous and it can have troubling side effects for some patients. There is also a significant allergic reaction known as angioedema that is associated with the use of Darifenacin.

As a muscarinic antagonist, Darifenacin has been known to have specific anticholinergic effects on the central nervous system (CNS)which can result in numerous side effects as well as having an effect on motor skills and the ability of the patient to perform work under the influence of the drug. Physicians prescribing Darifenacin and the patients who take it need to weigh the potential benefits against these drawbacks and proceed carefully until it is clear exactly what effect the medication will have on the patient. Experiencing anticholinergic CNS effects should be cause for concern and use of this medication is not recommended for those who experience them. With this being said, Darifenacin still can be a very potent treatment for many adults who are struggling with bladder control.

Conditions Treated:

  • Incontinence
  • Frequent Urination
  • Overactive Bladder

Kind of Medicine:

  • Muscarinic antagonist

Side Effects:

As with any medication of this nature, Darifenacin will provide a patient with its intended effects but may also cause certain side effects. The medication affects different people in various ways and not all side effects may necessarily occur in all individual. However, in the event that they do occur some have been known to be serious enough to require medical attention. If any of the following serious side effects do occur, the patient should inform their doctor immediately.

Serious side effects that are uncommon but still grievous include those associated with the condition treated such as painful urination, bloody or cloudy urine, bladder pain a burning feeling while urinating, and a frequent need to urinate. These may be accompanied by a serious pain in the lower back or sides.

Some serious side effects have been recorded by their instance is unknown. These include associated conditions such as a decrease in the frequency of urination, decrease in urine volume, difficulty in urination, dribbling urine, and pain in the genital area.

One of the dangerous side effects can be an oversensitivity to Darifenacin and this can lead to an overdose of the drug. If this overdose occurs, immediate emergency medical care is necessary. The main symptom of this overdose is a change in vision such as blurry vision or difficulty making out shapes. Other symptoms of the overdose include constipation, abdominal pain, sudden inability to urinate, and pronounced weakness of the body.

Not all side effects will necessarily need medical attention, and some of the side effects of Darifenacin are routine. These side effects will usually be explained by your doctor before prescribing Darifenacin and are expected to subside as the body gets used to taking the medication. However, if these symptoms do not go away as they are expected to or if they are more intense than described this can indicate that there is more to worry about. Consult with your physician if you are concerned about any of these side effects.

The most common of the routine side effects include excess stomach acid when the medication is first taken, leading to a sour stomach. This can be accompanied by a dry mouth, belching, heartburn, indigestion, and stomach pain. Patients experiencing these symptoms often experience constipation or difficulty in moving the bowels.

Less common short-term side effects of Darifenacin include experiencing gastrointestinal problems such as diarrhea and nausea or vomiting. Some patients feel very weak and dizzy when they first take this medicine and may experience unusually dry eyes.

Numerous routine side effects have also been recorded but are not common and the chance that the side effect will be exerienced by a patient are unknown. These symptoms include the following:

  • Dry skin
  • Dryness or soreness of the throat
  • Difficulty with moving
  • General feeling of discomfort or illness
  • Headache
  • Thick, white vaginal discharge with no odor or with a mild odor
  • Tightness in the chest
  • Tingling of the hands or feet
  • Trouble with swallowing
  • Unusual weight gain or loss
  • Runny nose
  • Fever
  • Sneezing
  • Stuffy nose
  • Voice changes
  • Vomiting
  • Wheezing
  • Nervousness
  • Pain during sexual intercourse
  • Pain or tenderness around the eyes and cheekbones
  • Pounding in the ears
  • Hoarseness
  • Itching of the vagina or genital area
  • Rash
  • Tender, swollen glands in the neck
  • Accidental injury
  • Bloating or swelling of the face, arms, hands, lower legs, or feet
  • Chills
  • Congestion
  • Itching skin
  • Joint pain
  • Loss of appetite
  • Muscle aches and pains
  • Muscle stiffness
  • Cough producing mucus
  • Difficulty with breathing
  • Shortness of breath or troubled breathing
  • Slow or fast heartbeat

These are the most notable side effects, but if any other side effects are experienced that are not listed patients should consult with a healthcare provider as they may indicate a more serious condition.

Dosage:

When taking Darifenacin a patient should always take the medication as directed. These directions should be included on the label and supplemental instructions and may differ from the manufacturer's recommendations. These represent the average dose for the patient but may vary based on a number of factors. In the case of a conflict, follow the prescription.

The dose for Darifenacin when it is taken as an extended-release tablet is 7.5mg once daily to start. This dose may be increased by the prescribing physician as needed to provide relief from incontinence. If prescribed for a child, this dosage will be at the discretion of a qualified pediatrician. If the dose is missed and less than 12 hours have elapsed since the scheduled dose, the pill should be taken at that time. At least 12 hours are required between doses, so if less time will elapse before taking the next dose it may be advisable to skip to that dose. Double-dosing may lead to an overdose or other undesirable effects. If any symptoms of an overdose occur immediately call for emergency medical assistance.

Interactions:

Certain medications should not be used while a patient is using Darifenacin. These may have a negative drug interaction or either medication could increase the chances of side effects in either or both medications. If the medications need to be used together due to the conditions they are treating and a lack of alternatives patients need to be prepared for the possibility of serious interactions. Patients should not take potassium when using Darifenacin and a doctor may decide not to treat with this medication if a patient needs to take potassium for a serious condition.

Some medications are not recommended to be used with Darifenacin but may be required if there is no alternative. In these cases, the risks may be mitigated by changing dosages or dosing schedules. These include the following medications:

  • Desipramine
  • Oxymorphone
  • Thioridazine
  • Tiotropium
  • Bupropion
  • Ceritinib
  • Donepezil
  • Flecain
  • Imipramine
  • Lumacaftor
  • Conivaptanide
  • Idelalisib

Some medications come with an increased risk of certain side effects when used with Darifenacin, but the risk may be acceptable as they could be the best treatment for the patient. Ketoconazole is one medication that is known to fit into this category, but there may be others. Make sure that your doctor knows all prescription medication, nonprescription medication, vitamins, and supplements that are being taken. In addition to drug interactions, Darifenacin may have interactions with other foods such as food or drink. Drinking alcohol with Darifenacin is not recommended.

Certain medical conditions may preclude a patient from taking Darifenacin. Inform your doctor if you currently have or have a history of the following conditions:

  • Bladder blockage
  • Intestinal or stomach problems
  • Myasthenia gravis
  • Narrow-angle glaucoma
  • Liver disease
  • Stomach problems
  • Urinary retention problems

Warnings:

There are several precautions which need to be taken when using Darifenacin. If you have any history of allergies to any substance a doctor needs to be informed because this may indicate a susceptibility to a serious allergic reaction associated with Darifenacin. Such substances may include foods, dyes, preservatives, or animals.

While taking Darifenacin patients will be required to visit their doctor regularly to ensure that the medication is working as intended. Certain indications discovered during these regular examinations may cause the doctor to reconsider maintaining a regimen of the drug. Darifenacin has been known to cause a serious type of allergic reaction called angioedema which is potentially fatal and requires immediate medical aid. This medication should be ceased immediately if the patient experiences any of the following:

  • Thick, white vaginal discharge with no odor or with a mild odor
  • Tightness in the chest
  • Tingling of the hands or feet
  • Trouble with swallowing
  • Unusual weight gain or loss
  • Runny nose
  • Fever

Darifenacin can cause certain nervous system effects that can make patients dizzy, drowsy, or experience blurred vision. Until it is clear how the medication affects a patient they should avoid operating heavy machinery, driving, or doing other potentially dangerous tasks. Those taking Darifenacin may sweat less, causing the body temperature to increase. Extra care should be taken not to become overheated during exercise or hot weather while using this medicine. Overheating in this condition may result in serious injury such as heat stroke. One of the most unwelcome effects of Darifenacin is that it can cause constipation, and if severe pain or discomfort accompanies this condition a doctor should be informed.

Darifenacin can cause dry mouth when it is first taken. There are a number of temporary remedies that can alleviate this condition including chewing gum or melting ice in the mouth. Saliva substitutes may be available to use at over-the-counter or prescription strength. This should be a temporary effect, and if it continues for more than two weeks a doctor or dentist will need to be consulted. Dry mouth can cause serious dental problems such as gum disease, infections, or tooth decay.

Storage:

Darifenacin should be stored in a closed container, preferably the container that it came in. It needs to be kept in a secure location away from heat, freezing temperatures, moisture, and direct sunlight. It needs to be kept out of the reach of children. If the medication is expired or no longer needed it should be disposed of in accordance with guidelines for disposing of medical waste.

Summary:

Darifenacin is a very useful medication that reduces muscle spasms of the bladder and urinary tract to enable those who take it to better control how often they need to use the bathroom and avoid potentially embarrassing loss of bladder control. It is a common treatment for the symptoms of overactive bladder, such as frequent or urgent urination, and incontinence. Although it may be used for off-label purposes, it is not a common treatment for any other malady other than that indicated by the manufacturer. It is well known to be effective for this intended purpose, but its use comes with significant warnings that doctors and patients need to be aware of.

While Darifenacin has been known to have a chance of serious allergic reactions and side effects it is still popular with doctors and patients because of how effective it is in the treatment of incontinence. When used properly and with good levels of communication between doctors and patients, this beneficial medication can help older adults live a better life free of their debilitating symptoms. So long as patients are aware of the potential risks along with the benefits of Darifenacin there is no reason why it cannot be a valid treatment option for long-term relief of incontinence.