The oxybutynin transdermal patch is the only over-the-counter (OTC) medication approved to treat overactive bladder (OAB) syndrome.

OAB syndrome causes frequent and sudden urges to urinate and can also induce urinary incontinence.

The condition can significantly affect a person’s quality of life when these urges interfere with daily activities, in which dashing to a restroom may not be convenient.

Read on to discover several ways to treat OAB without prescription medication and when it might be time to seek medical help.

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The oxybutynin (Oxytrol) transdermal patch is the only OTC medication the Food and Drug Administration (FDA) has approved for treating OAB.

It is part of the antimuscarinic class of medications and helps relieve OAB by relaxing bladder muscle spasms that cause urinary urgency.

Dose and instructions

The medication comes as a 3.9 milligrams per day patch that the person applies to their skin twice weekly, every 3 to 4 days. To keep it consistent, a person can pick the same 2 days of the week to change the patch.

Application sites include:

  • stomach, avoiding the waist area
  • hips
  • buttocks

It is important to protect the patch location from direct sun exposure and to place it in a spot where clothes will not rub it off.

The person taking the medication should also follow the directions on the medication packaging and ask their doctor or pharmacist for clarification on anything they need.

Side effects

Side effects may include:

Serious side effects that require medical treatment include urgent, frequent, or painful urination or allergic reactions.

Anaphylaxis: Symptoms and what to do

Anaphylaxis is a severe allergic reaction that can be life threatening. The symptoms develop suddenly and include:

  • hives
  • swelling of the face or mouth
  • wheezing
  • fast, shallow breathing
  • a fast heart rate
  • clammy skin
  • anxiety or confusion
  • dizziness
  • vomiting
  • blue or white lips
  • fainting or loss of consciousness

If someone has these symptoms:

  1. Check whether they are carrying an epinephrine pen. If they are, follow the instructions on the side of the pen to use it.
  2. Dial 911 or the number of the nearest emergency department.
  3. Lay the person down from a standing position. If they have vomited, turn them onto their side.
  4. Stay with them until the emergency services arrive.

Some people may need more than one epinephrine injection. If the symptoms do not improve in 5–15 minutes, or they come back, use a second pen if the person has one.

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Before starting a new medication, an individual should check with a doctor to ensure there are no medication interactions or ingredient allergies.

Individuals with certain medical conditions should exercise caution or consult their doctor before taking oxybutynin. The conditions include:

It is important to note that this medication can cause drowsiness. Before driving or operating machinery, a person must evaluate how the medication affects them. Alcohol can also enhance the drowsy effect.

It is important that people discuss starting any new medication with a doctor to ensure that it does not interact with other drugs and that they do not have allergies to the medications they are taking.

While there are some claims that herbal remedies and supplements help treat OAB, research on those therapies is limited and often restricted to animal studies.

However, several alternative therapies may reduce symptoms.

Lifestyle changes

Implementing several lifestyle changes may significantly reduce symptoms associated with OAB.

  • Weight management: Individuals with excess weight may consider implementing healthy weight management techniques to help reduce symptoms.
  • Moderate fluid intake: Focusing on drinking six to eight glasses of water daily and reducing excess fluid intake. Avoiding drinking fluids within 2 hours before bedtime can also help.
  • Avoid bladder irritants: Several ingredients in beverages and foods, such as caffeine, spices, and alcohol, may irritate the bladder and increase symptoms.
  • Smoking cessation: Smoking can aggravate the bladder and cause urinary urgency.
  • Promoting regular bowel movements: Having regular bowel movements and avoiding constipation may help reduce OAB symptoms.
  • Regular physical activity: Regular exercise and boosting overall health may help a person have less urinary urgency.

Bladder training

Research from 2021 has shown bladder training to have promising results in reducing OAB symptoms.

It involves urinating at scheduled intervals, starting with 30 minutes, and gradually extending the duration between restroom visits to 3 to 4 hours.

This training may help regain control over urinary urges.

Pelvic floor exercises

Pelvic floor muscle training (PFMT) can have a significantly positive effect on reducing OAB symptoms. The main types of PFMT include:

Individualized therapy under the guidance of a physical therapist is the most beneficial, as no one therapy works for all. A physical therapist can assess which muscles in the pelvic area need strengthening or relaxing and develop a treatment plan.

If OTC medication, lifestyle changes, and other therapies are insufficient in managing OAB symptoms, or if symptoms are worsening over time, consulting with a healthcare professional may be beneficial. This is especially true if their symptoms affect their quality of life.

What prescription medications treat OAB?

An individual may want to consider prescription medications when other measures or therapies do not manage symptoms adequately.

Their healthcare professional may prescribe medications that target bladder muscle function and nerve signaling, such as anticholinergics (oxybutynin, tolterodine, solifenacin) or beta-3 adrenergic agonists (mirabegron).

Regular follow-up appointments with the healthcare professional are important for monitoring the effectiveness of the treatment, adjusting medications as necessary, and addressing any side effects or other concerns.

Other medical therapies

If an individual does not respond to prescription medications or is unable to take them, additional therapies may include:

  • Botox injections that temporarily paralyze some of the bladder muscles
  • intermittent stimulation of nerves affecting the bladder
  • an implanted device that stimulates a sacral nerve
  • surgical changes to the bladder

Which OTC medication has the least side effects?

The oxybutynin patch is currently the only FDA-approved OTC medication to treat OAB. Common side effects may include skin irritation to the patch, dry mouth, and constipation.

It is important to consult with a doctor before starting a new medication to receive personalized guidance.

What is the best OTC medication for OAB?

Currently, the oxybutynin patch is the only FDA-approved OTC medication to treat OAB. It works by helping reduce bladder muscle spasms to decrease urinary urgency and frequency.

What is the best home remedy for OAB?

Maintaining a moderate body mass index, avoiding constipation, and reducing bladder irritants such as smoking, caffeine, alcohol, and spicy foods may help reduce OAB symptoms.

It is also important to keep fluid intake to a moderate level, such as six to eight glasses of water daily, and to avoid drinking fluids 2 hours before bedtime.

Which is the best medication for OAB in older adults?

Which medication best suits an older adult depends on factors such as overall health, other medical conditions, and medications.

It is best to receive personalized guidance from a healthcare professional familiar with the person’s medical history and current condition.

Treating symptoms of having an overactive bladder may involve a combination of the OTC medication oxybutynin and lifestyle changes such as maintaining a moderate weight, avoiding bladder irritants, and monitoring fluid intake during the day.

Bladder training and pelvic floor exercises can also play a role in reducing inconvenient symptoms associated with OAB.

An evaluation by a healthcare professional is important when symptoms start affecting daily activities and quality of life.