Imida

Indications

Imidafenacin is used to treat overactive bladder in adults. This condition causes a sudden, strong need to pass urine (urgency), passing urine often during the day and night, and sometimes leaking before reaching the toilet (urge incontinence).

How It Works

Imidafenacin is an antimuscarinic medicine. It blocks muscarinic receptors (mainly the M3 and M1 types) that tell the bladder muscle to squeeze. This relaxes the bladder, lets it hold more urine and reduces sudden urges and leaks.

Dosage and Administration

The usual adult dose is 0.1 mg twice a day, after breakfast and after the evening meal. If the effect is not enough, the doctor may increase it to 0.2 mg twice a day. Swallow the tablet with water. It may take a few weeks to see the full benefit. Lower doses or extra care may be needed in liver or kidney disease; follow your doctor's advice.

Interactions

• Strong CYP3A4 blockers such as Ketoconazole, Itraconazole, Clarithromycin and Ritonavir can raise imidafenacin levels.
• Other anticholinergic medicines, such as Oxybutynin, some antihistamines, tricyclic antidepressants like Amitriptyline and some antipsychotics, add to side effects like dry mouth, constipation and urine retention.
• It may reduce the effect of medicines that speed up stomach emptying, such as Metoclopramide or Domperidone.

Contraindications

• Urinary retention (being unable to empty the bladder).
• Angle closure glaucoma that is not controlled.
• Blockage of the stomach or bowel, paralytic ileus, or severe ulcerative colitis or toxic megacolon.
• Myasthenia gravis.
• Severe heart disease or severe liver impairment.
• Allergy to imidafenacin.

Side Effects

Common: dry mouth, constipation, blurred vision, dry eyes and stomach discomfort. Less common: difficulty passing urine, dizziness, drowsiness, headache, rash and itching. Rare: urinary retention, angle closure glaucoma, liver problems and heart rhythm changes.

Get urgent medical help if you cannot pass urine, have sudden eye pain with blurred vision, severe abdominal pain or no bowel movement for several days, yellowing of the skin or eyes, a fast or irregular heartbeat, or swelling of the face or throat.

Pregnancy and Lactation

There is little information on use in pregnancy, so it is generally avoided unless the doctor decides it is needed. It is not recommended while breastfeeding.

Precautions and Warnings

Use with care in men with an enlarged prostate or anyone with weak urine flow, as urine retention can occur. Use with care in older people, people with heart rhythm problems, dementia or reduced bowel movement. It can cause blurred vision and drowsiness, so be careful when driving. Your doctor should rule out other causes such as urine infection before treatment. It can reduce sweating, so avoid overheating in hot weather.

Overdose

Overdose may cause severe anticholinergic effects: very dry mouth, flushing, fast heartbeat, confusion, hallucinations, fever and inability to pass urine. Seek emergency medical care.

Therapeutic Class

Urinary antispasmodic, antimuscarinic

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.