Enablex vs Vesicare

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Introduction

For patients with symptoms of overactive bladder (OAB) or other urinary disorders, certain drugs that control the contractions of the muscles in your bladder can help manage frequent urination and urgency. Enablex and Vesicare are two such medications often prescribed for these conditions. Both work by blocking a specific type of neurotransmitter receptor, called muscarinic receptors, present on the muscle cells in the bladder wall. This action inhibits involuntary muscle contractions and increases bladder capacity, thereby reducing OAB symptoms.

Enablex is known as a selective M3 muscarinic antagonist which specifically targets M3 receptors responsible for bladder contraction during urine storage phase. On the other hand, Vesicare has affinity to both M2 and M3 receptors but exhibits its primary therapeutic effect via inhibition of M3 receptors as well.

What is Enablex?

Darifenacin (the generic name for Enablex) is a medication frequently used to treat symptoms of overactive bladder. It was first approved by the FDA in 2004. Enablex works by blocking the action of acetylcholine, which helps control involuntary muscle movements. This effectively reduces bladder spasms and aids in controlling urinary frequency, urgency and incontinence.

On the other hand, Solifenacin (brand name Vesicare), also an antimuscarinic drug like Darifenacin, has a similar mechanism of action but it's known to stay longer in the body compared to Enablex due to its long half-life. Vesicare was approved by FDA later than Enablex, around 2005.

Both these medications are selective towards muscarinic receptors located specifically on detrusor muscles of bladder causing fewer side effects related with non-selective muscarinic antagonists such as dry mouth and constipation. However, they may still cause blurred vision or drowsiness so caution should be exercised while driving or operating machinery.

What conditions is Enablex approved to treat?

Enablex is approved for the treatment of certain bladder and urinary conditions:

Overactive bladder with symptoms of urge urinary incontinence
Urgency, and frequency in adults

On the other hand, Vesicare is used to treat similar conditions such as:

Overactive bladder with symptoms of urge urinary incontinence
Urgency, and frequency.

How does Enablex help with these illnesses?

Enablex helps to manage symptoms of overactive bladder by blocking the action of acetylcholine, a neurotransmitter involved in muscle contractions, on the muscarinic receptors in the bladder. This results in relaxation of the detrusor muscle that surrounds the bladder, allowing it to hold more urine and reducing urinary frequency, urgency and instances of leakage.

Acetylcholine is a chemical messenger that carries signals across synapses in many parts of our body including brain and muscles. In people with overactive bladders, acetylcholine appears to cause excessive contraction of this muscle leading to frequent urge for urination and sometimes involuntary leakage. By inhibiting these actions through binding with muscarinic receptors (without activating them), Enablex can aid patients manage their condition better thereby improving their quality of life.

What is Vesicare?

Vesicare is a brand name for solifenacin, which belongs to the class of medications known as antimuscarinics. It works by relaxing the muscles in the bladder, increasing its capacity and reducing the urge to urinate. This makes it effective in treating overactive bladder symptoms such as urgency, frequency, and urinary incontinence. Solifenacin was first approved by the FDA in 2004.

As an antimuscarinic medication, Vesicare does not impact norepinephrine or dopamine levels like some other types of drugs do. Its main mechanism of action revolves around blocking muscarinic receptors on smooth muscle tissue within the urinary tract.

Its side-effect profile is also different from that of SSRIs or NDRIs; instead of causing sedation or weight gain, common side effects include dry mouth and constipation. These effects on muscarinic receptors can be beneficial for managing overactive bladder symptoms especially when other typical treatments have proven ineffective.

What conditions is Vesicare approved to treat?

Vesicare is a medication approved for the treatment of:

Overactive bladder (OAB) with symptoms of urge urinary incontinence, urgency and urinary frequency
Detrusor overactivity associated with a neurologic condition such as multiple sclerosis or spinal cord injury.

How does Vesicare help with these illnesses?

Vesicare is a medication with the active ingredient solifenacin, which acts as an anticholinergic agent. Its primary role in the body is to control overactive bladder by relaxing the muscles that cause involuntary contractions and spasms. By blocking acetylcholine's activity on muscarinic receptors, Vesicare can help reduce sudden urges to urinate, frequent urination, and urinary incontinence. Much like Enablex (darifenacin), it targets M3 receptors located predominantly in bladder muscle tissues; however, Vesicare has been demonstrated to provide effective symptom relief across various severities of overactive bladder conditions. Since it does not significantly affect other types of muscarinic receptors, it may be prescribed when patients do not respond well or experience side effects from "typical" antimuscarinics such as Enablex.

How effective are both Enablex and Vesicare?

Both darifenacin (Enablex) and solifenacin (Vesicare) are widely used in the treatment of overactive bladder, which includes symptoms such as frequent urination, urgency, and urinary incontinence. They were approved by the FDA only a year apart, with Enablex being granted approval in 2004 and Vesicare following in 2005. Both drugs function as muscarinic receptor antagonists, but they target slightly different subtypes of these receptors.

A randomized double-blind study conducted in 2008 compared the efficacy and safety profiles of Enablex versus Vesicare. The results showed that both medications reduced episodes of urinary frequency and urgency to similar degrees. However, patients who received Vesicare had a slightly higher rate of dry mouth compared to those given Enablex.

In a comprehensive review published in 2011 examining various trials on darifenacin use for managing overactive bladder symptoms indicated its effectiveness from the first week onwards. Darifenacin was found to have a good balance between efficacy and tolerability making it preferable among many healthcare providers worldwide.

Meanwhile, results from another meta-analysis carried out on solifenacin use for treating overactive bladder symptoms affirmed its superiority to placebo regarding improved continence rates and reducing micturition frequency while maintaining an acceptable side effect profile like constipation or dry mouth.

Still, either drug could be considered first-line therapy options depending on individual patient's reactions or tolerance levels towards potential side effects because there is no significant difference between them concerning their therapeutic benefits.

abstract image of a researcher studying a bottle of drug.

At what dose is Enablex typically prescribed?

Oral dosages of Enablex usually start at 7.5 mg/day, and it has been shown to be effective for treating overactive bladder in most adults. If necessary, the dosage can be increased to 15 mg/day after two weeks if there is no response or insufficient control of symptoms. On the other hand, Vesicare typically starts with a dose of 5 mg once daily and may increase to a maximum dosage of 10mg once daily depending on individual patient response and tolerability. It's worth noting that these medications should only be used under the guidance of a healthcare professional who will consider all relevant factors including age, overall health status and potential interactions with other drugs.

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At what dose is Vesicare typically prescribed?

Vesicare treatment usually begins with a dosage of 5 mg/day, taken orally once a day. If the symptoms persist and there is no improvement in bladder control or urinary urgency after two weeks, the dose can be increased to 10 mg/day. The maximum daily dose should not exceed 10 mg as it may increase the risk of side effects such as constipation and dry mouth. It's important to take Vesicare at approximately the same time each day to maintain consistent levels of medication in your body, which helps optimise its effectiveness while limiting potential side effects.

What are the most common side effects for Enablex?

Common side effects of Enablex and Vesicare include:

Dry mouth
Constipation
Nausea, indigestion or heartburn
Blurred vision
Dizziness and fatigue
Sleepiness/drowsiness (somnolence)
Abdominal pain or discomfort
Urinary tract infection (UTI)

These medications can also cause less common but potentially serious side effects, such as urinary retention (difficulty fully emptying the bladder), heat stroke due to decreased sweating, and angioedema (swelling under the skin). If you experience any severe symptoms after taking these drugs, it's essential to seek medical attention immediately.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Enablex?

While both Enablex and Vesicare are typically well-tolerated, there can be significant side effects in some cases. The following symptoms should not be ignored:

Allergic reactions such as hives or skin rash, difficulty breathing, swelling of your face, lips, tongue or throat.
Vision changes including blurred vision, eye pain or discomfort, seeing halos around lights.
An accelerated heartbeat or fluttering in the chest. If you feel lightheaded like you might faint due to a rapid heart rate immediately stop taking the medication and seek medical attention right away.
Signs of low sodium levels - headache with confusion; loss of coordination causing unsteadiness; slurred speech; severe weakness; vomiting.
Symptoms indicating a possible nervous system reaction: rigid muscles accompanied by high fever and sweating; fast uneven heartbeats leading to tremors feeling like you might pass out.

These signs indicate that immediate medical intervention is needed. While these medications do provide relief for overactive bladder symptoms when used correctly under physician guidance they should never cause extreme discomfort or put patients at risk.

What are the most common side effects for Vesicare?

Vesicare, like Enablex, is a medication used to treat overactive bladder symptoms. However, it has its own set of potential side effects that you should be aware of:

Dry mouth and throat
Blurred vision
Stomach pain or upset stomach
Constipation or trouble emptying your bowels completely
Insomnia or other sleep disturbances
Headache and dizziness
Increased heartbeat in some cases
Feelings of anxiety or restlessness can occur but are less common. Remember each person's response to medication can vary greatly; therefore the above mentioned reactions may not apply universally.

Are there any potential serious side effects for Vesicare?

While Vesicare is generally a safe medication, there are some potential side effects that may require immediate medical attention. Please watch out for:

Signs of an allergic reaction such as hives; difficulty breathing; swelling in your face, lips, tongue or throat.
Severe abdominal pain or constipation for 3 days or longer
Dehydration symptoms - feeling very thirsty or hot, being unable to urinate, heavy sweating, or hot and dry skin
Blurred vision and eye pain - if these occur suddenly and last for a short period of time it might be an indication of a rare but serious eye problem called narrow-angle glaucoma.
Serious skin reactions – fever, sore throat, swelling in your face or tongue could indicate a severe skin reaction like SJS (Stevens-Johnson syndrome) which needs emergency treatment.

If you experience any of the above issues while taking Vesicare make sure to contact your health care provider immediately.

Contraindications for Enablex and Vesicare?

Both Enablex and Vesicare are used to treat overactive bladder symptoms, but just like any other medications, they have potential side effects. If you notice a severe allergic reaction or worsening of your symptoms after taking these drugs, please seek immediate medical attention.

Neither Enablex nor Vesicare should be taken if you currently are on or recently stopped using certain antifungal or antibiotic medicines known as potent CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin). These drugs can increase the levels of Enablex and Vesicare in your body leading to an increased risk of side effects. Always tell your physician which medications you're taking; potent CYP3A4 inhibitors may require some time to clear from the system before starting treatment with either drug.

Further caution is needed for patients with liver disease or decreased kidney function when considering either medication as it could lead to higher than normal amounts in the bloodstream potentially increasing their side effect risk. Hence it's important that physicians adjust dosages accordingly based on individual patient health status.

How much do Enablex and Vesicare cost?

For the brand name versions of these drugs:

The price for 30 tablets of Enablex (7.5 mg) averages around $348, which works out to approximately $11.60 per day.
The price for 30 tablets of Vesicare (5 mg) is about $362, working out to roughly $12/day.

Thus, if your prescribed dosage is typical for either drug, then brand-name Enablex may be slightly less expensive on a per-day treatment basis than Vesicare. However, as always it's important to remember that cost should not be a primary consideration in determining which of these drugs is right for you.

For the generic versions of Enablex (darifenacin) and Vesicare (solifenacin), costs are significantly lower:

Darifenacin comes in packs ranging from 30 to 90 tables with an average cost between $1 and $3 per day depending upon dosages which typically range from 7.5mg to 15mg daily.
Solifenacin also comes in packs ranging from 30 up to 90 tablets with prices starting from as low as about $.80/day and not exceeding about $2.40/day based on doses typically ranging from 5mg up to a maximum dose of only10mg daily.

Please note that while there can be significant savings by opting for generic versions over their branded counterparts, you should always consider factors such as efficacy and side-effects alongside the cost when choosing between different medications.

Popularity of Enablex and Vesicare

Darifenacin, available under the brand name Enablex, was estimated to have been prescribed to around 400 thousand people in the US in 2019. It accounted for just over 5% of antimuscarinic prescriptions for overactive bladder (OAB) in the US. Darifenacin is a selective M3 antagonist which means it specifically targets the muscarinic receptors responsible for bladder muscle contractions thereby reducing instances of urinary urgency and incontinence.

On the other hand, Solifenacin, including brand versions such as Vesicare, was prescribed to about 1.7 million people in the USA during that same year. In terms of antimuscarinic prescriptions for OAB treatment within America, solifenacin accounts for approximately 22%. Although not as selective as darifenacin, solifenacin offers a good balance between efficacy and side effects and has maintained an impressive prescription volume since its introduction.

Both drugs are considered effective treatments for OAB symptoms but individual responses may vary due to factors like overall health status or presence of co-existing conditions which could influence drug choice.

Conclusion

Both Enablex (darifenacin) and Vesicare (solifenacin) are widely used in the treatment of overactive bladder, with numerous clinical studies proving their efficacy above placebo treatments. In some scenarios, these drugs may be combined to increase effectiveness; however, this decision should always come from a qualified healthcare provider as they also have contraindications with each other. Due to their different pharmacokinetics - with Enablex being selective for M3 muscarinic receptors that control bladder contraction and Vesicare having less selectivity but longer half-life - they tend to be prescribed under distinctive circumstances.

Enablex is often considered when patients show signs of severe urinary urgency or frequency while Vesicare could serve as an adjunct therapy alongside Enablex or those who didn’t respond well to first-line antimuscarinics due to its longer action time.

Both drugs have generic forms available which can result in significant cost savings, especially beneficial for patients paying out-of-pocket. Both Enablex and Vesicare might require a period of adjustment before noticeable effects set in.

The side effect profile is relatively similar between both medications including common anticholinergic side effects like dry mouth, constipation, and blurred vision but usually well-tolerated by most individuals. With both medications, it's important for patients to monitor any changes closely when starting treatment and seek medical attention immediately if symptoms worsen or new problems arise.