Skip to main content
Log in

Darifenacin

In the Treatment of Overactive Bladder

  • Adis Drug Profile
  • Published:
Drugs & Aging Aims and scope Submit manuscript

Abstract

▴ Darifenacin is a selective muscarinic M3-receptor antagonist that has been evaluated in clinical trials in patients with overactive bladder syndrome (OAB) using a controlled-release formulation.

▴ In multicentre, randomised, double-blind trials in patients with OAB, darifenacin 7.5 or 15mg once daily for 12 weeks significantly reduced the frequency of urinary incontinence, frequency of micturition and frequency and severity of urgency versus placebo. A significant difference from placebo was apparent 2 weeks after starting treatment. At a dosage of 30mg once daily, darifenacin significantly prolonged warning time compared with placebo.

▴ Darifenacin 15mg once daily for 2 weeks was as effective as oxybutynin 5mg three times daily at reducing the frequency of urinary incontinence and frequency and severity of urgency in patients with OAB.

▴ Darifenacin was generally well tolerated in clinical trials. The most common adverse events were dry mouth and constipation. CNS tolerability appeared to be similar to that of placebo.

▴ Darifenacin had no adverse effect on cognitive function in healthy elderly volunteers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

Notes

  1. The use of trade names is for product identification purposes only and does not imply endorsement.

References

  1. Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-Committee of the International Continence Society. Neurourol Urodyn 2002; 21: 167–78

    Article  PubMed  Google Scholar 

  2. Milsom I, Abrams P, Cardozo L, et al. How widespread are the symptoms of an overactive bladder and how are they managed? A population-based prevalence study. BJU Int 2001; 87: 760–6

    Article  PubMed  CAS  Google Scholar 

  3. Stewart WF, Van Rooyen JB, Cundiff GW, et al. Prevalence and burden of overactive bladder in the United States. World J Urol 2003; 20: 327–36

    PubMed  CAS  Google Scholar 

  4. Andersson K-E. Antimuscarinics for treatment of overactive bladder. Lancet Neurology 2004; 3(1): 46–53

    Article  PubMed  CAS  Google Scholar 

  5. Wallis RM, Burges RA, Cross PE, et al. Darifenacin, a selective muscarinic M-3 antagonist [abstract]. Pharmacol Res 1995; 31 Suppl.: 54

    Article  Google Scholar 

  6. Nunn PA, Greengrass PM, Newgreen DT, et al. The binding profile on the novel muscarinic receptor antagonist darifenacin against the five cloned human muscarinic receptors expressed in CHO cells [abstract no. 130P]. Br J Pharmacol 1996 Apr; 117 Suppl.

    Google Scholar 

  7. Eglen RM, Pulido-Rios MT, Webber AP, et al. Characterization of the interaction of darifenacin at muscarinic receptor subtypes in vitro [abstract no. 35P]. Br J Pharmacol 1996 Jul; 118 Suppl.

    Google Scholar 

  8. Smith CM, Wallis RM. Characterisation of [3H]-darifenacin as a novel radiolig and for the study of muscarinic M3 receptors. J Recept Signal Transduct Res 1997; 17(1–3): 177–84

    PubMed  CAS  Google Scholar 

  9. Napier C, Gupta P. Darifenacin is selective for the human recombinant M3 receptor subtype [abstract no. 445]. 32nd Annual Meeting of the International Continence Society; 2002 Aug 27–30; Heidelberg [online]. Available from URL: http://www.icsoffice.org/publications [Accessed 2004 Sep 1]

  10. Gillberg PG, Sundquist S, Nilvebrant L. Comparison of the in vitro and in vivo profiles of tolterodine with those of subtype-selective muscarinic receptor antagonists. Eur J Pharmacol 1998 May 22; 349(2–3): 285–92

    Article  PubMed  CAS  Google Scholar 

  11. Nelson CP, Gupta P, Napier CM, et al. Functional selectivity of muscarinic receptor antagonists for inhibition of M3-mediated phosphoinositide responses in guinea-pig urinary bladder and submandibular salivary gland. J Pharmacol Exp Ther 2004 May 12

    Google Scholar 

  12. Ohtake A, Ukai M, Hatanaka T, et al. In vitro and in vivo tissue selectivity profile of solifenacin succinate (YM905) for urinary bladder over salivary gland in rats. Eur J Pharmacol 2004 May 25; 492(2–3): 243–50

    Article  PubMed  CAS  Google Scholar 

  13. Wallis RM, Napier CM. Muscarinic antagonists in development for disorders of smooth muscle function. Life Sci 1999; 64(6–7): 395–401

    Article  PubMed  CAS  Google Scholar 

  14. Miyamae K, Yoshida M, Murakami S, et al. Pharmacological effects of darifenacin on human isolated urinary bladder. Pharmacology 2003 Dec; 69(4): 205–11

    Article  PubMed  CAS  Google Scholar 

  15. Newgreen DT, Naylor AM. Comparison of the functional muscarinic receptor selectivity of darifenacin with tolterodine and oxybutinin [abstract no. 107P]. Br J Pharmacol 1996 Apr; 117 Suppl.

    Google Scholar 

  16. Alexandrou A, Claringbold A, Harris J, et al. Darifenacin has a low affinity for muscarinic M1 receptors in dog saphenous vein confirming its M3 selectivity [abstract no. 458]. Eur Urol Suppl 2003; 1: 117

    Article  Google Scholar 

  17. Newgreen DT, Naylor AM. Characterisation of functional muscarinic receptors in human bladder [abstract no. 45P]. Br J Pharmacol 1996 Oct; 119 Suppl.

    Google Scholar 

  18. Chua CB, Harriss DR, Marsh KA, et al. Effect of darifenacin on muscarinic responses in normal and unstable human detrusor smooth muscle cells. Neurourol Urodyn 1997; 16: 355–6

    Google Scholar 

  19. Williamson IJR, Newgreen DT, Naylor AM. The effects of darifenacin and oxybutynin on bladder function and salivation in the conscious rat [abstract no. 205P]. Br J Pharmacol 1997 Mar; 120 Suppl.

    Google Scholar 

  20. Davies CL, Dodd MG, Merner PA, et al. In vivo bladder selectivity of the novel muscarinic antagonist, darifenacin, in the conscious minipig [abstract no. 202P]. Br J Pharmacol 1996 Apr; 117 Suppl.

    Google Scholar 

  21. Mundy AR, Abrams P, Chapple CR, et al. Darifenacin, the first selective M3 antagonist for overactive bladder: comparison with oxybutynin on ambulatory urodynamic monitoring and salivary flow [abstract no. 221]. 31st Annual Meeting of the International Continence Society; 2001 Sep 17–21; Seoul [online]. Available from URL: http://www.icsoffice.org/publications [Accessed 2004 Aug 31]

  22. Gupta P, Anderson C, Carter A, et al. In vivo bladder selectivity of darifenacin, a new M3 antimuscarinic agent, in the anesthetised dog [abstract no. 515]. Eur Urol 2002; 1Suppl 1: 131

    Google Scholar 

  23. Newgreen DT, Anderson CWP, Carter TJ, et al. Darifenacin: a novel bladder-selective muscarinic antagonist for the treatment of urge incontinence [abstract no. 1156]. J Urol 1996 May; 155 Suppl.: 600A

    Google Scholar 

  24. Matsui M, Motomura D, Karasawa H, et al. Multiple functional defects in peripheral autonomic organs in mice lacking muscarinic acetylcholine receptor gene for the M3 subtype. Proc Natl Acad Sci U S A 2000 Aug 15; 97(17): 9579–84

    Article  PubMed  CAS  Google Scholar 

  25. Kay G. The M3 selective receptor antagonist darifenacin has no clinically relevant effect on cognition and cardiac function [abstract no. 65]. Prog Urol 2004; 14Suppl. 3: 22

    Google Scholar 

  26. Wesnes K, Lipton R, Kolodner K, et al. Darifenacin, an M3 selective receptor antagonist for the treatment of overactive bladder, does not affect cognitive function in elderly volunteers [abstract no. 513]. 19th Congress of the European Society of Urology; 2004 Mar 24–27; Vienna [online]. Available from URL: http://www.uroweb.org [Accessed 2004 Jun 18]

  27. Kerbusch T, Wahlby U, Milligan PA, et al. Population pharmacokinetic modelling of darifenacin and its hydroxylated metabolite using pooled data, incorporating saturable first-pass metabolism, CYP2D6 genotype and formulation-dependent bioavailability. Br J Clin Pharmacol 2003 Dec; 56(6): 639–52

    Article  PubMed  CAS  Google Scholar 

  28. Beaumont KC, Cussans NJ, Nichols DJ, et al. Pharmacokinetics and metabolism of darifenacin in the mouse, rat, dog and man. Xenobiotica 1998 Jan; 28(1): 63–75

    Article  PubMed  CAS  Google Scholar 

  29. Data on file. Novartis Pharma AG, 2004 Aug 26

  30. Kerbusch T, Milligan PA, Karlsson MO. Assessment of the relative in vivo potency of the hydroxylated metabolite of darifenacin in its ability to decrease salivary flow using pooled population pharmacokinetic-pharmacodynamic data. Br J Clin Pharmacol 2004 Feb; 57(2): 170–80

    Article  PubMed  CAS  Google Scholar 

  31. Haab F, Stewart L, Dwyer P. Darifenacin, an M3 selective receptor antagonist, is an effective and well-tolerated once-daily treatment for overactive bladder. Eur Urol 2004 Apr; 45(4): 420–9; discussion 429

    Article  PubMed  CAS  Google Scholar 

  32. Khullar V. Darifenacin, an M3 selective receptor antagonist, reduces the frequency of nocturnal awakening, an important symptom of overactive bladder [abstract no. 491]. J Urol 2004 Apr; 171 (4 Suppl.): 131

    Google Scholar 

  33. Corcos J, Steers W. Efficacy, tolerability and safety of darifenacin given by a flexible titration dosing regimen [abstract no. 178]. Joint Meeting of the International Continence Society and the International Urogynecological Assocation; 2004 Aug 23–27; Paris [online]. Available from URL: http://www.icsoffice.org [Accessed 2004 Jul 2]

  34. Cardozo L, Dixon A. Darifenacin prolongs median and minimum warning time associated with urinary urgency [abstract]. Obstet Gynecol 2004 Apr; 103 (4 Suppl.): 130

    Google Scholar 

  35. Zinner N, Tuttle J, Marks L. Efficacy and tolerability of darifenacin, a muscarinic M3 selective receptor antagonist, compared with oxybutynin in the treatment of patients with overactive bladder [abstract no. 378]. Joint Meeting of the International Continence Society and the International Urogynecological Assocation; 2004 Aug 23–27; Paris [online]. Available from URL: http://www.icsoffice.org [Accessed 2004 Jul 2]

  36. Chapple CR. Darifenacin is well tolerated and provides significant improvement in the symptoms of overactive bladder: a pooled analysis of phase III studies [abstract no. 487]. J Urol 2004 Apr; 171 (4 Suppl.): 130

    Article  Google Scholar 

  37. Abrams P, Foot J, Lheritier K, et al. Responder rates, a better way to express drug efficacy: data from darifenacin pooled phase III studies [abstract no. 389]. Joint Meeting of the International Continence Society and the International Urogynecological Assocation; 2004 Aug 23–27; Paris [online]. Available from URL: http://www.icsoffice.org [Accessed 2004 Jul 2]

  38. Chapple C, Kelleher C, Perrault L. Darifenacin, an M3 selective receptor antagonist, improves quality of life in patients with overactive bladder [abstract no. 67]. Prog Urol 2004; 14Suppl. 3: 22

    Google Scholar 

  39. Glavind K, Perrault L. Patient satisfaction, preference and willingness to reuse darifenacin in the treatment of overactive bladder [abstract no. UP-14.17]. 27th Congress of the Société International d’Urologie; 2004 Oct 3–7; Honolulu [online]. Available from URL: http://www.siu2004.com [Accessed 2004 Sep 30]

  40. Foote JE. Darifenacin, an M3 selective receptor antagonist (M3SRA), is effective and well tolerated in elderly patients with overactive bladder [abstract no. P321]. J Am Geriatr Soc 2004 Apr; 52 (4 Suppl.): 126–7

    Google Scholar 

  41. Hill S. The effects of darifenacin on the reduction of incontinence episodes in patients with overactive bladder [abstract no. 610]. J Pelvic Med Surg 2004; 10Suppl. 1

    Google Scholar 

  42. Foote J, Glavind K, Kay G. Central nervous system (CNS)-related adverse events in patients with overactive bladder (OAB) treated with darifenacin versus tolterodine [abstract]. 27th Congress of the Société International d’Urologie; 2004 Oct 3–7; Honolulu [online]. Available from URL: http://www.siu2004.com [Accessed 2004 Sep 30]

  43. Novartis. Darifenacin increases warning time for OAB sufferers. Media release 2003 Oct 10 [online]. Available from URL: http://www.novartis.com [Accessed 2004 Jun 15]

  44. Pharma Times. Novartis’ Emselex wins nod for OAB. Media release 2004 Jul 30 [online]. Available from URL: http://www.pharmatimes.com/news/300704e.asp [Accessed 2004 Jul 30]

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Katherine F. Croom.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Croom, K.F., Keating, G.M. Darifenacin. Drugs Aging 21, 885–892 (2004). https://doi.org/10.2165/00002512-200421130-00005

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00002512-200421130-00005

Keywords

Navigation