Efficacy, tolerability and safety profile of propiverine in the treatment of the overactive bladder (non-neurogenic and neurogenic)

Abstract

Propiverine hydrochloride (propiverine) is a compound that has neurotropic and musculotropic effects on the urinary bladder smooth muscle. Controlled clinical trials have shown its effectiveness in treating detrusor hyperreflexia and in treating patients with symptoms of an overactive bladder: this is true not only for adults but in children and the elderly as well. European and Japanese studies have also documented that propiverine is well tolerated. It is better tolerated than oxybutynin (particularly in regard to frequency and severity of dryness of the mouth). In several Japanese studies authors demonstrated that propiverine is well tolerated on a long-term basis. Voigt reported an adverse event incidence rate of 13% in a follow-up investigation during 10 years of treatment. A post-marketing drug surveillance consisting of 4390 patients provided additional data concerning efficacy and safety of propiverine. It is one of the few drugs recommended for the treatment of detrusor overactivity by the Committee on Pharmacological Treatment during the First International Consultation on Incontinence.

Comparison of the effect of anti-muscarinic agents on bladder activity, urinary ATP level, and autonomic nervous system in rats

“…Propiverine hydrochloride appears to have an additional spasmolytic effect in addition to its anti-muscarinic effect (2). In rabbit, propiverine alters intracellular Ca 2+ homeostasis in addition to its muscarinic antagonist effect (16). Because bladder contraction in response to muscarinic receptor stimulation requires the influx of Ca 2+ via nifedipine-sensitive L-type calcium channels (17), a calcium antagonist effect combined with an anti-muscarinic effect may lead to marked reduction of the urinary ATP level by propiverine.…”

Novel insights into renal d-amino acid oxidase accumulation: propiverine changes DAAO localization and peroxisomal size in vivo

“…Nowadays, increasing overweight and obesity are problematic since a positive correlation of weight and the extent of urinary incontinence has been reported (Subak et al 2009). Propiverine is one of six anticholinergics which are recommended by the Committee on Pharmacological Treatment for the treatment of OAB (Madersbacher and Mürtz 2001). Upon oral administration to humans, propiverine is rapidly absorbed and undergoes extensive first-pass metabolism in the liver (Haustein and Huller 1988).…”

Efficacy and Safety of Propiverine Hydrochloride for Overactive Bladder in Adult: a Systematic Review and Meta-analysis

“…The main adverse effects reduced the quality of life (QOL) largely, particularly those with OAB associated with LUTS. Many studies suggested that propiverine combined a1-receptor antagonist was more effective for the treatment of both OAB and LUTS [16]. In theory, when voiding symptoms are the first priority in LUTS, an a1-receptor antagonist can be considered as a treatment of choice.…”