Darifenacin
ENABLEX
What it isM3-selective muscarinic antagonist; urgency and urge incontinence from overactive bladder.
Why this oneIts bladder-focused M3 selectivity aims to spare cognitive M1 effects better than oxybutynin.
What limits itConstipation and dry mouth remain prominent; urinary retention and CYP2D6 or CYP3A4 interactions can end treatment.
FDA-approved for
- overactive bladder (2004)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Overactive bladder (urge incontinence, urgency, frequency) | Adults | 7.5 mg QD | 7.5-15 mg QD | 15 mg QD |
Titration May increase to 15 mg QD as early as 2 weeks after starting.
Renal Undefined
Hepatic Moderate (Child-Pugh B): do not exceed 7.5 mg QD. Severe (Child-Pugh C): not recommended.
Instructions
- Take orally once daily with water.
- May take with or without food.
- Swallow whole; do not chew, divide, or crush.
- With potent CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, ritonavir, nelfinavir, clarithromycin, nefazodone): do not exceed 7.5 mg QD.
Contraindications
- Urinary retention
- Gastric retention
- Uncontrolled narrow-angle glaucoma
Cautions
- Urinary retention — caution in clinically significant bladder outflow obstruction
- Decreased GI motility/gastric retention — caution in GI obstructive disorders
- Caution in narrow-angle glaucoma
- CNS effects: somnolence — caution driving/operating machinery
Adverse reactions
- Constipation
- Dry mouth
- Headache
- Dyspepsia
- Nausea
- Urinary tract infection
Pregnancy No human data; not teratogenic in animals. Use only if benefit outweighs fetal risk.
Lactation No human data; present in rat milk.
NO BOXED WARNINGS
Principal riskConstipation and dry mouth
Cost, est. cash$10–$300/month
Generic entry2015
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityGenerally tolerated at therapeutic doses; clinically important risks are agent-specific and increase with interactions or organ impairment.
Mechanism of action: Darifenacin ballicule
Open Darifenacin in the interactive console ↗
Memory aids: mascots and interaction avatars
“Red as a beet” crimson color theme → anticholinergic
