Is It True That Ditropan Has To Be Taken On An Empty Stomach Or Not?

Here is My Question:

I have been taking Ditropan for bladder problems for several years until fairly recently at a dose of 5mg 1 to 2 times per day. Relapses in the past few months have meant that I now take 5mg 3 times per day, with limited positive results.

However, I have very recently been told that Ditropan's effect is very limited if it is taken with food, and that it should be taken either 1 hour prior to, or 2 hours after food. The comment was also made that as a dry mouth is a common side effect, "if you don't have a dry mouth, it's probably not working very effectively." I am quite annoyed at not being told this, and have checked the drug information sheet provided by the pharmacy, which makes no mention of taking it on an empty stomach. Is this true?

Also, I have found elsewhere that one of the contra-indications to taking this is having a hiatus hernia, which I have. This has never been discussed with me by my neurologist, gastroenterologist or general practitioner. So what should I do?

Answer:

It sounds like your MS has been active recently and has influenced the complex micturition reflex (you can read more about this reflex in Dr. Kinkel’s blog here:  http://www.healthcarejourney.com/urinationbowel-problems.html).  Ditropan treats overactive bladder (detrusor) function.  However, there is more to the story than the detrusor for micturition. 

I’d suggest discussing this with your neurologist and a separate urological consultation may be needed to address the recent changes in your bladder function (ie, 1- to identify any other factors at play, and 2- develop a treatment strategy specific to your current bladder needs).  Keep in mind that sometimes higher doses of Ditropan may be needed (up to 30mg/day)—although I do not recommend doing this on your own, but with the close observation of your treating physician (if it makes sense to do so in your specific situation).

To answer your specific questions about Ditropan:

1. Ditropan can be taken with or without food.  It doesn’t make a difference regarding absorption of the drug.
2. I would not gauge Ditropan’s effectiveness based on the side effect of dry mouth.  To my knowledge (and my experience), this does not predict the effectiveness of Ditropan.
3. I am not aware of a hiatal hernia being a contraindication for Ditropan.  One of the potential side effects of Ditropan is that it can slow down peristalsis (movement of food through the digestive track).  Therefore, if an individual has severe constipation or problems emptying the stomach, then Ditropan can exacerbate that problem and caution is advised.
   

Hope this helps.

-A. Scott Nielson, MD, MMSc, Virginia Mason