Some Drugs Used to Treat Urinary Incontinence
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Drug |
How It Works |
Comments |
For weakness of the urinary sphincter or pelvic muscles (bladder outlet incompetence) causing stress incontinence |
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Duloxetine |
Helps strengthen contractions of the urinary sphincter |
Not as thoroughly studied as many other drugs Not approved for this use in the United States |
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Imipramine (a tricyclic antidepressant) |
Helps strengthen urinary sphincter contractions and relax an overactive bladder (an anticholinergic effect*) |
Also used for overactive bladder and urge incontinence FDA approved as temporary therapy for reducing nighttime incontinence (enuresis) in children aged 6 years and older |
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Pseudoephedrine (an alpha-adrenergic stimulant) |
Helps strengthen urinary sphincter contractions |
Can cause anxiety, insomnia, and, in men, inability to urinate OTC medication used primarily as a decongestant |
For bladder outlet obstruction in men causing urge or overflow incontinence |
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Alpha-adrenergic blockers: |
Help relax the urinary sphincter |
Tend to increase the speed of urine flow and help the bladder empty more completely May decrease blood pressure or cause fatigue |
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5-Alpha reductase inhibitors: |
Help shrink an enlarged prostate |
Can take weeks or months to become effective Sometimes decrease sex drive or contribute to erectile dysfunction |
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Phosphodiesterase type 5 (PDE5) inhibitor: |
Doctors are not certain how this drug affects an enlarged prostate |
Low dose taken daily (also used to treat erectile dysfunction) |
For overactive bladder with urge or stress incontinence |
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Darifenacin |
Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects†) |
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Dicyclomine |
Relaxes involuntary muscles Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects*) |
Not as thoroughly studied as many other drugs |
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Fesoterodine |
Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects†) |
Not as thoroughly studied as many other drugs |
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Hyoscyamine |
Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects*) |
Not as thoroughly studied as many other drugs |
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Imipramine (a tricyclic antidepressant) |
Helps strengthen urinary sphincter contractions Increases the bladder's filling capacity and decreases bladder wall muscle spasms (an anticholinergic effect*) |
Particularly useful for nighttime incontinence |
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Mirabegron (a beta-adrenergic stimulant) |
Relaxes the bladder wall |
Not as thoroughly studied as many other drugs May increase blood pressure |
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OnabotulinumtoxinA (a type of botulinum toxin) |
Blocks the nerve activity in the bladder muscle that causes the bladder to contract involuntarily |
Injected into the bladder wall through a cystoscope inserted in the bladder Used to treat incontinence in adults with overactive bladder caused by a neurologic disorder (such as multiple sclerosis) when other drugs are ineffective or have too many side effects |
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Oxybutynin |
Many effects, such as relaxation of involuntary muscles and anticholinergic effects*, which include increasing the bladder's filling capacity and decreasing the bladder wall muscle spasms |
May be the most effective drug Available as a tablet, skin patch, and gel |
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Solifenacin |
Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects†) |
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Tolterodine |
Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects†) |
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Trospium |
Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects*) |
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For weak bladder wall muscles with overflow incontinence |
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Bethanechol |
Helps bladder wall muscles contract |
Usually ineffective Can cause flushing, abdominal cramps, and an increased heart rate |
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* Anticholinergic effects (such as dry mouth, constipation, and sometimes blurred vision or confusion) can be bothersome, particularly in older people. |
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† These drugs have anticholinergic effects that target the urinary system, so they tend to have fewer other anticholinergic side effects than other drugs with anticholinergic effects. |
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FDA = Food and Drug Administration; OTC = over-the-counter. |
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