Medication | How It Works | Comments |
---|---|---|
For weakness of the urinary sphincter or pelvic muscles (bladder outlet incompetence) causing stress incontinence | ||
Duloxetine | Helps strengthen contractions of the urinary sphincter | Not as thoroughly studied as many other medications Not approved for this use in the United States |
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 Urinary Incontinence in Children Urinary incontinence is defined as the involuntary release of urine occurring two or more times per month after toilet training has been completed. Incontinence may be present During the day... read more ) in children aged 6 years and older |
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 | ||
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 |
5-Alpha reductase inhibitors:
| Help shrink an enlarged prostate | Can take weeks or months to become effective |
Phosphodiesterase type 5 (PDE5) inhibitor:
| Doctors are not certain how this medication affects an enlarged prostate | |
For overactive bladder with urge or stress incontinence | ||
Darifenacin | Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects†) | — |
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 medications |
Fesoterodine | Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects†) | Not as thoroughly studied as many other medications |
Hyoscyamine | Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects*) | Not as thoroughly studied as many other medications |
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 |
Mirabegron (a beta-adrenergic stimulant) | Relaxes the bladder wall | May increase blood pressure |
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 medications are ineffective or have too many side effects |
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 medication Available as a tablet, skin patch, and gel |
Solifenacin | Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects†) | — |
Tolterodine | Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects†) | — |
Trospium | Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects*) | — |
Vibegron (a beta-adrenergic stimulant) | Relaxes the bladder wall | No apparent effect on blood pressure |
For weak bladder wall muscles with overflow incontinence | ||
Bethanechol | Helps bladder wall muscles contract | Usually ineffective Can cause flushing, abdominal cramps, and an increased heart rate |
* Anticholinergic effects (such as dry mouth, constipation, and sometimes blurred vision or confusion) can be bothersome, particularly in older adults. | ||
† These medications have anticholinergic effects that target the urinary system, so they tend to have fewer other anticholinergic side effects than other medications with anticholinergic effects. | ||
FDA = Food and Drug Administration; OTC = over-the-counter. |