Table: Some Medications Used to Treat Urinary Incontinence-Merck Manual Consumer Version

Some Medications Used to Treat Urinary Incontinence

Medication	How It Works	Comments
For weakness of the urinary sphincter or pelvic muscles (bladder outlet incompetence) causing stress incontinence
	Helps strengthen contractions of the urinary sphincter	Not as thoroughly studied as many other medications Not approved for this use in the United States
	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
	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 Sometimes decrease sex drive or contribute to erectile dysfunction
Phosphodiesterase type 5 (PDE5) inhibitor:	Doctors are not certain how this medication affects an enlarged prostate	Low dose taken daily (also used to treat erectile dysfunction)
For overactive bladder with urge or stress incontinence
	Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects†)	—
	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
	Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects†)	Not as thoroughly studied as many other medications
	Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects*)	Not as thoroughly studied as many other medications
	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
	Relaxes the bladder wall	May increase blood pressure
(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
	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
	Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects†)	—
	Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects†)	—
	Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects*)	—
	Relaxes the bladder wall	No apparent effect on blood pressure
For weak bladder wall muscles with overflow incontinence
	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.

Medication

How It Works

Comments

For weakness of the urinary sphincter or pelvic muscles (bladder outlet incompetence) causing stress incontinence

Helps strengthen contractions of the urinary sphincter

Not as thoroughly studied as many other medications

Not approved for this use in the United States

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

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

Sometimes decrease sex drive or contribute to erectile dysfunction

Phosphodiesterase type 5 (PDE5) inhibitor:

Doctors are not certain how this medication affects an enlarged prostate

Low dose taken daily (also used to treat erectile dysfunction)

For overactive bladder with urge or stress incontinence

Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects†)

—

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

Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects†)

Not as thoroughly studied as many other medications

Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects*)

Not as thoroughly studied as many other medications

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

Relaxes the bladder wall

May increase blood pressure

(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

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

Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects†)

—

Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects†)

—

Increases the bladder's filling capacity and decreases bladder wall muscle spasms (anticholinergic effects*)

—

Relaxes the bladder wall

No apparent effect on blood pressure

For weak bladder wall muscles with overflow incontinence

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.