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by Polsdorfer R

Medications for Urinary Incontinence

The information provided below is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Prescription Medications

Anticholinergics
Common names include:
  • Darifenacin (Enablex)
  • Flavoxate (Urispas)
  • Oxybutynin (Ditropan, Oxytrol, and Gelnique)
  • Solifenacin (Vesicare)
  • Tolterodine (Detrol)
  • Trospium (Sanctura)
  • Fesoterodine (Toviaz)
These drugs act on the automatic nervous system to alter the balance between bladder pressure and sphincter tone. They specifically weaken the bladder emptying muscle, relieving incontinence that is caused by sudden urges to void due to a full or irritated bladder. Possible side effects include:
  • Urine retention
  • Dry mouth
  • Constipation or diarrhea
  • Nausea
  • Lightheadedness
  • Sleepiness
  • Blurred vision
Muscle Relaxants
  • Mirabegron (Myrbetriq)
This drug relaxes the smooth muscles associated with urination. Possible side effects include:
  • High blood pressure
  • Cold symptoms
  • Urinary tract infection
  • Headache
Estrogens
Common names of topical estrogens include:
  • Ogen
  • Premarin
  • Estrace
  • Estring
Estrogen can also be given in oral, injectable, or transdermal forms, but topical is best for this condition.
Estrogen is the hormone that stimulates and maintains the breasts, ovaries, uterus, and vagina. At menopause , estrogen levels drop dramatically and these organs begin to age. The tissue that supports the bladder is the anterior wall of the vagina. If this becomes weakened and stretched out, the bladder drops, and stress incontinence may result. Replacing estrogen in your body rejuvenates the vaginal wall and may cure the leaking.
Estrogen has both positive and negative effects. To avoid most of the side effects, estrogen for urinary stress incontinence can be given topically as a vaginal cream.
Possible side effects include:
Botulinum Toxin Injections
Botulinum toxin type A can be injected directly into bladder muscles during an outpatient procedure. For people with urge incontinence, botox may be able to relax the bladder muscle.
Possible side effects include:
  • Pain
  • Infection
  • Inflammation

Special Considerations

When using estrogen other than the topical creams, ask your doctor to discuss the pros and cons. Also, having a medical condition may mean that you cannot take certain medications. For example, some people who have glaucoma cannot use anticholinergics.
If you have bladder trouble, check with your doctor before using any other medications, including over-the-counter drugs and herbal supplements. Many have urinary side effects.
If you are taking medications, follow these general guidelines:
  • Take your medicines as directed. Do not change the amount or the schedule.
  • Do not stop taking them without talking to your doctor.
  • Do not share them.
  • Ask what results and side effects to expect. Report them to your doctor.
  • Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medicines and herb or dietary supplements.
  • Plan ahead for refills so you don’t run out.

When to Contact Your Doctor

Call your doctor if:
  • You have concerns about estrogen treatment
  • Side effects are causing significant problems

References

Mirabegron. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 18, 2013. Accessed December 2, 2013.
Phenylpropanolamine. Drug Bank website. Available at: http://www.drugbank.ca/drugs/DB00397. Accessed December 2, 2013.
Phenylpropanolamine. Med Help website. Available at: http://www.medhelp.org/drugs/phenylpropanolamine/show/4094. Updated November 2009. Accessed March 5, 2010.
1/11/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: AHRQ evidence report on treatment for overactive bladder in women 2009. Agency for Healthcare Research and Quality website. Available at: http://www.ahrq.gov. Published August 2009. Accessed January 11, 2010.
12/3/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Dmochowski R, Chapple C, Nitti VW, et al. Efficacy and safety of onabotulinumtoxinA for idiopathic overactive bladder: a double-blind, placebo controlled, randomized, dose ranging trial. J Urol. 2010;184:2416-2422.

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