Medication can help when other bladder control options don’t work. Learn what drugs are available and what side effects they can cause. Bladder control problems may persist after lifestyle changes and attempts at bladder training. If other options don’t work, it may be time to talk to your doctor about medications. Medications are available for people who frequently have a sudden, intense urge to urinate, also known as overactive bladder. It can also be used by people with urine leakage, which can occur with overactive bladder. This is called urge urinary incontinence.
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Limited drugs are available for people who leak urine during activity. This is called stress urinary incontinence. Stress urinary incontinence can leak when you cough, sneeze, or lift heavy objects. Here, we discuss medications commonly used to treat bladder control problems and their possible side effects. A combination of drug therapy and behavioral therapy may be more effective than drug therapy alone.
Anticholinergic
How they work
Anticholinergics block the action of the chemical messenger acetylcholine. Acetylcholine sends signals to the brain that trigger bladder contractions associated with overactive bladder. These bladder contractions can cause the urge to urinate even if the bladder is not full. Anticholinergics include:
- Oxybutynin (Ditropane XL, Oxytrol, Gernik)
- Tolterodine (Detrol, Detrol LA)
- darifenacin
- Solifenacin (Vesicare, Vesicare LS)
- tropium
- Fesoterodine (Tobias)
These prescription drugs are usually given orally as tablets or pills. Oxybutynin is also available as a prescription gel or skin patch that releases continuous doses of the drug. Additionally, oxybutynin is available as a skin patch without a prescription (Oxytrol for Women). It may take several weeks for symptoms to improve with anticholinergic drugs. It may take up to 12 weeks for the full effect of the drug to be seen. The most common side effects of anticholinergics are dry mouth and constipation. A once-daily sustained-release formulation may have fewer side effects.
If you have a dry mouth, try chewing candy or chewing gum to increase saliva. Other less common side effects include heartburn, blurred vision, rapid heartbeat, skin flushing, and urinary problems. Cognitive side effects can also occur. These include memory issues and confusion. Oxybutynin skin patches can cause skin irritation. Your doctor may suggest relocating the patch.
Mirabegron (Myrbetriq)
Usage
Mirabegron is approved for the treatment of certain types of urinary incontinence. It can relax the bladder muscles and increase the amount of urine that the bladder can hold. It can also increase the amount of urine you can urinate at one time. This allows the bladder to empty more completely. Mirabegron is available as tablets or granules.
Side effects
Common side effects of mirabegron include nausea, diarrhea, constipation, dizziness, and headache. May raise blood pressure. Blood pressure should be monitored while you are taking this medicine. Mirabegron may interact with other medicines. Give your doctor a list of all your medicines before you start taking this medicine.
Onabotulinum Toxin Type a (Botox)
Usage
Botox injections into the bladder muscle may help people with overactive bladder or urge incontinence. Botox blocks the action of acetylcholine and paralyzes the bladder muscles. Botox can help people who have not responded to other medications. Service may last for several months. A doctor may recommend that he repeat the injections 1-2 times a year.
Side effects
Studies have shown that Botox significantly improves incontinence symptoms and has few side effects. Some studies have shown that it may increase urinary tract infections, but data are limited. The Food and Drug Administration (FDA) warns that side effects may occur after using Botox for both approved and unapproved purposes. May include respiratory failure and death.