Medications

How Medications Affect Your Bladder

Several CLASSES of medicines affect the bladder muscle and the bladder outlet muscle. Sometimes these medicines are prescribed for conditions outside the urinary system and cause unwanted changes in bladder control. At other times, these changes are desirable and the same class of medicine is prescribed to treat incontinence.

Classes of Drugs Which May Affect Continence:

  • Diuretics (Water Pills): Any drug that increases the flow of urine. Bladder symptoms include frequency, urgency, increased amount of urine produced and output. Examples include Hyrdodiuril® (Hydrochlorothiazide – HCTZ), Lasix® (Furosemide), Maxzide® (HCTZ – triamterene)
  • Sedatives & Muscle Relaxants: Any drug that causes sedation and/or drowsiness. Bladder symptoms include the possible lack of appreciation of bladder events. Examples include Valium® (diazepam), Librium® (chlordiazepoxide) and Ativan® (lorazepam).
  • Narcotics: Any drug that produces analgesia, narcosis (stupor or sleep) and drug addiction. Effects retention of urine because the bladder is relaxed. Bladder symptoms consist of lack of concern or desire to use the toilet, difficulty in starting the urinary stream, straining to void, voiding with a week stream urinating between voids and frequency. Examples include Percocet® (oxycodone-APAP), Demerol® (meperidine), morphine.
  • Antihistamines: Synthetic drugs that counteract the effects of released histamine in the body. Increases retention of urine because the bladder is relaxed or bladder outlet resistance is increased. Bladder symptoms include difficulty in starting the urinary stream, straining to void, voiding with a weak stream, leaking in between urinations, frequency and urinary retention. Examples include Benadryl® (diphenhydramine).
  • Antipsychotics / Antidepressants (for depression or mental illness) Increases retention of urine because the bladder is relaxed or bladder outlet resistance is increased. Bladder symptoms include difficulty in starting the urinary stream, straining to void, voiding with a weak stream, leaking in between urinations, frequency and urinary retention. Examples include Elavin® (amitriptyline), Prolixin® (fluphenazine), Hadol® (haloperidol), Prozac® (fluoxetine HCL).
  • Calcium channel blockers: Increases retention of urine because the bladder is relaxed or bladder outlet resistance is increased. Bladder symptoms include difficulty in starting the urinary stream, straining to void, voiding with a weak stream, leaking in between urinations, frequency and urinary retention. Examples include Calan® (verapamil), Procardia® (nifedipine) and Cardizem® (diltiazem).
  • Anticholinergics*Effects include possible difficulty in passing urine due to relaxation of bladder muscle. Bladder symptoms include possible decrease in bladder emptying, overactive bladder (OAB) and urge/overflow incontinence. Examples include oxybutynin, tolterodine tartrate, trospium chloride and darifenacin.
  • Alpha adrenergic agonist:Increases the resistance of the bladder outlet muscle. Bladder symptoms include urinary retention and voiding with a weak stream. Examples include Entex® and Sudafed® (psuedoepherdrine).
  • Over the counter cold remedies:Increased retention of urine either because the bladder is relaxed or the strength of the bladder outlet muscle is increased, depending on the particular medication. Bladder symptoms include urinary retention, difficulty in starting the urinary stream, straining to void, voiding with a weak stream, leaking between urinations and frequency. Examples include Nyquil®, Theraflu®, Alka Seltzer Plus Cold Relief®, and Afrin® nasal spray.
  • Alpha adrenergic antagonist:Relaxes the bladder outlet muscle. Symptoms include leaking when coughing, sneezing, laughing, exercising, etc. Examples include Htrin® (terazosin), Cardura® (doxazosin), and Flomax® (tamsulosin). DDAVP® (desmopressin acetate) Decreases the urine output made by the kidneys. Bladder symptoms include the possible decrease in blood levels of salts and decreased urine production.

Prescription Medications to Treat Incontinence

Medicines often are given to correct problems with the bladder or the bladder outlet muscle. These drugs may be used in combination with behavioral and exercise treatments. Read further to read about the specific medications used for different diagnoses.

Overactive Bladder and Urgency incontinence
Click here to view a complete and detailed list of the brand name and generic medications used for treating overactive bladder and urgency incontinence. 

(Note: At the 2009 meeting of the American Urological Association, researchers presented findings from a studying comparing generic and branded medication for overactive bladder, and announced that generic formulations of the medication can vary from 80% to 125% of the branded drug in terms of "bioequivalence" which can translate into differences in safety and efficacy).

Stress Incontinence
These drugs help tighten up the bladder outlet muscle.

  • Tofranil® (imipramine**)
  • Sudafed® (pseudophedrine)

Post-menopausal women
These drugs help improve the condition of the vagina and urethral lining due to a decrease in female hormones after menopause.

  • Estrace® (estrogen*)
  • Estring® (estrodiol vaginal ring)
  • Vagifem® (estrodiol vaginal tablets)

Overflow Incontinence
Overflow incontinence is a more rare type of incontinence that may be caused by an underactive bladder muscle, a decrease in bladder muscle tone, or restricted urine flow from an enlarged prostate in males. These drugs stimulate the bladder muscle, relax the sphincter or shrink the prostate to allow unrestricted urine flow.

  • Urecholine® or Duvoid® (bethanechol)
  • Hytrin® (terazosin)
  • Cardura® (terazosin)
  • Uroxatral® (alfuzosin)
  • Proscar® (finasteride)

Bedwetting
Bedwetting may occur when too much urine is produced. These drugs work by decreasing bladder contractions, tightening the sphincter muscle or decreasing urine production. Learn more about products that help children become dry.

  • Tofranil® (imipramine**)
  • DDAVP® nasal spray (desomopressin)

Urinary Tract Infection
Sudden onset of urine leakage can be caused by bacteria or urinary tract infections. Antibiotics can be prescribed by your doctor to cure infections that cause leakage.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088. Please click here to read what you should know about prescription drug advertising.