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 | ||
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) 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 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 | ||
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. | ||