Bladder control problems: Medications for treating urinary incontinence

Learn about medications used to treat bladder control problems, including how they work to treat urinary incontinence and possible side effects.

By Mayo Clinic Staff

You've given up coffee and soda. You've followed your doctor's suggestions for bladder retraining. But bladder control remains a problem. What else can you do? Ask your doctor about medication options.

Effective medications are available for people with overactive bladder and urge incontinence — a bladder control problem marked by sudden, intense urinary urges and urine leakage. Fewer medication options exist for stress incontinence — urine leakage prompted by a physical movement or activity, such as coughing, sneezing or heavy lifting.

Here's an overview some medications commonly prescribed to treat urinary incontinence along with their possible side effects.

Anticholinergics

How they work

Anticholinergic drugs block the action of a chemical messenger — acetylcholine — that sends signals to your brain that trigger abnormal bladder contractions associated with overactive bladder. These bladder contractions can make you feel the need to urinate even when your bladder isn't full.

Anticholinergic medications include:

  • Oxybutynin (Ditropan XL, Oxytrol)
  • Tolterodine (Detrol)
  • Darifenacin (Enablex)
  • Solifenacin (Vesicare)
  • Trospium (Sanctura)
  • Fesoterodine (Toviaz)

Some of these medications are available in an extended-release form, meaning you take them once a day. These may have fewer side effects than the immediate-release versions, which are usually taken multiple times a day.

Still, the immediate-release form may be helpful if you experience incontinence only at certain times, such as at night, or if you want to take a medication for only a short time, such as when you travel. These medications are usually given as a pill or tablet that you take by mouth. Oxybutynin is also available as a cream or skin patch that delivers a continuous amount of medication.

Side effects

The most common side effects of anticholinergics are dry mouth and constipation. To counteract dry mouth, you might suck on a piece of candy or chew gum to produce more saliva. Other less common side effects include heartburn, blurry vision, rapid heartbeat (tachycardia), flushed skin, urinary retention and cognitive side effects, such as impaired memory and confusion.

The most common side effect of the oxybutynin skin patch is skin irritation. Your doctor may recommend that you rotate the location of your patch.

Mirabegron (Myrbetriq)

How it works

Mirabegron is a medication approved to treat certain types of urinary incontinence. It relaxes the bladder muscle and can increase the amount of urine your bladder can hold. It may also increase the amount you are able to urinate at one time, helping to empty your bladder more completely.

Side effects

Some side effects of mirabegron include increased blood pressure, common cold symptoms (nasopharyngitis), urinary tract infection and headache. Constipation also may occur. Before taking mirabegron, talk with your doctor if you have kidney or liver disease. Mirabegron may also interact with other medications, so make sure your doctor knows which medications you're taking before you begin taking mirabegron.

OnabotulinumtoxinA (Botox)

How it works

Injections of Botox into the bladder muscle may benefit people who have an overactive bladder. Botox blocks the actions of acetylcholine and paralyzes the bladder muscle. Botox may be helpful for people who haven't responded to other medications. Benefits can last several months. Your doctor may recommend repeat injections once or twice a year.

Side effects

Studies have found that Botox significantly improves symptoms of incontinence and causes few side effects. Some research indicates it may increase urinary tract infections, but the data aren't conclusive.

The FDA warns that adverse reactions including respiratory arrest and death may occur after the use of Botox for both approved and unapproved uses.

Sep. 13, 2014 See more In-depth