Medications Used to Treat Incontinence
Medications | Mechanisms | Comments |
|---|---|---|
Outlet Bladder incompetence in stress incontinence | ||
It appears to be effective, but experience with it is limited. | ||
Tricyclic antidepressant, anticholinergic, and alpha-agonist effects | Acceptable as temporary adjunctive therapy to reduce enuresis in children aged ≥ 6 years. | |
Alpha-agonist effects | Adverse effects include insomnia, anxiety, and, in men, urinary retention. This drug is not recommended for people with heart disorders, hypertension, glaucoma, diabetes, hyperthyroidism, or benign prostatic hyperplasia. | |
Bladder outlet obstruction in men with urge or overflow incontinence | ||
Alpha-adrenergic blockade | In men, alpha-adrenergic blockers relieve symptoms of outlet obstruction, may reduce postvoid residual volume and outlet resistance, and may increase urinary flow rate. Effect occurs within days to weeks. Adverse effects include hypotension, fatigue, asthenia, and dizziness. | |
5-Alpha-reductase inhibition | Adverse effects are minimal and consist of sexual dysfunction (eg, decreased libido, erectile dysfunction). | |
Not established | If possible, it should not be used in patients taking nitrates or alpha-adrenergic blockers. | |
Detrusor overactivity in urge or stress incontinence* | ||
Anticholinergic effects, selective M3 muscarinic antagonism | ||
Smooth muscle relaxation, anticholinergic (antimuscarinic) effects | ||
Anticholinergic effects, selective M3 muscarinic antagonism | The dose should not exceed 4 mg once a day in patients with renal impairment. | |
Smooth muscle relaxation, anticholinergic (antimuscarinic) effects | Adverse effects include nausea, vomiting, dry mouth, and blurred vision. Adverse effects are tolerable with doses of up to 1200 mg/day. | |
Anticholinergic effects | ||
Tricyclic antidepressant, anticholinergic, and alpha-agonist effects | ||
Beta-3 adrenergic agonist | It may increase blood pressure. | |
Beta-3 adrenergic agonist | ||
Blockage of neuromuscular transmission by binding to receptor sites on nerve terminals and inhibiting the release of acetylcholine | It is used to treat adults with overactive bladder or neurogenic urge incontinence if they have an inadequate response to or cannot tolerate anticholinergic drugs. | |
Smooth muscle relaxation; anticholinergic, nonselective antimuscarinic, and local anesthetic effects | Efficacy may increase over time. Adverse effects include anticholinergic effects (eg, dry mouth, constipation), which may interfere with adherence and worsen incontinence. Adverse effects are less severe with extended-release and transdermal forms. | |
Anticholinergic effects | This drug must be taken on an empty stomach. | |
Anticholinergic effects, selective M1 and M3 muscarinic antagonism | ||
Anticholinergic effects, selective M3 muscarinic antagonism | Because M3 Dose reduction is needed in patients with severe renal impairment. | |
Anticholinergic effects | Dose reduction is needed in patients with severe renal impairment. | |
Detrusor underactivity in overflow incontinence | ||
Cholinergic effects | Adverse effects include flushing, tachycardia, abdominal cramps, and malaise. | |
* Other prostate surgical procedures rarely cause established incontinence. | ||