Urinary Incontinence Medication

Urinary incontinence medication is a treatment option that you can speak with a physician about at the Urology Division and the Women’s Center for Continence and Sexual Health at Premier Medical Group. Urinary incontinence medication can be used to treat urinary incontinence in conjunction with behavioral techniques like bladder retraining, dietary changes, and exercise or rehabilitation.

What is urinary incontinence?

Urinary incontinence (UI) is when a person loses control of their bladder or is unable to control the frequency or urgency of their urination. UI is a common condition that is often different for each person experiencing it. Avoiding daily disruption and treating it while it is a minor problem is possible. Seek expert treatment as soon as you notice recurring or worrying symptoms.

When should I talk with my doctor about urinary incontinence medication?

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A healthcare professional may be reluctant to prescribe urinary incontinence medication before exploring alternate treatment methods. You might discuss urinary incontinence medication if:

  • Surgery is not safe or practical
  • Lifestyle changes (bladder training, weight loss, quitting smoking) cannot manage your urinary incontinence symptoms
  • Frequent or significant urine leakage affects your daily life

It is best to speak with a medical expert before UI escalates. If you are not satisfied with your current specialist, you may consider getting a second opinion.

How does urinary incontinence medication work?

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Urinary incontinence medication will reduce leakage and sometimes help to stabilize the muscle contractions that otherwise lead to an overactive bladder. Other specific medications help assist the muscles in relaxing so that your bladder can completely empty itself. Speaking to a urologist may also result in exploring hormone replacement therapies. These therapies typically involve a patient taking estrogen to compensate for lower levels due to menopause.

Which urinary incontinence medication is best for me?

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Different types of urinary incontinence require their own specialized treatment plans. Lifestyle changes and surgery are not always the solutions for someone experiencing urinary stress or urge incontinence.

 

Duloxetine

For urinary stress incontinence, Duloxetine is an antidepressant medicine that helps to improve the urethra’s muscle tone and keeps it closed. Your healthcare provider will need to monitor you for as long as you take the tablets twice per day.

Duloxetine is not suitable for every patient. Your doctor will need to discuss existing medical conditions that you have to determine whether or not you can safely take it.

Duloxetine side effects may include:

  • Nausea
  • Dry mouth
  • Extreme tiredness (fatigue)
  • Constipation

 

Antimuscarinics (Anticholinergics)

Urinary urge incontinence has other options for medication treatment. A doctor may prescribe an antimuscarinic, also referred to as an anticholinergic. Antimuscarinics are typically used for people with overactive bladder syndrome, whether or not they have urinary incontinence. The antimuscarinic medicines that physicians prescribe as urinary incontinence medication are:

  • Oxybutynin
  • Tolterodine
  • Darifenacin

 

All three can be taken orally, but Oxybutynin does come in patch form as well. Your physician will assess your treatment after four weeks to see if there is any improvement. Follow-ups will be conducted every six to 12 months to ensure that the medicine remains effective.

Other anticholinergic medications are:

  • Solifenacin
  • Trospium
  • Fesoterodine

It may take up to several weeks before you notice that an anticholinergic medication improves your UI symptoms. The full effect of the drug can take some patients as long as 12 weeks.

 

Mirabegron

Mirabegron is another treatment option for urinary urge incontinence. A doctor may prescribe the medication if antimuscarinics are unsuitable, unhelpful, or lead to unpleasant side effects. After taking Mirabegron by tablet, the bladder muscle will relax and fill up to store urine. Side effects to monitor for are:

  • Urinary tract infections (UTIs)
  • An irregular heartbeat
  • Heart palpitations
  • Rashes
  • Itchy skin

 

Desmopressin

Your physician may also determine that your urinary incontinence is a case of nocturia. The medication Desmopressin is used to treat nocturia. Desmopressin reduces how much urine kidneys produce at night, which helps control the frequent urge to wake up and urinate.

You may also consider asking your doctor if a loop diuretic is right for you. You would take a loop diuretic in the afternoon to remove any excess fluid during the day and potentially help improve symptoms late at night. Keep in mind that a loop diuretic is unlicensed and a doctor should inform you of that before discussing how the benefits of the treatment outweigh any associated risks.

 

OnabotulinumtoxinA (Botox)

Your doctor may prescribe Botox injections if you have not responded to other medications. Botox paralyzes the bladder muscle and results can last for several months. UI patients are sometimes known to repeat injections once or twice per year. Speak with your doctor about possible side effects, such as urinary tract infections, from Botox.

 

Estrogen

A decrease in estrogen’s natural production can lead to the weakening of the supportive tissues around the bladder. It may also affect the tube enabling urine to pass from the body. A low-dose, topical estrogen may be prescribed by a healthcare provider to restore the tissues in the vagina and relieve symptoms in the urinary tract.

People who might be ineligible for topical estrogen treatment are individuals with a history of:

  • Breast cancer
  • Urine cancer
  • Or both cancers

 

Imipramine

Imipramine (Tofranil) relaxes the bladder muscle and treats mixed incontinence, otherwise understood as the combination of urge and stress incontinence. It may be used for people experiencing UI at night, because the medication can cause drowsiness.

A child who wets the bed is a better candidate for the medication than an older adult. Side effects of Imipramine can include:

  • Rare heart and blood vessel problems
  • Irregular heartbeat
  • Dizziness
  • Fainting from low blood pressure
  • Dry mouth
  • Blurry vision
  • Constipation

Speak with your healthcare provider about all of the medications that you are currently taking.

 

If you experience side effects with any medication, speak immediately to your physician. Do not suddenly stop taking your prescribed dose. Self-medicating can lead to negative side effects.

What is the outlook for someone taking urinary incontinence medication?

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The results of urinary incontinence medication differ for each individual. Medication can help restore normal function to the bladder. Your healthcare provider will need to review your case thoroughly before selecting a urinary incontinence medication that aligns with what you need.

Providers generally put patients on a low dose before they gradually increase it. The method is done in order to reduce the patient’s risk of side effects. Your physician can also keep track of how effectively a particular medication treats your incontinence.

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