Even after giving up on coffee and soda, and following the doctor’s suggestions for bladder retraining, if bladder control still remains a problem, then it’s time to turn to medication options. Read on for a list of medications for frequent urination.
Medications for Frequent Urination
Many medications are available to deal with bladder control problems like overactive bladder and urge incontinence. These bladder issues are characterized by sudden and intense urinary urges, and urine leakage. Comparatively, fewer medication options exist for treating stress incontinence, i.e. urine leakage caused due to movement or activity like sneezing, coughing, or heavy lifting. However, it should be remembered that the medications for frequent urination or for better bladder control prove more effective when combined with behavioral treatment, rather than being used alone.
Some commonly prescribed medications for frequent urination and its possible side effects are:
Anticholinergic drugs limit the action of the chemical messenger called acetylcholine that transmits signals to the brain, which triggers abnormal bladder contractions linked with overactive bladder.(1) These bladder contractions can make the individual feel the need to urinate even when their bladder is not full. Anticholinergic drugs are the commonest medications used for treating frequent urination.
Some common anticholinergic medications are: oxybutynin, tolterodine, solifenacin, darifenacin, trospium and fesoterodine.(1) These medications are usually available in pill or tablet form that can be taken orally. Oxybutynin is available as a cream or skin patch too.(1) It can take many weeks for the symptoms to start improving with this type of medication, and these drugs take around 12 weeks to have their full effect.
Constipation and dry mouth are the most common side effects of anticholinergics.(2) In comparison to the immediate-release form of this medication, which needs to be taken multiple times a day; and its extended-release version has to be consumed only once a day and causes fewer side effects. The problem of dry mouth can be eased by sucking hard candy or chewing gum for increasing the production of saliva. Other less common side effects of this group of medications for frequent urination are blurry vision, heartburn, rapid heartbeat, urinary retention, flushed skin and cognitive side effects like confusion and impaired memory.(3) Oxybutynin skin patch can at times cause skin irritation. In such cases, the doctor can suggest the patients to rotate the location of their patch.
Mirabegron is used to treat certain kinds of urinary incontinence and are commonly used medications for frequent urination.(4) Mirabegron can relax the bladder muscle and increase the urine retention capacity of the bladder.(4) Mirabegron can even increase the amount of urine passed at a time, and thus help in emptying the bladder completely. Some common side effects of mirabegron include: constipation, nausea, dizziness, diarrhea, increased blood pressure and headache.(5) This drug also interacts with various medications, so one should inform their doctor about the medications that they are taking, before starting with mirabegron.
Onabotulinum Toxin type A (Botox)
Botox injection into the bladder muscle can help people with overactive bladder.(6) Botox stops the action of acetylcholine and paralyzes the bladder muscle.(7) Botox can also benefit people who have failed to respond to other medications. The benefits of Botox can last for several months and the doctor can recommend repeat injections once or twice every year. Studies have found that Botox greatly improves the symptoms of incontinence and causes very few side effects. However, at times the use of Botox can lead to increased urinary tract infections, respiratory arrest and even cause fatality. But as these medications for frequent urination are taken after medical consultation, their advice should be followed.
A woman’s body produces less amount of estrogen after menopause.(8) This reduction in estrogen can lead to weakening of the supportive tissues around the urethra and bladder, and aggravation of stress incontinence.(9) By applying a low-dose of topical estrogen in the form of a vaginal cream, a patch or an estrogen-containing ring, women can rejuvenate the deteriorating tissues in their vagina and urinary tract and also relieve certain incontinence symptoms. Estrogen too is included in the list of medications for frequent urination; especially in women. However, use of topical estrogen may not be advisable for women with a history of uterine cancer, breast cancer; or both.(10)
Combination hormone replacement therapy is different from topical estrogen and is not used to treat urinary incontinence any longer. Even oral estrogen replacement is not same as topical estrogen and can worsen incontinence symptoms. Topical estrogen therapy typically does not cause side effects if used correctly.
Imipramine (Tofranil) is a tricyclic antidepressant, which helps in relaxing the bladder muscle, while contracting the smooth muscles at the bladder neck.(11) Imipramine can be used to treat mixed incontinence, i.e. a combination of stress and urge incontinence. This type of drug too is one of the common medications for frequent urination. Imipramine can cause drowsiness, and so is mostly taken at night for relieving nighttime incontinence. Imipramine can also be given to children who bed-wet at night. But imipramine usually does not suit elderly adults and hence should be avoided by them. Some adverse effects of Imipramine include: irregular heartbeat, dizziness or fainting due to drop in blood pressure on standing up quickly.(12) Children and elders are more susceptible to these ill effects. Other side effects of Imipramine are: dry mouth, constipation and blurry vision. However, serious side effects rarely happen from imipramine. Tricyclic antidepressants react with various medications and so one should ensure that their doctor knows about all the other medications, which they are taking before starting with imipramine.
Duloxetine is basically a serotonin and norepinephrine reuptake inhibitor, which can be used to treat depression and anxiety.(13) Duloxetine can help to relax the urethral sphincter and improve urinary incontinence in women suffering from weak bladder problems and depression.(13) Hence, duloxetine is also included in the list of medications for frequent urination. Dry mouth, nausea, dizziness, constipation, fatigue and insomnia are some common ill effects of duloxetine. Women with chronic liver disease should not take duloxetine.(14)
One should consult a doctor to carefully review all the medications, which they are taking, including over-the-counter drugs or herbal remedies. Some medications tend to worsen bladder control problems. Others can interact with medications for frequent urination and end up increasing the urinary symptoms. The doctor can guide upon the need to take medications for frequent urination for a particular person and prescribe the most suitable medicine accordingly.
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