Anticholinergic medications for urinary incontinence in women

Examples

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Brand Name	Generic Name
Enablex	darifenacin

Brand Name	Generic Name
Toviaz	fesoterodine

Brand Name	Generic Name
Oxytrol [once-weekly skin patch]	oxybutynin

Brand Name	Generic Name
VESIcare	solifenacin

Brand Name	Generic Name
Detrol LA [extended-release]	tolterodine

Brand Name	Generic Name
Sanctura XR	trospium chloride

How It Works

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Anticholinergic medications block nerves that control bladder muscle contractions and allow for relaxation of the bladder smooth muscle. These actions work together to help control urinary incontinence.

Why It Is Used

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Anticholinergic medications are used to treat urge incontinence, also called overactive bladder.

How Well It Works

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A recent study showed an 85% reduction in urge incontinence using anticholinergic medication and behavioral techniques, compared with 72% and 57% reduction after using only anticholinergic medications or behavioral techniques. In other words, using anticholinergic medication and behavioral techniques together reduces urge incontinence better than either treatment used alone.¹

Side Effects

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Side effects are common and include:

• Dry mouth, nose, and throat.
• Dizziness, drowsiness, and confusion.
• Decreased sweating and skin rash.
• Nausea and constipation.
• Eye pain.
• Rapid heartbeat.

Extended-release formulas and the Oxytrol skin patch may have fewer side effects than anticholinergic medications that are taken several times a day.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

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If you have the eye disease glaucoma, it is important for you to talk with your ophthalmologist before you start taking anticholinergics. People who have glaucoma may need to be watched more closely while they are taking anticholinergic medicines.

These medicines may reduce the amount you sweat, which in hot weather could lead to heat exhaustion. Be careful about being physically active in hot conditions.

Avoid alcoholic beverages while taking anticholinergic medications, because they can increase the depressive effects of alcohol. Anticholinergic medications may cause drowsiness or blurred vision that could interfere with your ability to drive or to operate machinery. They may cause your eyes to become more sensitive to light. If this occurs, wear sunglasses to reduce eye discomfort. If you develop diarrhea while taking an anticholinergic medication, stop taking it and call your doctor. You may need to be checked for partial intestinal blockage.

Before taking medicines for urinary incontinence, talk to your doctor about the following:

• Can your incontinence be treated with behavioral or exercise therapy before trying medicines? Behavioral or exercise therapy, such as bladder training or pelvic floor (Kegel) exercises, is noninvasive, can be done at home, is inexpensive, has no side effects, and does not limit future therapy options if it is not successful.
• How much experience does your doctor have in treating incontinence? Some doctors do not realize the impact that urinary incontinence can have on a person's life and may disregard your concerns.
• Could any of the medicines you are taking for another condition be causing your incontinence? Some medicines cause the body to produce greater amounts of urine, which may contribute to incontinence problems. Take water pills or diuretics when you will easily be able to get to a restroom.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

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Citations

1. Sutherland SE, Goldman HB (2004). Treatment options for female urinary incontinence. Medical Clinics of North America, 88(2): 345–366.

Credits

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Author	Sandy Jocoy, RN
Editor	Kathleen M. Ariss, MS
Associate Editor	Pat Truman, MATC
Primary Medical Reviewer	E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer	Avery L. Seifert, MD - Urology
Last Updated	September 17, 2008