Anticholinergic medications for urinary incontinence in women

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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.

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

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 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.)

These medications 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 medications for urinary incontinence, talk to your health professional about the following:

• Can your incontinence be treated with behavioral or exercise therapy before trying medications? 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 health professional have in treating incontinence? Some health professionals do not realize the impact that urinary incontinence can have on a person's life and may disregard your concerns.
• Could any of the medications you are taking for another condition be causing your incontinence? Some medications 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.

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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.