Medications, including anticholinergics and drugs that relax your bladder, may help treat an overactive bladder.
Having an overactive bladder (OAB) can be uncomfortable and even painful. OAB is a set of symptoms that cause incontinence or a loss of bladder control. Symptoms include:
- frequent and sudden urges to urinate
- an inability to regulate urination
- the need to urinate more than once overnight
- urine leakage
These symptoms may interfere with your daily life. There’s no cure for OAB, but there are effective ways to manage it.
This article focuses on medications, but other options are available, including behavioral treatments, lifestyle strategies, and (sometimes) surgery.
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These drugs work by blocking a chemical in your body called acetylcholine, which usually sends a message to your bladder to contract. By blocking this chemical, these drugs reduce the contractions that cause you to release urine.
Anticholinergics are available under different brand names. Some are also available as generic drugs. These medications include:
- oxybutynin (Ditropan XL, Oxytrol)
- tolterodine (Detrol, Detrol LA)
- trospium (Sanctura)
- darifenacin (Enablex)
- solifenacin (Vesicare)
- fesoterodine (Toviaz)
All these drugs come as tablets or capsules you take by mouth, except for Oxytrol, which is available as a skin patch.
The most common side effects of anticholinergic drugs include:
Mirabegron (Myrbetriq) and vibegron (Gemtesa) work by relaxing the smooth muscles in the walls of your bladder, helping your bladder hold more urine.
These medications are available as a tablet you take by mouth once daily. This class of drugs can interact with various other medications, so it is important to tell your doctor about all medications you’re taking before starting either one.
The most common side effect of mirabegron is high blood pressure. Side effects of vibegron include nausea, headache, diarrhea, and symptoms similar to those of a common cold.
If other OAB drugs don’t work for you or you can’t take other OAB medications, your doctor may prescribe antidepressants.
These drugs treat depression but may help relieve some OAB symptoms in off-label use. (“Off-label” means that a doctor is prescribing a medication for something other than its specific approved use.) Your doctor may prescribe an antidepressant such as:
- desipramine (Norpramin)
- duloxetine (Cymbalta)
- imipramine (Tofranil)
Side effects of antidepressants used to treat OAB can include:
- drowsiness
- fatigue
- anxiety
- decreased sex drive
Some people may experience OAB due to weak support tissues around their bladder and urethra. If this is the cause of your OAB, your doctor may recommend topical estrogen.
Estrogen is a hormone that strengthens the muscles around your bladder, vagina, and urethra. After menopause, your body starts to make less estrogen. Applying topical estrogen is especially effective in reducing OAB symptoms in postmenopausal people.
Topical estrogens for OAB include estradiol cream (Estrace) and conjugated estrogen cream (Premarin). All estrogens raise your risk of some cancers, stroke, and heart attack.
Botox, which is well known for smoothing out wrinkles, may also be used in OAB treatment. Like anticholinergic drugs, this drug works by blocking acetylcholine. It also paralyzes the muscle of the bladder.
Doctors typically recommend Botox for OAB treatment only when lifestyle adjustments and medications have not worked.
Botox comes with severe risks, including potential bladder paralysis.
If your doctor can’t find a cause for your OAB, don’t worry. Medications can still help ease your symptoms.
Some of these drugs work by relaxing your bladder. They stop involuntary contractions that bring on the urge to urinate. Other medications help strengthen the tissues around your bladder that may have become weak. The stronger tissue can help improve your bladder control.
OAB can happen for several reasons. Sometimes treating the underlying cause of your OAB can help your symptoms. For instance, neurological disorders such as Parkinson’s disease and multiple sclerosis can cause your bladder to contract more often than it should.
Enlarged prostate glands, bladder stones, and cancerous growths may also cause OAB symptoms by placing pressure on your bladder.
If your doctor can find the cause of your OAB, they can recommend targeted treatment for the cause. This should, in turn, relieve your OAB symptoms. However, it’s not always possible to pinpoint the exact cause of OAB. In these cases, other medications are available.
A range of medications, including anticholinergic drugs, some antidepressants, and hormone therapies, can help manage symptoms of an overactive bladder (OAB).
The specifics of your treatment plan will vary, depending on the severity of your symptoms and the underlying cause of your OAB. It is important to work closely with your doctor to find the most effective plan for your needs.