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Understanding Bladder Control Medications (cont.)

Cholinergic Drugs for Bladder Problems

This class of drugs includes bethanechol (Duvoid, Urecholine). Cholinergic refers to nerve cells or fibers that use a certain type of chemical to send signals within the body. Cholinergic drugs are used when the bladder is not emptied completely following urination. This problem is known as residual urine in the bladder.

  • How cholinergic drugs work: These drugs contract the bladder, thus allowing complete emptying.
  • Who should not use these medications: Individuals with the following conditions should not use cholinergic drugs:
  • Use: Cholinergic drugs are taken by mouth and on an empty stomach (that is, one hour before eating or two hours after).
  • Drug or food interactions: Cholinergic drugs may increase effects of other drugs that also have cholinergic effects, such as tacrine (Cognex), donepezil (Aricept), galanthamine (Reminyl), and rivastigmine (Exelon or Exelon Patch). Anticholinergic drugs (such as those listed above) will likely reduce the effect of cholinergic drugs.
  • Side effects: Cholinergic drugs may cause vomiting, diarrhea, watery eyes, headache, dizziness, irregular heartbeat, wheezing, and/or breathing problems. Contact a doctor if these occur.

Beta Agonists for Bladder Problems

This class of medication, mirabegron (Myrbetriq), works by relaxing the bladder muscle during the storage phase, thus increasing the capacity of bladder to hold more urine. They can be used for the treatment of overactive bladder (OAB). Mirabegron (Myrbetriq) is the first drug in this category.

  • How beta-agonist drugs work: They work by relaxing the bladder muscles and reducing bladder overactivity.
  • Who should not use this medication: Individuals with the following conditions should not use mirabegron or a similar class of drugs:
  • Side effects of mirabegron include: elevation of blood pressure, urinary retention (inability to fully empty the bladder), dry mouth, inflammation of nasal passages, and constipation
  • Use: Mirabegron can be taken orally with or without food. It should be taken whole without crushing or chewing.
  • Drug or food interactions: Patients should inform their doctor if they are taking any other medications for leaky bladder. Certain medications actions and side effects can be enhanced if combined with mirabegron. For example, chlorpromazine, desipramine, digoxin, encainide, flecainide, metoprolol, nortriptyline, pimozide, propafenone, tetrabenazine, or thioridazine may have an increased risk of their side effects when combined with mirabegron.

Other Bladder Control Medications

If symptoms of urinary incontinence are thought to be caused by an enlarged prostate, different medications can be offered to reduce these symptoms. The prostate gland wraps around the urethra (the urinary outlet from the bladder), and if it is enlarged, it could squeeze the urinary passage tight, making the emptying of bladder more difficult and incomplete.

In brief, the following categories are available for the treatment of urinary symptoms caused by an enlarged prostate (prostatic hypertrophy):

Botox Injection for Bladder Problems

Botox (onabotulinumtoxinA) injection has recently been approved by the Food and Drug Administration (FDA) for the treatment of overactive bladder (OAB) for patients who have failed to respond to standard therapy with anticholinergic medications.

Overactive bladder is a type of urinary incontinence caused by overactivity of the muscles in the bladder, causing frequent squeezing of the bladder and, thus, frequent urge to urinate. Botox can be injected into the bladder directly through a cystoscope (catheter with a camera going into the bladder via the urethra).

Common side effects of Botox injection may include incomplete emptying, urinary tract infection, and painful urination.

Medically reviewed by Michael Wolff, MD; American Board of Urology

REFERENCE:

United States. Food and Drug Administration. "FDA Approves Botox to Treat Overactive Bladder." Jan. 18, 2013. <http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm336101.htm>.


Medically Reviewed by a Doctor on 11/16/2016
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