Drugs for Overactive Bladder

In people with overactive bladder, muscles in the bladder wall contract at the wrong time. A group of drugs called anticholinergics combat this problem by blocking the nerve signals related to bladder muscle contractions. Research suggests that these drugs also might increase bladder capacity and decrease the urge to go.

Anticholinergic drugs include:

Darifenacin (Enablex)

Fesoterodine (Toviaz)

Oxybutynin (Ditropan, Ditropan XL, Oxytrol, Gelnique)

Solifenacin (Vesicare)

Tolterodine (Detrol, Detrol LA)

Trospium (Sanctura)

Oxytrol for women is the only drug available over the counter. Overall, these drugs work about the same in treating overactive bladder, and generally people tolerate all of them well. The main side effect is dry mouth, but anticholinergics also can cause constipation, blurred vision, and increased heartbeat.

Anticholinergics aren’t right for everyone. Some people with glaucoma, urinary retention, or gastrointestinal disease should avoid using anticholinergic drugs.

The drug mirabegron (Myrbetriq) is the first in a class of drugs called beta-3 adrenergic agonists. These medications work by activating a protein receptor in bladder muscles that relaxes them and helps the bladder fill and store urine.

Another type of drug for overactive bladder is the tricyclic antidepressant imipramine hydrochloride (Tofranil), which also relaxes bladder muscles.

Botox, more commonly known for removing wrinkles, can be injected into the bladder muscle causing it to relax. This can increase capacity in the bladder and lessen contractions. Botox is only recommended for people who can’t control symptoms with behavioral therapies or oral medications.

Studies have found that the lack of estrogen that occurs after menopause can affect urination, and some women are treated for OAB with estrogen. However, there isn’t strong evidence to show that estrogen is an effective treatment for OAB. Sometimes overactive bladder treatment for men includes a type of blood pressure medication called alpha-blockers, but again, the research on these drugs isn’t conclusive.