Drugs that Contribute to Urinary Incontinence

Urinary incontinence is often the result of medicines being taken for other health issues. These medicines may cause incontinence or worsen existing incontinence. If you suspect you are experiencing incontinence or worsening incontinence it is very important to consult your physician to determine next steps. Never stop taking medicine without consulting your doctor.

When considering medication induced incontinence be sure to think of both prescription medicines and any over-the-counter medicines you may be taking. 

Here are some common drugs that may worsen or cause urinary incontinence:

High Blood Pressure Medicines

These drugs include alpha-adrenergic antagonists or alpha-blockers including Cardura, Minipress, Hytrin, doxazosin mesylate, prazosin hydrochloride and terazosin hydrochloride. These drugs work by dilating blood vessels to reduce blood pressure. In doing this they may also relax the bladder along with the blood vessels. 

They are some times prescribed to men to help with urinary problems such as enlarged prostate, benign prostatic hyperplasia (BPH). Alpha-blockers help relax the muscles in the bladder neck which allows urine to flow more easily and improving symptoms of BPH.

These drugs may lead to stress incontinence, which is leakage that occurs during strain such as sneezing, laughing, coughing, or physical exercise.

Antidepressant Drugs 

Antidepressant drugs may worsen incontinence in some people. These drugs include Nopramin, Cogentin, Haldol, Risperdal, Elavin, Prolixin (fluphenazine), Hadol (haloperidol), nortripramine, amitriptyline, desipramine, benztropine, halperidol, and risperidone.

These drugs can impair the ability of the bladder to contract resulting in an inability to empty (or void) the bladder completely. This may lead to overflow incontinence. Some antidepressant drugs may decrease your awareness of the need to go to the bathroom until it is too late to get to the toilet.

Diuretics

Diuretics are also known as water pills. They work in the kidneys to reduce blood pressure by flushing excess water and salt out of the body. Essentially, they cause the body to produce more urine. This translates to more trips to the toilet and possible worsening of incontinence. 

These drugs include any medicine prescribed as a diuretic including Bumex, Lasix (Furosemide), Aldactone, bumetanide, Hyrdodiuril (Hydrochlorothiazide HCTZ), Maxzide (HCTZ - triameterene), spironolactone, furosemide, theophyline and hydrochlorothalizide (and other “thalazides” which are common medications for hypertension).

Sleeping Pills 

Sleeping pills may create a problem for those with incontinence at night because the user don’t or can’t wake up when their bladder is full. These drugs include any sedative or sleeping aid that relaxes muscles and make you sleeping including Ativan (lorazepam), Valium (diazepam), Lunesta, Ambien, Librium (chlordiazepoxide), diazepam, flurazepam, lorazepam, eszopiclone and zolpidem. 

These drugs slow reflexes which may result in not recognizing the signal that it is time to go. They may put you in such a deep sleep that you miss the body alert to get up and use the toilet. Bed wetting effects approximately 10% of people with incontinence. 

Hormone Therapy Drugs

Hormone therapy including oral estrogen-only or combination estrogen and progesterone pills may cause or worsen urinary incontinence. At one time it was thought that these medicines helped incontinence symptoms, but they are now known to trigger or worsen both stress and urge incontinence. 

Decongestants and Antihistamines

These drugs may contain pseudoephederine which may tighten the urinary sphincter causing urinary retention. These drugs include Sudafed, Contac, Benadryl pseudoephedrine, and diphenhydramine.

For women this is frequently followed by sudden overflow incontinence. However, men who have leakage after prostate surgery may be using these drugs to temporarily clamp down on the bladder muscles to help prevent bladder leakage. 

Narcotics and Painkillers

These drugs are opium based painkillers that may interfere with the bladder’s ability to contract fully. This can lead to urine retention and overflow incontinence. They may also cause constipation and studies show that constipation desensitizes the bladder and worsens urge incontinence. These drugs include any opium-based pain medicine including OxyContin, MS-Contin, Oramorph, Percocet, Demerol, codeine, morphine and oxycodone.

Understanding that these types of drugs may cause or worsen incontinence is a key to opening a dialog with your doctor. Under the doctors supervision changes to drugs, behavior or physical activity amy help improve your condition. Being prepared for this conversation will help the dialog be open and beneficial as it is often uncomfortable. Keep in mind the following when speaking with your doctor:

• How long ago/ when did the incontinence begin?
• Did you have incontinence before taking these medicines? Was there a change? 
• What drugs are you taking (prescription and over-the-counter) and when did you start taking them? 

Please realize that there are many drugs that may not have been included on this list that may cause or contribute to urinary incontinence. It is very important to speak with your doctor about all medications you take in order for them to identify best options for your optimal care.