Medications for Overactive Bladder

Often a doctor will recommend several drugs in combination with behavioral approaches, such as Kegel exercises and bladder training, to treat overactive bladder. 

Medications aren't prescribed for everyone with OAB, but for some they can mean a return to normal activities. Your doctor may prescribe one or more of the following drugs:

  • Anticholinergics (also known as antispasmodics or bladder relaxants). These medications affect nerve activity and relieve OAB symptoms by relaxing bladder muscles and preventing spasms. Anticholinergics are available as pills, liquids and skin patches.
  • Female hormones (for women). There is conflicting research on the benefits of hormone replacement therapy (HRT) for overactive bladder. It is possible that HRT might have the desirable side effect of helping bladder symptoms. But some research has found that it can actually increase incontinence, which is associated with "wet" OAB. Because long-term systemic use of HRT may increase risk of heart attack, stroke and breast cancer, a doctor might recommend a vaginal estrogen cream for this purpose.
  • Alpha blockers and/or 5-alpha reductase inhibitors (for men). A common cause of overactive bladder in men is prostate enlargement or benign prostatic hyperplasia (BPH). Alpha blockers relax the smooth muscles of the prostate gland and the bladder's neck. The 5-alpha reductase inhibitors work by shrinking the prostate. Both may help relieve OAB symptoms.

Researchers are examining whether injections of Botox (Botulinum toxin type A) can treat conditions, including overactive bladder and prostate enlargement. There have been some encouraging results. This treatment is still experimental and not approved by the U.S. Food and Drug Administration, however. 

Tricyclic antidepressants are another unapproved drug treatment that is now being studied. They appear to work by tightening muscles in the urethra and relaxing muscles in the bladder.

As with other medications, drugs for overactive bladder have various side effects, such as dry mouth or blurred vision. Also note that certain drugs taken for other conditions may aggravate OAB. Some of the drugs listed here to treat OAB also have been known to cause bladder problems as a side effect. Ask about the risks and benefits of medications when discussing options with your doctor.

Reviewed by: David O. Sussman, D.O., FACOS

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