Version July 2025
| Medicines and other agents | Effect on bladder function | |
| Allergy | ||
| Antihistamines | First-generation H1 receptor antagonists (eg, brompheniramine, chlorpheniramine, clemastine, cyproheptadine, dimenhydrinate, diphenhydramine, hydroxyzine, others) | Decreased contractility via anticholinergic effect |
| Decongestants | Pseudoephedrine, phenylephrine | Increased urethral sphincter tone |
| Analgesic and sedative | ||
| Benzodiazepines | Chlordiazepoxide, clonazepam, temazepam, triazolam, others | Impaired micturition via muscle relaxant effect |
| Opioids | Codeine, meperidine, morphine, oxycodone, others | Decreased sensation of fullness and increased urethral sphincter tone |
| Anticholinergic* | ||
| Antimuscarinics (overactive bladder medications) | Darifenacin, fesoterodine, oxybutynin, solifenacin, tolterodine, trospium | Decreased contractility via anticholinergic effect |
| Spasmolytic | Dicyclomine, hyoscyamine, glycopyrrolate, methscopolamine, propantheline, scopolamine (hyoscine) | Decreased contractility via anticholinergic effect |
| Anticholinergics (antiparkinson medications) | Benztropine, trihexyphenidyl | Decreased contractility via anticholinergic effect |
| Cardiology¶ | ||
| ACE inhibitors | Enalapril, lisinopril, ramipril, others | Decreased contractility; chronic coughing |
| Alpha agonists | Midodrine, phenylephrine, vasopressors (various) | Increased urethral sphincter tone |
| Alpha1 blockers | Alfuzosin, doxazosin, prazosin, silodosin, tamsulosin, terazosin | Decreased urethral sphincter tone |
| Antiarrhythmic | Disopyramide, flecainide | Decreased contractility via local anesthetic effect on bladder mucosa or anticholinergic effect |
| Diuretics | Various | Increased urine production, contractility, or rate of emptying |
| Psychotropic | ||
| Antidepressants | SNRIs: duloxetine, reboxetineΔ | Increased urethral sphincter tone |
| Tricyclic antidepressants (amitriptyline, clomipramine, desipramine, doxepin, imipramine, nortriptyline, others) | Decreased contractility via anticholinergic effect | |
| Antipsychotics | First generation (chlorpromazine, fluphenazine, methotrimeprazine); second generation (clozapine, olanzapine, risperidone); others have lower effect | Mixed effects described; decreased contractility via anticholinergic effect; increased micturition and stress incontinence via inhibition of alpha1 receptors and/or central dopaminergic receptors |
| Other | ||
| Skeletal muscle relaxants | Orphenadrine, tizanidine (also cyclobenzaprine, baclofen, and methocarbamol; but effect is lower) | Decreased contractility via anticholinergic effect |
| Estrogens | Oral estrogens (hormone replacement therapy) | Increased urinary incontinence |
| Beta3 agonist | Mirabegron | Decreased contractility via beta3 adrenergic effect |
| Alcohol | Decreased contractility | |
| Caffeine | Increased contractility or rate of emptying | |
ACE: angiotensin-converting enzyme; BPH: benign prostatic hyperplasia; SNRIs: serotonin-norepinephrine reuptake inhibitors.
* Inhaled antimuscarinic bronchodilators (eg, ipratropium, tiotropium) and ophthalmic drops (eg, atropine, cyclopentolate) can be absorbed systemically in varying degrees; urinary retention has been rarely associated with their use particularly among older adults, among men with BPH, and with administration of an inhaled anticholinergic drug by nebulizer.
¶ Increased micturition reported by ≤3% of patients in clinical studies of calcium channel blockers; mixed effects have been described.
Δ Not available in the United States.