Anticholinergics for urinary incontinence in spinal cord injuries


Generic Name Brand Name
fesoterodine Toviaz
oxybutynin Ditropan, Ditropan XL [extended-release], Oxytrol [once-weekly skin patch]
solifenacin VESIcare
tolterodine Detrol, Detrol LA [extended-release]
trospium chloride Sanctura

How It Works

Anticholinergic medications prevent spasms of the bladder muscle, which keeps it from emptying involuntarily and helps control urinary incontinence.

Why It Is Used

Anticholinergics can be used to treat reflex incontinence after a spinal cord injury.

How Well It Works

Research reports that using anticholinergics results in fewer spasms of the bladder muscle and thus fewer accidents. The bladder may also be able to hold more urine.1

Side Effects

Side effects are common and include:

  • Dry mouth, nose, and throat.
  • Dizziness, drowsiness, and confusion.
  • Decreased sweating and skin rash.
  • Nausea and constipation.
  • Eye pain.
  • Rapid heartbeat.

Extended-release formulas and the Oxytrol skin patch may have fewer side effects than anticholinergic medications that are taken several times a day.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Some of these medications may cause you to sweat less. In hot weather, this could lead to heat exhaustion. Ask your health professional whether you should be careful about being physically active in hot conditions.

Avoid alcoholic beverages while taking anticholinergic medications, because they can increase the depressive effects of alcohol.

Anticholinergic medications may cause your eyes to become more sensitive to light. If this occurs, wear sunglasses to reduce eye discomfort.

If you have the eye disease glaucoma, talk with an eye doctor before you start taking anticholinergics. People who have glaucoma may need to be watched more closely while they are taking these medicines.

If you develop diarrhea while taking an anticholinergic medication, stop taking it, and call your doctor. You may need to be checked for partial intestinal blockage.

These medications may cause urinary retention.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.



  1. Benevento BT, Sipski ML (2002). Neurogenic bladder, neurogenic bowel, and sexual dysfunction in people with spinal cord injury. Physical Therapy, 82(6): 601–612.

Last Updated: February 18, 2009

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