Understanding Bladder Control Medications

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Alpha-adrenergic stimulators
This class of drugs includes midodrine (Pro-Amatine) and pseudoephedrine (Sudafed). (Alpha-adrenergic drugs mimic actions of the sympathetic nervous system, which controls various involuntary body functions.) Although not approved by the US Food and Drug Administration for use in bladder control problems, these drugs have been prescribed to treat stress incontinence.

* How alpha-adrenergic stimulators work: These drugs help the bladder to retain urine by constricting the sphincter muscle and relaxing the bladder wall. These actions reduce urine leakage due to abrupt increases in pressure on the bladder.
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* Who should not use these medications: Individuals with the following conditions should not use alpha-adrenergic stimulators:

o Allergy to alpha-adrenergic stimulators
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o Kidney disease
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o High blood pressure
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o Hyperactive thyroid
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* Use: Alpha-adrenergic stimulators are available as tablets and capsules. The amount and number of doses per day varies, depending on the particular drug.
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* Drug or food interactions: These drugs may counteract the effect of high blood pressure therapy. Do not use within 2 weeks of taking monoamine oxidase inhibitors (MAOIs) such as phenelzine (Nardil), pargyline (Eutonyl), nialamide (Espril, Niamid), moclobemide (Aurorix, Manerix), procarbazine (Matulane), or isocarboxazid (Enerzer, Marplan). Extreme increases in blood pressure have occurred when combined with MAOIs.
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* Side effects: Alpha-adrenergic stimulators may increase blood pressure, cause insomnia, and/or aggravate conditions such as diabetes, heart rhythm disturbances, heart disease, glaucoma, or enlarged prostate.

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