Drugs Q & A

What Drugs Can Cause Urinary Retention?

What is urinary retention?

Urinary retention is a condition where your bladder doesn’t empty all the way or at all when you urinate. Your bladder is like a storage tank for urine. Urine is made up of waste that’s filtered out of your blood by your kidneys. Once filtered, the urine moves to your bladder where it waits till it’s time to move through the urethra and out of the body.

When a urinary retention occurs as a result of the use or administration of a drug or medication, it is known as drug induced urinary retention. Urinary retention has been linked with the use of drugs with anticholinergic activity (e.g. antipsychotic drugs, antidepressant agents and anticholinergic respiratory agents), opioids and anaesthetics, alpha-adrenoceptor agonists, benzodiazepines, NSAIDs, detrusor relaxants and calcium channel antagonists.

When you have urinary retention, it can be acute (sudden) or chronic (long-term). Acute means that it comes on quickly and it could be severe. Chronic urinary retention means that you’ve had the condition for a longer period of time.

The acute form of urinary retention is an emergency. In this case, you’ll need to see a healthcare provider right away. The chronic form happens most of the time in older men, but it can also occur in women.

What Drugs Can Cause Urinary Retention?

Research has linked the following class of medications to urinary retention, they include:

Antipsychotic drugs: Antipsychotic medications are used as a short or long-term treatment for bipolar disorder to control psychotic symptoms such as hallucinations, delusions, or mania symptoms. Examples include:

  • aripiprazole (Abilify)
  • asenapine (Saphris)
  • cariprazine (Vraylar)
  • clozapine (Clozaril)
  • lurasidone (Latuda)
  • olanzapine (Zyprexa)
  • quetiapine (Seroquel)
  • risperidone (Risperdal)

Antidepressant Drugs:  Antidepressants are a type of medicine used to treat clinical depression. They can also be used to treat a number of other conditions, including: obsessive compulsive disorder (OCD) generalised anxiety disorder. Examples include:

  • amitriptyline (Elavil)
  • amoxapine.
  • clomipramine (Anafranil)
  • desipramine (Norpramin)
  • doxepin (Sinequan)
  • imipramine (Tofranil)
  • maprotiline.
  • nortriptyline (Pamelor)

Anticholinergic bronchodilators: Anticholinergic bronchodilators (or muscarinic receptor antagonists) block the parasympathetic nerve reflexes that cause the airways to constrict, so allow the air passages to remain open. Muscarinic receptor antagonists bind to muscarinic receptors and inhibit acetylcholine mediated bronchospasm. Examples include:

  • Aclidinium (Tudorza Pressair)
  • Glycopyrronium (Seebri Neohaler)
  • Ipratropium (Atrovent)
  • Tiotropium (Spiriva)
  • Umeclidinium (Incruse Ellipta)

Opioids: Opioids are a broad group of pain-relieving drugs that work by interacting with opioid receptors in your cells. Opioids can be made from the poppy plant. When opioid medications travel through your blood and attach to opioid receptors in your brain cells, the cells release signals that muffle your perception of pain and boost your feelings of pleasure. Examples include:

  • Codeine
  • Fentanyl (Actiq, Abstral, Duragesic, Fentora)
  • Hydrocodone (Hysingla, Zohydro ER)
  • Hydrocodone/acetaminophen (Lorcet, Lortab, Norco, Vicodin)
  • Hydromorphone (Dilaudid, Exalgo)
  • Meperidine (Demerol)
  • Methadone (Dolophine, Methadose)
  • Morphine (Kadian, MS Contin, Morphabond)

Alpha-adrenoceptor agonists: Alpha-adrenergic agonists are a class of sympathomimetic agents that selectively stimulate alpha adrenergic receptors. They have been used for decades to treat common medical conditions such as hypertension; attention-deficit/hyperactivity disorder; various pain and panic disorders; symptoms of opioid, benzodiazepine, and alcohol withdrawal; and cigarette craving. Examples include:

Benzodiazepines: Benzodiazepines are a class of drugs that can treat a range of conditions. Doctors often prescribe them to treat anxiety, seizures, and insomnia. The short-term use of these medications is usually safe and effective, but long-term use can lead to tolerance, dependence, and other adverse effects. Examples include:

NSAIDs: Non-steroidal anti-inflammatory drugs (NSAIDs) are medicines that are widely used to relieve pain, reduce inflammation, and bring down a high temperature. They’re often used to relieve symptoms of headaches, painful periods, sprains and strains, colds and flu, arthritis, and other causes of long-term pain. Calcium channel antagonists: Calcium channel blockers, calcium channel antagonists or calcium antagonists are a group of medications that disrupt the movement of calcium through calcium channels. Calcium channel blockers are used as antihypertensive drugs, i.e., as medications to decrease blood pressure in patients. Examples include:

  • Ibuprofen.
  • Naproxen.
  • Diclofenac.
  • Celecoxib.
  • Mefenamic acid.
  • Etoricoxib.
  • Indomethacin.
  • High-dose aspirin (low-dose aspirin is not normally considered to be an NSAID)

Calcium channel antagonists: Calcium channel blockers, calcium channel antagonists or calcium antagonists are a group of medications that disrupt the movement of calcium through calcium channels. Calcium channel blockers are used as antihypertensive drugs, i.e., as medications to decrease blood pressure in patients. Examples include:

  • Amlodipine (Norvasc)
  • Diltiazem (Cardizem, Tiazac, others)
  • Felodipine.
  • Isradipine.
  • Nicardipine.
  • Nifedipine (Adalat CC, Procardia)
  • Nisoldipine (Sular)
  • Verapamil (Calan, Verelan)
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