Safety in Lactation: Drugs for urinary frequency, enuresis, and incontinence

Laura Kearney, Regional Principal Medicines Information Pharmacist, Midlands and East Medicines Advice Service (Midlands site) & UK Drugs in Lactation Advisory ServicePublished

This group of drugs have varied mechanisms of action in treating urinary control conditions. Indications are broadly similar for all drugs, although there are small differences which can limit their interchangeability. The majority are indicated for urinary frequency, urgency and urge incontinence, for which oxybutynin is preferred due to its short elimination half-life.
Duloxetine is specifically indicated for stress incontinence in women.
There is a small risk that suppression of milk production could occur with those drugs with an anticholinergic action, although there is no published evidence to support this. It is therefore advisable to monitor breastfed infants for signs of decreased lactation, e.g. poor weight gain, if used long-term.