Bedwetting Medicines

You’re ready to start the Time to be Dry program! Do you continue the medications or stop them?  It depends on the medication.

The ultimate goal is to get kids dry and OFF of medications. The three most common bedwetting medicines are ditropan (oxybutynin), desmopressin (DDAVP) and Imipramine (tofranil). If your child is on a different medication speak with your provider on your next steps.

Talk with your provider about stopping the following medications as you work through the Time to be Dry program.

Ditropan (Oxybutynin)

Ditropan is a medication that is commonly used for overactive bladder.  This is often given to children who have daytime wetting, urgency, and frequency.  This medication can be used with the Time to be Dry program or you can stop it.  It does not need to be weaned. I would consider working on the Optimizing your Bladder portion of the program while still on Ditropan. I like to use hydration and timed voiding with Ditropan to help relax the bladder for a month or two.  Then, I would then start Alarm Therapy and after 14 dry nights without the alarm sounding, stop Ditropan and continue the alarm for 14 more dry nights. Speak with your provider before stopping the medication.

Desmopressin (DDAVP)

Desmopressin is the most commonly prescribed bedwetting medicine but it only works in 30% of kids. It helps concentrate the urine overnight so your child has less urine to hold.  It has to be taken very specifically.  If your child goes to bed at 8 pm. They have to STOP drinking at 6 pm.  They take desmopressin with a sip of water at 7 pm and then pee and go to sleep at 8 pm. Nothing more to drink after taking the medicine.  If your child is wetting every night despite desmopressin, I would have them stop it completely.  It only works the night they take it and it doesn’t cure the problem. 

If they are dry on desmopressin or rarely wetting, I recommend continuing desmopressin until they start the Alarm Therapy.  Then I have them wean by 0.5 to 1 tablet a week while concurrently using the alarm.  The goal with Alarm Therapy is to have them wet while using the alarm.  If they are dry every night on desmopressin, they won’t be giving the brain the opportunity to recognize the signals of their bladder while they are sleeping. Once they are off of desmopressin I encourage my patients to continue the alarm for 2 more weeks with waking up dry without it alarming.  That’s considered cured!

Imipramine (Tofranil)

Imipramine is a tricyclic antidepressant.  It can be used to help with bedwetting.  This medication should NOT be stopped cold turkey.  It needs to be weaned.  If you are ready to stop using this medication, speak with your provider about how to decrease this medication correctly.  You can start the Time to be Dry program while concurrently weaning this medication.