From the Guidelines
Xanax (alprazolam) can potentially cause urinary retention in some individuals, and it is essential to consult a healthcare provider if urinary changes are experienced while taking this medication. This medication, which belongs to the benzodiazepine class, may cause increased urination (diuresis) or, conversely, urinary retention in certain patients due to its effects on the central nervous system and smooth muscle relaxation 1. The effects of benzodiazepines like Xanax on the central nervous system can lead to changes in bladder function, and older adults may be particularly susceptible to these side effects.
Some potential urinary side effects of Xanax include:
- Increased urination (diuresis)
- Urinary retention
- Difficulty initiating urination
- Incomplete bladder emptying It is crucial to stay hydrated while taking Xanax, but avoid excessive fluid intake before bedtime if experiencing increased nighttime urination. If severe symptoms like painful urination or inability to urinate occur, seek medical attention promptly as these could indicate more serious complications requiring immediate intervention. According to a recent study on the management of non-neurogenic male lower urinary tract symptoms, the treatment of urinary symptoms should be individualized, and healthcare providers should consider the patient's overall health and medical history when making treatment decisions 1.
In terms of management, treatment options for urinary symptoms after prostate cancer surgery, which may be relevant to Xanax-induced urinary retention, include behavioral and pelvic floor physical therapy referral, anticholinergic medications, and urodynamic testing by a urologist 1. However, the primary concern with Xanax is its potential to cause urinary retention, and patients should be monitored closely for this side effect. Overall, it is essential to prioritize the patient's morbidity, mortality, and quality of life when managing Xanax-induced urinary retention, and healthcare providers should be vigilant in monitoring for potential urinary side effects.
From the FDA Drug Label
Alprazolam has a weak uricosuric effect Although other medications with weak uricosuric effect have been reported to cause acute renal failure, there have been no reported instances of acute renal failure attributable to therapy with alprazolam tablets The usual precautions in treating patients with impaired renal, hepatic or pulmonary function should be observed
The use of Xanax (alprazolam) may have a weak uricosuric effect. However, there have been no reported instances of acute renal failure attributable to therapy with alprazolam tablets.
- Patients with impaired renal function should be treated with caution.
- The FDA label does not provide information on the effect of Xanax on urination frequency or volume. 2
From the Research
Xanax and Urination
- Xanax, a type of benzodiazepine, has been associated with urinary incontinence in older adults, with a nearly 45% increased risk 3.
- The risk of urinary incontinence seems to be greater for exposure to oxidative benzodiazepines, such as Xanax, than to nonoxidative benzodiazepines 3.
- Benzodiazepines, including Xanax, can also cause urinary retention, especially in elderly patients, due to their anticholinergic activity 4.
- A systematic review found that antipsychotic and antidepressant medications, which can interact with benzodiazepines, are associated with urinary retention, although the incidence varies widely depending on the specific medication 5.
- Xanax has been shown to be effective in treating anxiety disorders, panic disorder, and depression, but its use can lead to dependence and withdrawal symptoms, including potentially life-threatening symptoms 6, 7.
- The metabolic pathway of benzodiazepines, such as Xanax, can affect their potential to cause urinary incontinence or retention, with oxidative benzodiazepines potentially being more harmful than nonoxidative agents 3.