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Oxybutynin chloride

Oral
Transdermal
Topical
Class
Anticholinergics
Subclass
Muscarinic receptor antagonists
Substance name
Oxybutynin chloride
Brand names
Gelnique®
Common formulations
Tablet
See also
Oxybutynin chloride XL (Ditropan XL®)
Dosage and administration
Adults patients
Neurogenic bladder
•
Maintenance: 5 mg PO BID-TID
•
Maximum: 20 mg per day
Consider starting at 2.5 mg BID-TID in frail elderly patients.
Vasomotor symptoms with menopause • Off-label
•
2.5-5 mg PO BID
Other off-label uses
•
Treatment of chronic urticaria (inducible)
•
Treatment of hyperhidrosis
•
Prevention and treatment of catheter-related bladder discomfort
Indications for use
Labeled indications
Adults
•
Treatment of neurogenic bladder
Children
•
Treatment of neurogenic bladder (in patients > 5 years)
Off-label indications
Adults
•
Treatment of chronic urticaria (inducible)
•
Treatment of hyperhidrosis
•
Treatment of vasomotor symptoms with menopause
•
Prevention and treatment of catheter-related bladder discomfort
Safety risks
Contraindications
Hypersensitivity to oxybutynin or its components
Known or risk of gastroparesis or other severe gastrointestinal motility disorders
Known or risk of urinary retention
Uncontrolled angle-closure glaucoma
Warnings and precautions
Anticholinergic syndrome
•
Maintain a high level of suspicion, as oxybutynin has been associated with anticholinergic CNS effects. Monitor for signs of anticholinergic CNS effects, including headache, dizziness, somnolence, confusion, and hallucinations, particularly after initiating treatment or dose uptitration. Consider reducing the dose or discontinuing the drug if anticholinergic CNS effects occur.
Decreased gastrointestinal motility
•
Use caution in patients with ulcerative colitis, intestinal atony, or autonomic neuropathy.
Esophagitis
•
Use caution in patients with GERD and/or taking drugs causing/exacerbating esophagitis, such as bisphosphonates.
Exacerbation of dementia
•
Use caution in patients with dementia receiving cholinesterase inhibitors.
Exacerbation of hyperthyroidism
•
Use caution in patients with hyperthyroidism.
Exacerbation of LUTS
•
Use caution in patients with BPH.
Exacerbation of muscle weakness
•
Use caution in patients with myasthenia gravis.
Exacerbation of Parkinson's disease
•
Use caution in patients with Parkinson's disease.
Exacerbation of tachycardia, hypertension, HF, cardiac arrhythmias
•
Use caution in patients with tachycardia, hypertension, coronary heart disease, congestive HF, or cardiac arrhythmias.
Gastroparesis
•
Use caution in patients with gastrointestinal obstructive disorders.
Urinary retention
•
Use caution in patients with clinically significant bladder outflow obstruction.
Specific populations
Renal impairment
CrCl 0-90 mL/min
•
No dose adjustment required. Use with caution.
Renal replacement therapy
Any modality
•
No dose adjustment required. Use with caution.
Hepatic impairment
Any severity
•
No dose adjustment required. Use with caution.
Pregnancy and breastfeeding
Pregnancy
All trimesters • Australia Category: B1
•
Use only if benefits outweigh potential risks.
Breastfeeding
Use with caution during breastfeeding.
Unknown amount excreted in breastmilk.
Unknown drug levels in breastfed infants.
Some adverse effects on lactation reported.
Adverse reactions
Very common > 10%
•
Constipation, dizziness, dry mouth, nausea, somnolence
Common 1-10%
•
Blurred vision, diarrhea, dyspepsia, headache, insomnia, nervousness, palpitations, peripheral edema, cardiac arrhythmias, skin flushing, itching, skin dryness, ↑ thirst, abdominal pain, belching, dysphagia, flatulence, change in taste, vomiting, arthralgia, flank pain, eye irritation, dry eyes, dysuria, bronchospasm, nasal congestion, cough, hoarseness, nasopharyngitis, dry nose, throat pain, fatigue, urinary hesitancy, urinary retention, urinary tract infections, upper respiratory tract infections
Uncommon < 1%
•
Gastroesophageal reflux disease
Unknown frequency
•
Anaphylaxis, ↑QT interval, seizure, ↑ intraocular pressure, memory impairment, delirium, agitation
Interactions
Drug(s)
Check Interactions
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