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Oxybutynin chloride XL

Class
Anticholinergics
Subclass
Muscarinic receptor antagonists
Substance name
Oxybutynin chloride XL
Brand names
Ditropan XL®
Common formulations
Tablet
See also
Oxybutynin chloride (Gelnique®, Oxytrol®)
Dosage and administration
Adults patients
Overactive bladder
•
Maintenance: 5-10 mg PO daily
•
Maximum: 30 mg per day
Taken at approximately the same time every day. Consider titrating in 5 mg increments at approximately weekly intervals to response and tolerance.
Vasomotor symptoms with menopause • Off-label
•
15 mg PO daily
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 overactive 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
Gastroparesis or severely decreased gastrointestinal motility
Uncontrolled angle-closure glaucoma
Urinary retention
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 muscle weakness
•
Use caution in patients with myasthenia gravis.
Exacerbation of Parkinson's disease
•
Use caution in patients with Parkinson's disease.
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%
•
Dry mouth
Common 1-10%
•
Gastroesophageal reflux disease, peripheral edema, abdominal pain, change in taste, arthralgia, asthenia, back pain, throat pain, blurred vision, chest pain, dry nose, confusion, constipation, cough, depression, hypertension, diarrhea, dizziness, dry eyes, dyspepsia, dysuria, fatigue, flank pain, flatulence, headache, insomnia, itching, vomiting, nausea, nervousness, palpitations, skin flushing, somnolence, urinary retention, rhinitis, skin dryness, skin erythema, urinary tract infections, sinusitis, upper respiratory tract infections, xerophthalmia
Uncommon < 1%
•
Loss of appetite, hot flashes, dysphagia, change in voice
Unknown frequency
•
Agitation, anaphylaxis, angioedema, cardiac arrhythmias, delirium, ↑ intraocular pressure, ↑QT interval, eye pain, nightmares, hallucinations, memory impairment, seizure
Interactions
Drug(s)
Check Interactions
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