Oxybutynin

Reviewed on 8/27/2021

Brand Name: Ditropan XL

Generic Name: Oxybutynin

Drug Class: Antispasmodic Agents, Urinary

What Is Oxybutynin and How Does It Work?

Oxybutynin is indicated for the relief of symptoms of bladder instability associated with voiding in patients with uninhibited neurogenic or reflex neurogenic bladder (i.e., urgency, frequency, urinary leakage, urge incontinence, dysuria).

Oxybutynin is available under the following different brand names: Ditropan XL.

Dosages of Oxybutynin

Dosage Forms and Strengths

Tablets

Tablets, extended release

  • 5 mg
  • 10 mg
  • 15 mg

Syrup

  • 5 mg/5mL

Dosage Considerations – Should be Given as Follows:

Overactive Bladder

Adults

  • Relief of symptoms (e.g., urge incontinence, frequency, urgency) in patients with uninhibited neurogenic or reflex neurogenic bladder
  • Immediate-release: 5 mg orally twice/three times daily; not to exceed 5 mg orally four times daily
  • Extended-release: 5-10 mg/day orally; may be increased by 5 mg/day at weekly intervals; not to exceed 30 mg/day

Geriatric

  • Immediate-release: Initiate at lower dosage in frail elderly; 2.5 mg orally every 8-12 hours initially; may be increased to 5 mg every 8-12 hours if warranted
  • Extended-release: 5-10 mg orally once/day; pharmacokinetics similar to adults in elderly up to age 78 years

Detrusor Overactivity

Pediatric

  • Bladder overactivity associated with a neurologic condition (e.g., spina bifida)
  • Children 5 years and older (immediate-release): 5 mg orally every 12 hours; may be increased to 5 mg orally every 8 hours
  • Children 6 years and older (extended-release): 5 mg/day orally initially; may be increased by 5 mg/day at weekly intervals; not to exceed 20 mg/day

Dose Modifications

Renal Impairment

  • Not studied; use caution

Hepatic Impairment

  • Not studied; use caution

SLIDESHOW

Urinary Incontinence in Women: Types, Causes, and Treatments for Bladder Control See Slideshow

What Are Side Effects Associated with Using Oxybutynin?

Common side effects of oxybutynin include:

Less common side effects of oxybutynin include:

  • Loss of appetite
  • Fluid retention
  • Hot flush
  • Difficulty speaking
  • Difficulty swallowing
  • Frequent bowel movements
  • Chest discomfort
  • Thirst

Other side effects of oxybutynin include:

  • Inability to focus the eye
  • Impairment of mental alertness
  • Memory impairment
  • Dilated pupils
  • Fast heart rate
  • QT prolongation

Postmarketing side effects of oxybutynin reported include:

This is not a complete list of side effects and other serious side effects may occur. Call your doctor for information and medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What Other Drugs Interact with Oxybutynin?

If your doctor has directed you to use this medication for your condition, your doctor or pharmacist may already be aware of any possible drug interactions or side effects and may be monitoring you for them. Do not start, stop, or change the dosage of this medicine or any medicine before getting further information from your doctor, healthcare provider or pharmacist first.

  • Oxybutynin has no known severe interactions with other drugs.
  • Moderate Interactions of oxybutynin include:
    • potassium chloride
    • pramlintide
    • Oxybutynin has moderate interactions with at least 127 different drugs.
  • Oxybutynin has mild interactions with at least 94 different drugs.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

What Are Warnings and Precautions for Oxybutynin?

Warnings

This medication contains oxybutynin. Do not take Ditropan XL if you are allergic to oxybutynin or any ingredients contained in this drug.

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

Effects of Drug Abuse

  • None

Short-Term Effects

  • See "What Are Side Effects Associated with Using Oxybutynin?"

Long-Term Effects

  • See "What Are Side Effects Associated with Using Oxybutynin?"

Cautions

  • Caution in controlled angle-closure glaucoma; mild-to-moderate ulcerative colitis, hyperthyroidism; partial obstructive uropathy; benign prostatic hyperplasia.
  • Caution in hepatic or renal impairment.
  • May increase risk of heat prostration during hot weather.
  • May cause memory loss.
  • Angioedema necessitating hospitalization and emergency medical treatment has occurred with first or subsequent doses of oral oxybutynin; if angioedema develops, oxybutynin-containing products should be discontinued and appropriate therapy promptly provided.
  • Caution with gastrointestinal obstructive disorders or decreased intestinal motility because of the risk of gastric retention.
  • May aggravate symptoms of decreased gastrointestinal motility in patients with autonomic neuropathy.
  • Caution with GERD and/or those taking drugs that can cause or exacerbate esophagitis (e.g., bisphosphonates).
  • Caution with myasthenia gravis because of decreased cholinergic activity.
  • Caution with other anticholinergics (antimuscarinics); may increase risk for xerostomia, constipation, headache, dizziness, and blurred vision.
  • Somnolence reported with oxybutynin-containing products; use caution with activities requiring mental alertness.
  • May aggravate Parkinson disease symptoms.
  • Hallucinations or confusion may occur; monitor.
  • May exacerbate symptoms of heart failure, hypertension, and/or cardiac arrhythmias; use with caution.
  • May aggravate symptoms of dementia in patients cholinesterase inhibitors; use with caution.
  • Use with caution in patients with hiatal hernia.
  • The use of the extended release formulation has been associated (rare) with symptoms of obstruction in patients with known stricture/narrowing of the GI tract.
  • Before using over the counter product, consider other causes of frequent urination, including early pregnancy, diabetes, and other serious conditions; contact healthcare provider if symptoms do not improve with 2 weeks of initial use.

Pregnancy and Lactation

  • Oxybutynin may be acceptable for use during pregnancy. Either animal studies show no risk but human studies are not available, or animal studies showed minor risks and human studies were done and showed no risk.
  • It is unknown if oxybutynin passes into breast milk; use with caution if breastfeeding.
  • Oxybutynin is considered safe for use while breastfeeding.
References
Medscape. Oxybutynin.
https://reference.medscape.com/drug/ditropan-xl-oxybutynin-343066
DailyMed. Oxybutynin Chloride.
https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=98526d8f-9f39-d138-1cf9-fa5335bf2ba5

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