Oxybutynin
Urinary Incontinence Products · Anticholinergic
Indications
Urinary incontinence, urgency and frequency due to idiopathic detrusor instability or neurogenic bladder disorders. Nocturnal enuresis in children.
Dosage
Adults: 10-15 mg daily in two or three doses; max 20 mg daily in divided doses. Elderly: Initially 3 mg twice daily. Titrate according to response. Children: Under 5 yr, not recommended. Urinary frequency, urgency and incontinence, neurogenic bladder instability: 5-12 yr, 2.5-3 mg twice daily, increased to 5 mg 2-3 times daily; 12-18 yr, 5 mg 2-3 times daily, increased if necessary to max 5 mg 4 times daily. Nocturnal enuresis associated with overactive bladder: 5-18 yr, 2.5-3 mg twice daily increased to 5 mg 2-3 times daily (last dose before bedtime).
Adverse Effects
Facial flushing, dry mouth, GI upset, blurred vision, dry eye, urinary retention, dysuria, UTI, palpitations, skin reactions, anorexia, confusion, dizziness, headache, insomnia, somnolence, oropharyngeal pain, cough, nasal dryness, fatigue, dysgeusia. Reports of agitation and hallucinations.
Risk Factor (Pregnancy/Lactation)
Pregnancy: No evidence of risk in humans. Lactation: Contraindicated or not recommended. Contraindications: GI obstruction including paralytic ileus, intestinal atony, toxic megacolon. Severe ulcerative colitis. Myasthaenia gravis, glaucoma. Shallow anterior chamber, bladder outflow obstruction or urinary retention. Precautions: Autonomic neuropathy. Hepatic or renal disease. Hyperthyroidism, coronary artery disease, congestive cardiac failure, cardiac arrhythmias, tachycardia, prostatic hypertrophy, hiatus hernia, Parkinson's disease, cognitive disorders, GI motility disorders, GI obstruction, ulcerative colitis. Risk of narrow angle glaucoma. High environmental temperature ( risk of heat prostration). Elderly.
Interactions
Phenothiazines, amantadine, butyrophenones, levodopa, digoxin, tricyclic antidepressants, other anticholinergics, antipsychotics, TCADs, antihistamines, CYP3A4 inhibitors, anticholinesterases, bisphosphonates, alcohol, dipyridamole, prokinetic drugs.
Advice to Patient
Take with or without meals. Preferably taken on an empty stomach, 1 hour before or 2 hours after meals. If there are GI adverse effects, take with food or milk. Do not chew or crush tablets, swallow whole. Contact prescriber if there is difficulty in urination, fast heartbeat, chest pain, palpitations or changes in vision. Avoid alcohol during therapy. Avoid exercising and other activities in hot weather to prevent heatstroke.
Pharmacokinetics
Onset of action: Oral: Immediate release: 30-60 mins. Peak effect: Immediate release: 3-6 hrs; Extended release: 3 days. Duration: Oral: Immediate release: 6-10 hrs; Extended release: Up to 24 hrs; Transdermal: 96 hrs. Absorption: Oral: Rapid and well absorbed; Transdermal: High. Metabolism: Hepatic. Oral: High first-pass metabolism. Bioavailability: Oral: Immediate release: 6%. Half-life elimination: IV: Approx. 2 hrs (parent drug), 7-8 hrs (metabolites); Oral: Immediate release: Approx. 2-3 hrs; Extended release: Approx. 13 hrs; Transdermal: 64 hrs. Time to peak, serum: Oral: Immediate release: Approx. 60 mins. Extended release: 4-6 hrs; Transdermal: 24-48 hrs. Excretion: Urine.
Unlicensed Use
Children: Urinary frequency, urgency and incontinence, neurogenic bladder instability: 2-5 yr, 1.25-2.5 mg 2-3 times daily.
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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