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Oxybutynin information from DrugsUpdate  

See Available Brands of Oxybutynin in India

P - Caution when used during pregnancy
L - Caution when used during lactation

Oxybutynin is an anticholinergic medication used to relieve urinary and bladder difficulties, including frequent urination and inability to control urination (urge incontinence), by decreasing muscle spasms of the bladder. It competitively antagonizes the M1, M2, and M3 subtypes of the muscarinic acetylcholine receptor. It also has direct spasmolytic effects on bladder smooth muscle as a calcium antagonist and local anesthetic, but at concentrations far above those used clinically. It is available orally in generic formulation and as the brand-names Ditropan and Lyrinel XL, as a transdermal patch under the brand name Oxytrol, and as a topical gel under the brand name Gelnique. Also Ditrospam by Avenzor Syria.

Oxybutynin is also a possible treatment of hyperhidrosis, or hyper-active sweating.

Pharmacodynamics

Pharmacokinetics

Oxybutynin exerts direct antispasmodic effect on the smooth muscle by inhibiting the muscarinic action of acetylcholine. It exhibits moderate anticholinergic effect, but has potent antispasmodic effects on urinary smooth muscle.

Absorption

Peak plasma concentrations after 1 hr.

Distribution
Crosses the blood-brain barrier; enters breast milk.

Metabolism

Hepatic: Undergoes first-pass metabolism.

Excretion

Excreted in urine and faeces as metabolites. Elimination half life 2-3 hours.

Oxybutynin Indications / Oxybutynin Uses

Information Not Available

Oxybutynin Adverse Reactions / Oxybutynin Side Effects

Dry mouth, constipation, nausea, abdominal pain; blurred vision; headache, dizziness, drowsiness; dry skin, rash; photosensitivity, diarrhoea, insomnia, palpitation, weakness, dry eyes, confusion, hypertension, UTI, dyspepsia.

Precautions

Oxybutynin chloride should be used with caution in the frail elderly, in patients with hepatic or renal impairment, and in patients with myasthenia gravis.

Oxybutynin chloride may aggravate the symptoms of hyperthyroidism, coronary heart disease, congestive heart failure, cardiac arrhythmias, hiatal hernia, tachycardia, hypertension, myasthenia gravis, and prostatic hypertrophy.

Overdosage
Anticholinergic effects including CNS excitation (e.g. restlessness, tremor, irritability, convulsions, delirium, hallucinations), flushing, fever, dehydration, cardiac arrhythmia, vomiting, and urinary retention may occur after overdose. Treatment should be symptomatic and supportive. Activated charcoal may be administered.

Special Precautions

Elderly; hepatic or renal impairment; neuropathy; hyperthyroidism; prostatic hyperplasia; hiatus hernia; cardiac disease, reflux oesophagitis, ulcerative colitis, myasthenia gravis; pregnancy and lactation. High environmental temperature might cause heat prostration (fever with heat stroke due to decreased sweating).

Other Drug Interactions

Co-administration with other anticholinergic drugs may cause undesirable increased anticholinergic effects. Additive sedation with CNS depressants and alcohol. Concentration may be increased by CYP3A4 inhibitirs (e.g. imidazole antifungals, macrolide antibiotics).

Other Interactions

Information Not Available

Dosage

Oral
Overactive bladder
Adult: 2.5-5 mg bid-tid. May be increased to max 5 mg 4 times daily if necessary. As extended-release preparation: Initially, 5 mg once daily increased by 5 mg every weeks if necessary to max 30 mg daily.
Child: >7 years for nocturnal enuresis: 2.5-3 mg bid increased if necessary to 5 mg bid-tid. Last dose should be given before bedtime. As extended-release preparation: 5 mg once daily, increased by 5 mg weekly if necessary to max 20 mg daily.
Elderly: Initially, 2.5-3 mg bid increased to 5 mg bid if necessary.

Oral
Neurogenic bladder disorders
Child: >5 years: 2.5 or 3 mg bid increased to 5 mg bid according to response. Max 5 mg tid.

Transdermal

Overactive bladder
Adult: 1 transdermal system (delivering 3.9 mg per day) applied to dry, intact skin on the abdomen, hip, or buttock twice weekly.

Food(before/after)

May be taken with or without food

List of Contraindications

Oxybutynin and Pregnancy

Caution when used during pregnancy

Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).

Oxybutynin and Lactation

Caution when used during lactation

Oxybutynin and Children

The safety and efficacy of Oxybutynin chloride administration have been demonstrated for pediatric patients 5 years of age and older.

Oxybutynin and Geriatic

Dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

Oxybutynin and Other Contraindications

GI obstruction or atrophy, severe toxic megacolon, significant bladder outflow obstruction, glaucoma, urinary retention.

Storage

Oral
Store at 15-30°C (59-86°F).

Transdermal
Store at 15-30°C (59-86°F).

Lab interference

Oral
Store at 15-30°C (59-86°F).

Transdermal
Store at 15-30°C (59-86°F).

Oxybutynin brands in India:

Cystran Ildamen Nocturin Oxyspas Tropan

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