Dr. Saltiel received his Pharm.D. from the University of California, San Francisco, in 1980, following undergraduate work at UCLA. At UCSF, he was the recipient of the Outstanding Service Award and the Bowl of Hygeia Award. He completed a residency in clinical pharmacy practice at the University of Illinois, in Chicago.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Oxybutynin is a drug for treating bladder spasms.
Oxybutynin has a dual mechanism of action. Contraction of the smooth muscle of the bladder is stimulated by the release of acetylcholine by the nerves within the bladder and the attachment of the acetylcholine to receptors on the surface of the muscle cells. Oxybutynin suppresses involuntary contractions of the bladder's smooth muscle (spasms) by blocking the release of acetylcholine. This is called an "anticholinergic effect." Oxybutynin also directly relaxes the bladder's outer layer of muscle (the detrusor muscle).
GENERIC: Yes (Immediate-release tablets only)
PRESCRIPTION: Yes
PREPARATIONS: Oxybutynin is available as 5 mg tablets. It is available in an extended release form as 5, 10, and 15 mg tablets and as a transdermal delivery system or patch (Oxytrol) providing 3.9 mg/day of oxybutynin. A liquid preparation also is available as oxybutynin chloride syrup, 5 mg/5 ml.
STORAGE: Oxybutynin should be stored at room temperature, 15-30°C (59-86°F). All medicines should be kept out of the reach of children.
PRESCRIBED FOR: Oxybutynin is used for adults with symptoms of overactive bladders that including sudden urges to urinate (urgency), urinary incontinence (the inability to control urination), and frequent urination. It also is used in children, aged 6 years and older, with symptoms of detrusor muscle hyperactivity associated with neurological conditions, such as spina bifida.
DOSING: The usual dose of immediate-release oxybutynin is 5 mg two to four times daily. Elderly patients sometimes start with a lower dose of 2.5 mg. The extended-release tablets are taken once daily. The oral forms can be taken with or without food. The extended release tablets must not be chewed, crushed, or broken. The tablet shell is not absorbed and is eliminated in the feces. The oxybutynin patch is applied twice weekly. The patch should be applied to dry, intact skin on the abdomen, hip, or buttock. A different application site should be used with each new patch, avoiding re-application to the same site within 7 days.
DRUG INTERACTIONS: The use of oxybutynin in patients who are receiving other drugs with anticholinergic effects will likely result in an increased frequency and/or severity of anticholinergic side effects. Such effects include dry mouth, constipation, confusion, blurred vision, urinary retention (the inability to urinate) and an increased heart rate or palpitations. There are many such drugs. A few include: diphenhydramine (Benadryl), dimenhydrinate (Dramamine), scopolamine (Trans-Scop), benztropine (Cogentin), disopyramide (Norpace), thioridazine (Mellaril), and amitriptyline (Elavil).
PREGNANCY: Studies of oxybutynin in pregnant rabbits, rats, and mice have not produced any evidence of harm in the fetus; however, since no controlled studies have been done in pregnant women, the potential benefit of this medicine needs to be weighed against any theoretical harm.
NURSING MOTHERS: It is not known if oxybutynin is excreted in human milk.
SIDE EFFECTS: The most common side effects of oxybutynin are dry mouth (3 out of every 5 or 60% of patients), constipation (1out of every 6 patients), tiredness (1 out of every 8 patients), and headache (1 out of every 10 patients). About 1 in every 14 patients taking oxybutynin cannot tolerate it because of side effects.
Overactive bladder is a sudden involuntary contraction of the muscle wall of the bladder causing urinary urgency (an immediate unstoppable need to urinate). Overactive bladder is is a form of urinary incontinence. Treatment options may include Kegel exercises, biofeedback, vaginal weight training, pelvic floor electrical stimulation, behavioral therapy, and medications.
There are many types of urinary incontinence (UI), which is the accidental leakage of urine. These types include stress incontinence, urge incontinence, and overflow incontinence. Urinary incontinence in men may be caused by prostate or nerve problems. Treatment depends upon the type and severity of the UI and the patient's lifestyle.
Urinary retention (inability to urinate) may be caused by nerve disease, spinal cord injury, prostate enlargement, infection, surgery, medication, bladder stone, constipation, cystocele, rectocele, or urethral stricture. Symptoms include discomfort and pain. Treatment depends upon the cause of urinary retention.
Spina bifida is the most common neural tube defect in the United States. There are four types of spina bifida; 1) occulta, 2) closed neural tube defects, 3) meningocele, and 4) myelomeningocele. The cause of spina bifida is not known. Theories include genetic, nutritional, and environmental factors. Lack of folic acid during pregnancy is highly suspected. Symptoms of spina bifida vary from individual to individual. Treatment depends on the type of spina bifida the person suffers.
People who have bladder spasms, the sensation occurs suddenly and often severely. A spasm itself is the sudden, involuntary squeezing of a muscle. A bladder spasm, or "detrusor contraction," occurs when the bladder muscle squeezes suddenly without warning, causing an urgent need to release urine. The spasm can force urine from the bladder, causing leakage. When this happens, the condition is called urge incontinence or overactive bladder.
Urinary incontinence in children (enuresis) is twice as common in boys as in girls and may occur during the daytime or nighttime. Nighttime urinary incontinence is also called bedwetting and sleepwetting. The cause of nighttime incontinence in children is unknown. Daytime incontinence in children may be caused by an overactive bladder. Though many children overcome urinary incontinence naturally, it may be necessary to treat incontinence with medications, bladder training and moisture alarms, which wake the child when he or she begins to urinate.
A nerve problem might affect your bladder control if the nerves that are supposed to carry messages between the brain and the bladder do not work properly. Such problems include urine retention, poor control of sphincter muscles, and overactive bladder. Treatment depends upon the cause of the nerve damage and resulting type of bladder control problem.
*Urinary incontinence (UI) in men facts Medically Edited by:
Melissa Conrad Stöppler, MD
The definition of urinary incontinence in men is the unintentional loss of urine. Weak bladder muscles, overactive bladder muscles, certain prostate conditions, and nerve damage are just some of the possible underlying causes of urinary incontinence in men.
There are different types of urinary incontinence in men, including stress incontinence, urge incontinence, and overflow incontinence.
Diagnosis of urinary incontinence in men may involve a physical exam, an ultrasound, urodynamic testing, and tests including an electroencephalogram (EEG) and an electromyogram (EMG). The doctor will also take a medical history and may recommend keeping a bladder diary.
Treatment of urinary incontinence in men may include behavioral treatments, like bladder training and Kegel exercises, medication, surgery, or...
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