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What is oxybutynin, and how does it work (mechanism of action)?
Oxybutynin is an oral drug that is used for treating urinary bladder spasm. 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 bladder's muscle cells. Oxybutynin suppresses involuntary contractions of the bladder's smooth muscle (spasms) by blocking the release of acetylcholine. This is referred to as an "anticholinergic effect." Oxybutynin also directly relaxes the bladder's outer layer of muscle (the detrusor muscle). The FDA approved oxybutynin in July 1975.
What brand names are available for oxybutynin?
Ditropan (discontinued brand in the US); Ditropan XL; Oxytrol; Anturol; Gelnique
Do I need a prescription for oxybutynin?
What are the side effects of oxybutynin?
The most common side effects of oxybutynin are dry mouth, constipation, tiredness, and headache. About 1 in every 14 patients taking oxybutynin tablets cannot tolerate it because of side effects. Diarrhea, urinary tract infections, blurred vision, and difficulty urinating also may occur. The transdermal patch or gel may also cause local reactions at the application sites such as itching and rash. Transdermal patches or gel cause fewer side effects than the tablets. Serious hypersensitivity reactions involving swelling of the throat, lips, and tongue also may occur.
What is the dosage for oxybutynin?
- The usual dose of immediate-release oxybutynin is 5 mg 2 to 3 times daily. Elderly patients sometimes start with a lower dose of 2.5 mg.
- The recommended dose using extended-release tablets is 5 to 10 mg once daily not to exceed 30 mg 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 patch is applied twice weekly (every 3 to 4 days). 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.
- One sachet of the 10% gel or three pumps of the 3% gel should be applied to intact skin of the abdomen, upper arm, shoulder or thighs. Application sites should be rotated. Patients should wash hands immediately after applying the gel in order to avoid transferring oxybutynin to other parts of the body or other individuals.
Which drugs or supplements interact with oxybutynin?
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 which include 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, including diphenhydramine (Benadryl), dimenhydrinate (Dramamine), scopolamine (Trans-Scop), benztropine (Cogentin), disopyramide (Norpace), thioridazine (Mellaril), and amitriptyline (Elavil, Endep).
Oxybutynin may delay passage of potassium tablets through the digestive system and result in ulceration or narrowing of the small intestine.
Is oxybutynin safe to take if I'm pregnant or breastfeeding?
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.
It is not known if oxybutynin is excreted in human milk.
What else should I know about oxybutynin?
What preparations of oxybutynin are available?
Tablets (immediate release): 5 mg; Tablets (extended release): 5, 10, and 15 mg; Transdermal delivery system or patch: 3.9 mg/day; Syrup: 5 mg/5 ml. Transdermal Gel: 3% or 10%.
How should I keep oxybutynin stored?
Oxybutynin should be stored at room temperature, 15 C to 30 C (59 F to 86 F). It should be kept out of the reach of children.
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Daily Health News
Oxybutynin (Ditropan XL, Oxytrol, Anturol, Gelnique) is a drug prescribed for symptoms of overactive bladder, frequent urination, and hyperactivity associated with neurological conditions like spina bifida. Side effects, dosing, drug interactions, and pregnancy safety should be reviewed prior to taking this medication.
Related Disease Conditions
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.
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 Incontinence in Children
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.
Overactive Bladder (OAB)
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.
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.
Spina Bifida (Anencephaly, Neural Tube Defects) in Babies and Adults
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 spanina bifida the person suffers.
Nerve Disease and Bladder Control
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.
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