Oxybutynin

Indications
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 wk if necessary to max 30 mg daily.
Child: >7 yr 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 wkly 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 yr: 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 wkly.
Contraindications
GI obstruction or atrophy, severe toxic megacolon, significant bladder outflow obstruction, glaucoma, urinary retention.
Warnings / 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).
Adverse Reactions
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.
Overdose Reactions
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.
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).
See Below for More oxybutynin Drug Interactions
Mechanism of Actions
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 hr.
Administration
May be taken with or without food.
Storage Conditions
Oral: Store at 15-30°C (59-86°F). Transdermal: Store at 15-30°C (59-86°F).
ATC Classification
G04BD04 - oxybutynin ; Belongs to the class of urinary antispasmodics.
Storage
Oral: Store at 15-30°C (59-86°F). Transdermal: Store at 15-30°C (59-86°F).
Available As
  • Oxybutynin 10 mg
  • Oxybutynin 2.5 mg
  • Oxybutynin 5 mg
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