oxybutynin


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oxybutynin

 [ok″se-bu´tĭ-nin]
an anticholinergic and antimuscarinic having direct antispasmodic effects on smooth muscle; used orally as the chloride salt in treatment of uninhibited neurogenic bladder and reflex neurogenic bladder.

oxybutynin

Cystrin (UK), Kentera (UK), Oxytrol

Pharmacologic class: Anticholinergic

Therapeutic class: Urinary tract antispasmodic

Pregnancy risk category B

Action

Inhibits acetylcholine action at postganglionic receptors, relaxing smooth muscle lining of GU tract and preventing bladder irritability

Availability

Syrup: 5 mg/5 ml

Tablets: 5 mg

Tablets (extended-release): 5 mg, 10 mg, 15 mg

Topical gel: 1 g in 1.14-ml sachet

Transdermal system (patch): 39 cm2/36 mg

Indications and dosages

Frequent urination, urinary urgency or incontinence, and nocturia caused by neurogenic bladder; overactive bladder

Adults: 5 mg P.O. two to three times daily (not to exceed 5 mg q.i.d.); or 5 to 15 mg P.O. once daily (extended-release); or one 3.9 mg/day transdermal system applied twice weekly; or apply contents of one gel sachet daily.

Children older than age 5: 5 mg P.O. b.i.d., to a maximum of 5 mg t.i.d.

Dosage adjustment

• Elderly patients

Contraindications

• Hypersensitivity to drug
• Glaucoma
• Intestinal obstruction, severe colitis, atony, paralytic ileus, megacolon, or hemorrhage
• Obstructive uropathy, urinary retention
• Myasthenia gravis
• Acute hemorrhage with shock

Precautions

Use cautiously in:
• cardiovascular disease, hyperthyroidism, GI disease
• elderly patients
• pregnant or breastfeeding patients
• children younger than age 5 (safety not established).

Administration

• Give oral forms without regard to food.
• Don't crush or break tablets.
• Apply contents of one gel sachet to dry, intact skin on the abdomen, upper arms, shoulders, or thighs.

Adverse reactions

CNS: dizziness, drowsiness, hallucinations, insomnia, weakness, anxiety, restlessness, headache

CV: palpitations, hypotension, tachycardia

EENT: blurred vision, cycloplegia, increased intraocular pressure, mydriasis, photophobia

GI: nausea, vomiting, diarrhea, constipation, bloating, dry mouth

GU: urinary hesitancy, urinary retention, erectile dysfunction, suppressed lactation

Metabolic: hyperthermia

Skin: decreased sweating, urticaria, application-site reactions

Other: allergic reactions, fever, hot flashes

Interactions

Drug-drug.Anticholinergics, anticholinergic-like drugs (including amantadine, antidepressants, disopyramide, haloperidol, phenothiazines): additive anticholinergic effects

Atenolol: increased atenolol absorption

CNS depressants (including antidepressants, antihistamines, opioids, sedative-hypnotics): additive CNS depression

Digoxin: increased digoxin blood level (with extended-release oxybutynin)

Haloperidol: decreased haloperidol blood level, tardive dyskinesia, worsening of schizophrenia

Levodopa: decreased levodopa efficacy

Nitrofurantoin: increased nitrofurantoin blood level, greater risk of toxicity

Drug-herbs.Angel's trumpet, jimsonweed, scopolia: increased anticholinergic effects

Drug-behaviors.Alcohol use: additive CNS depression

Patient monitoring

• Monitor vital signs and temperature. Watch for hypotension, fever, and tachycardia.
• Evaluate patient's vision.
• Assess results of cystometric studies. Stay alert for urinary retention.

Patient teaching

• Tell patient he may take with or without food. Caution him not to crush, break, or chew extended-release tablets.
• Instruct patient to apply transdermal patch to dry, intact skin on abdomen, hip, or buttock. Tell him to use a new skin area with each new system and not to reapply new patch to same site within 7 days. Caution him not to cut or puncture patch.
• Instruct patient to apply contents of one gel sachet daily to dry, intact skin on the abdomen, upper arms, shoulders, or thighs. Tell patient to use a new skin area daily. Advise patient to cover application site with clothing if skin-to-skin contact at application site is anticipated and to wash hands immediately after product application. Warn patient that gel is flammable and to avoid open fire or smoking until gel has dried.
• Tell patient to report blurred vision, fever, skin rash, nausea, or vomiting.
• Advise patient he'll need to undergo periodic bladder exams.
• Caution patient to avoid driving and other hazardous activities if drug causes drowsiness or blurred vision.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs, herbs, and behaviors mentioned above.

oxybutynin

/oxy·bu·ty·nin/ (-bu´tĭ-nin) an anticholinergic having direct antispasmodic effect on smooth muscle; used as the chloride salt in the treatment of uninhibited or reflex neurogenic bladder.

oxybutynin

(ŏk′sē-byo͞ot′n-ĭn)
n.
An anticholinergic drug, C22H31NO3, used to treat incontinence and other urinary symptoms.

oxybutynin

Ditropan® Urology A spasmolytic anticholinergic GI and GU tract colic used to ↓ urge incontinence, overactive bladder, bladder Sx associated with neurogenic bladder–eg, frequency, urgency, dysuria, urinary leakage Contraindications Urinary retention, gastric retention, narrow-angle glaucoma Adverse effects Dry mouth, constipation, somnolence, diarrhea, blurred vision, dry eyes, dizziness, rhinitis. See Urge incontinence.

oxybutynin

An anticholinergic antispasmodic drug used to treat urinary urgency, frequency and incontinence and bed-wetting in children. Brand names are Cystrin, Ditropan and Lyrinel XL.

oxybutynin

an anticholinergic having direct antispasmodic effect on smooth muscle; used in the treatment of uninhibited neurogenic bladder and reflex neurogenic bladder.
References in periodicals archive ?
Recently, the effects of darifenacin and oxybutynin on cognitive measures were compared in a head-to-head clinical trial.
A more meaningful comparison would have been between extended-release oxybutynin and long-acting tolerodine.
The immediate-release (IR) (Ditropan[R]) and extended-release (ER) (Ditropan XL[R]) formulations of oxybutynin are currently the only pharmacological agents approved for the treatment of OAB in children in North America.
market sales for Oxybutynin Chloride Extended-Release Tablets, USP, which is used in the treatment of overactive bladder, were approximately $156 million for the twelve months ended August 31, 2016.
Human health company ACETO (NasdaqGS:ACET) stated on Monday that it plans to introduce Oxybutynin Chloride Extended-Release Tablets, USP in the market .
Data also support the use of oral oxybutynin for hyperhidrosis, he noted.
Those who took at least 10 milligrams (mg) per day of the tricyclic antidepressant doxepin (Sinequan[R]), 4 mg per day of the antihistamine diphenhydramine (Benadryl[R]), or 5 mg per day of the anticholinergic drug oxybutynin (Ditropan[R]) for more than three years were found to be at greater risk for dementia.
26, 2015 in JAMA Internal Medicine, people who took high doses of tricyclic antidepressants such as doxepin (Sinequan), diphenhydramine (Benadryl), older antihistamines such as chlorpheniramine (Chlor-Trimeton), or antimuscarinic drugs for bladder control, such as oxybutynin (Ditropan) for longer than three years were significantly more likely to develop dementia.
The study, published in journal Jama Internal Medicine, showed people were at higher risk if they took at least 10mg a day of antidepressant doxepin, 4mg a day of diphenhydramine or 5mg a day of bladder control drug oxybutynin for more than three years.
The US study by the University of Washington, in journal Jama Internal Medicine, showed people were at higher risk of dementia if they took at least 4mg diphenhydramine, 10mg of antidepressant doxepin, or 5mg of bladder control drug oxybutynin every day for three years