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Oxybutynin: Pediatric drug information

Oxybutynin: Pediatric drug information
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For additional information see "Oxybutynin: Drug information" and "Oxybutynin: Patient drug information"

For abbreviations, symbols, and age group definitions show table
Brand Names: US
  • Ditropan XL [DSC];
  • Gelnique [DSC];
  • Oxytrol;
  • Oxytrol For Women [OTC]
Brand Names: Canada
  • APO-Oxybutynin;
  • Ditropan XL [DSC];
  • Oxytrol [DSC];
  • PMS-Oxybutynin;
  • RIVA-Oxybutynin;
  • TEVA-Oxybutynin
Therapeutic Category
  • Antispasmodic Agent, Urinary
Dosing: Pediatric
Hyperhidrosis, primary focal

Hyperhidrosis, primary focal: Limited data available: Children ≥4 years and Adolescents: Immediate release: Oral: Initial: 2.5 mg once daily; increase by 2.5 mg/dose at 1- to 2-week intervals based on patient response and tolerability; usual effective dose range: 5 to 10 mg/day in 1 to 2 divided doses. Maximum reported daily dose: 15 mg/day (Ref).

Neurogenic/overactive bladder

Neurogenic/overactive bladder:

Oral:

Immediate release:

Weight-directed dosing:

Infants, Children, and Adolescents: Limited data available: Oral: 0.1 to 0.6 mg/kg/day in 2 to 4 divided doses; most commonly divided in 3 doses; maximum dose: 5 mg/dose (Ref).

Fixed dosing:

Children >5 years and Adolescents: Oral: Initial: 5 mg twice daily; increase as necessary up to 5 mg 3 times daily; adult maximum dose: 5 mg 4 times daily (Ref).

Extended release:

Children ≥6 years and Adolescents: Oral: Initial: 5 mg once daily; adjust dose as needed in 5 mg increments at weekly intervals; maximum daily dose: 20 mg/day (Ref).

Intravesical: Limited data available:

Infants, Children, and Adolescents: Intravesical: 0.1 to 0.9 mg/kg/day in 2 to 3 divided doses (higher daily doses are usually administered in 3 divided doses); maximum dose: 5 mg/dose (Ref).

Transdermal: Limited data available:

Children ≥4 years and Adolescents: Transdermal: Apply one 3.9 mg/day patch twice weekly (every 3 to 4 days); dosing based on 2 small pediatric studies (Ref).

Nocturnal enuresis

Nocturnal enuresis: Limited data available: Children ≥6 years and Adolescents: Immediate release: Oral: Initial: 5 mg once daily at bedtime; may increase dose by 2.5 mg/dose at 2-week intervals based on patient response to a maximum of 10 mg once daily. Use in combination with desmopressin (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Pediatric

Altered kidney function: Mild to severe impairment: Infants, Children, and Adolescents: Oral, Transdermal: There are no dosage adjustments provided in the manufacturer's labeling (has not been studied). Dosage adjustment is likely unnecessary, as <0.1% is eliminated unchanged in the urine; however, use with caution due to limited data in patients with altered kidney function (Ref).

Hemodialysis, intermittent: Unlikely to be dialyzed (highly protein bound).

Peritoneal dialysis: Unlikely to be dialyzed (highly protein bound).

Dosing: Liver Impairment: Pediatric

Oral, Transdermal: There are no dosage adjustments provided in the manufacturer’s labeling (has not been studied); use with caution.

Dosing: Adult

(For additional information see "Oxybutynin: Drug information")

Hyperhidrosis, primary focal

Hyperhidrosis, primary focal (alternative agent) (off-label use): Oral:

Extended release: 5 to 10 mg once daily (Ref).

Immediate release: Initial: 2.5 mg once daily; gradually titrate as needed and tolerated; usual effective dose range: 5 to 10 mg/day in 2 divided doses (Ref).

Overactive bladder

Overactive bladder (urinary urgency with or without incontinence) (alternative agent): Note: Consider use after inadequate response to or in conjunction with nonpharmacologic measures (Ref). Use of other antimuscarinic agents may be preferred to minimize adverse effects (eg, cognitive deficits) (Ref). Full benefit may not be observed until after several weeks of treatment; trial for ≥4 to 12 weeks before considering other options (Ref). Antimuscarinic agents are not recommended in patients with stress type incontinence (Ref).

Oral:

Note: ER formulations are preferred due to improved tolerability (Ref).

Extended release: Initial: 5 to 10 mg once daily; adjust dose as needed based on response and tolerability in 5 mg increments every 1 to ≥2 weeks (Ref); maximum dose: 30 mg once daily.

Immediate release: 5 mg 2 to 3 times daily; adjust dose as needed based on response and tolerability in 5 mg increments approximately every 2 weeks (Ref); maximum dose: 5 mg 4 times daily.

Topical gel: Apply contents of 1 sachet (100 mg/g) once daily.

Transdermal: Apply one 3.9 mg/day patch twice weekly (every 3 to 4 days); change the patch on the same 2 days each week.

OTC labeling (patient-guided therapy): Females: Apply one 3.9 mg/day patch every 4 days.

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.

Oral, topical, transdermal:

Altered kidney function: Mild to severe impairment: No dosage adjustment necessary (<0.1% of drug and its active metabolite eliminated in urine) (Ref); however, use with caution due to limited data in patients with altered kidney function (Ref).

Hemodialysis, intermittent (thrice weekly): Unlikely to be dialyzed (highly protein bound): No supplemental dose or dosage adjustment necessary (Ref); use with caution.

Peritoneal dialysis: Unlikely to be dialyzed (highly protein bound): No dosage adjustment necessary (Ref); use with caution.

Dosing: Liver Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied); use with caution.

Adverse Reactions (Significant): Considerations
Anticholinergic effects

Anticholinergic agents, including oxybutynin, may cause reversible, dose-dependent antimuscarinic adverse effects, including, but not limited to, CNS effects (agitation, confusion, cognitive impairment, drowsiness, dizziness, hallucinations, headache), GU effects (eg, urinary retention), GI effects (eg, gastric retention, decreased gastrointestinal motility, constipation, xerostomia) ophthalmic effects (eg, blurred vision, mydriasis, xerophthalmia), cardiovascular effects (eg, tachycardia), and dermatologic effects (eg, hypohidrosis, xeroderma) in adult and pediatric patients (Ref). Exertional heat illness (risk factor anticholinergic-induced hypohidrosis) may occur, especially when patients exert themselves under high environmental temperatures/humidity. Xerostomia is the most frequent adverse reaction causing discontinuation of therapy.

When compared to other medications used for the treatment of overactive bladder (eg, anticholinergic agents, beta3 agonists), oxybutynin has been associated with a higher risk of affect/mood disorders, agitation, and balance/movement disorders (Ref).

Mechanism: Dose-related; an extension of antimuscarinic pharmacological properties.

Of note, an active metabolite, desethyloxybutynin, has pharmacological activity similar to that of oxybutynin; therefore, a route of administration which bypasses hepatic metabolism to desethyloxybutynin (eg, transdermal) may result in less antimuscarinic activity (Ref).

Onset: Varied; timing may be impacted by high doses, dose titration, or accumulation.

Risk factors:

• Conditions which may lead to accumulation (eg, older patients (Ref), patients with hepatic or renal impairment)

• Routes of administration that lead to higher serum concentrations (eg, immediate release oral formulations, intravesical administration) or higher concentrations of active metabolite (eg, oral formulations) (Ref).

• Preexisting decreased GI motility or GI obstructive disorders. In patients with ulcerative colitis, use may decrease gastric motility to the point of increasing the risk of paralytic ileus or toxic megacolon.

• Preexisting angle-closure glaucoma (use is contraindicated with uncontrolled narrow-angle glaucoma)

• Preexisting coronary artery disease, heart failure, hypertension, and/or cardiac arrhythmias

• Physical exertion in high ambient temperature and humidity may lead to exertional heat illness

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. As reported with oral administration, unless otherwise noted.

>10%:

Gastrointestinal: Constipation (oral: 9% to 15%; transdermal: 3%; topical gel: 1%) (table 1), nausea (5% to 12%), xerostomia (oral: 35% to 72%; topical gel, transdermal: 4% to 10%) (table 2)

Oxybutynin: Adverse Reaction: Constipation

Drug (Oxybutynin)

Placebo

Dose

Dosage Form

Number of Patients (Oxybutynin)

Number of Patients (Placebo)

3%

0%

Oxytrol (3.9 mg/day)

Transdermal

121

117

Oxybutynin: Adverse Reaction: Xerostomia

Drug (Oxybutynin)

Placebo

Dose

Dosage Form

Number of Patients (Oxybutynin)

Number of Patients (Placebo)

10%

8%

Oxytrol (3.9 mg/day)

Transdermal

125

132

8%

3%

Gelnique (1 g/day)

Gel

389

400

4%

2%

Oxytrol (3.9 mg/day)

Transdermal

121

117

Local: Application-site pruritus (transdermal: 14% to 17%; topical gel: 2%)

Nervous system: Dizziness (oral: 5% to 17%; topical gel: 3%) (table 3), drowsiness (6% to 14%)

Oxybutynin: Adverse Reaction: Dizziness

Drug (Oxybutynin)

Placebo

Dose

Dosage Form

Number of Patients (Oxybutynin)

Number of Patients (Placebo)

3%

1%

Gelnique (1 g/day)

Gel

389

400

1% to 10%:

Cardiovascular: Decreased blood pressure (1% to 5%), edema (1% to 5%), flushing (1% to 5%), increased blood pressure (1% to 5%), palpitations (1% to 5%), peripheral edema (1% to 5%), sinoatrial nodal rhythm disorder (1% to 5%)

Dermatologic: Macular eruption (transdermal: 3%; application site), pruritus (oral, topical gel: 1% to 2%), xeroderma (2% to 3%)

Endocrine & metabolic: Fluid retention (<5%), increased serum glucose (1% to 5%), increased thirst (≤5%)

Gastrointestinal: Abdominal pain (2%), coated tongue (1% to 5%), diarrhea (3% to 8%), dysgeusia (2%), dyspepsia (5% to 6%), eructation (1% to 5%), flatulence (1% to 3%), gastroesophageal reflux disease (≤1%), upper abdominal pain (1% to 5%), viral gastroenteritis (topical gel: 2%), vomiting (1% to 2%)

Genitourinary: Cystitis (1% to 5%), dysuria (oral, transdermal: 2%), increased post-void residual urine volume (2% to 4%), pollakiuria (1% to 5%), urinary hesitancy (2% to 9%), urinary retention (1% to 6%), urinary tract infection (oral, topical gel: 7%)

Infection: Fungal infection (1% to 5%)

Local: Application-site dermatitis (topical gel: 2%), application-site erythema (transdermal: 6% to 8%), application-site rash (transdermal: 3%), application-site reaction (topical gel: 5%), application-site vesicles (transdermal: 3%)

Nervous system: Asthenia (1% to 5%), confusion (1% to 5%), falling (1% to 5%), fatigue (oral, topical gel: 2% to 3%), headache (oral: 8%; topical gel: 2%), insomnia (3% to 6%), nervousness (7%), pain (1% to 5%)

Neuromuscular & skeletal: Arthralgia (1% to 5%), back pain (1% to 5%), limb pain (1% to 5%)

Ophthalmic: Blurred vision (4% to 10%), dry eye syndrome (3%), eye irritation (1% to 5%), visual disturbance (transdermal: 3%) (table 4)

Oxybutynin: Adverse Reaction: Visual disturbance

Drug (Oxybutynin)

Placebo

Dose

Dosage Form

Number of Patients (Oxybutynin)

Number of Patients (Placebo)

3%

0%

Oxytrol (3.9 mg/day)

Transdermal

121

117

Renal: Flank pain (1% to 5%)

Respiratory: Asthma (1% to 5%), bronchitis (1% to 5%), cough (2% to 3%), dry nose (2% to 5%), dry throat (2% to 3%), hoarseness (1% to 5%), nasal congestion (1% to 5%), nasopharyngitis (oral, topical gel: 1% to 5%), oropharyngeal pain (2%), paranasal sinus congestion (1% to 5%), pharyngolaryngeal pain (1% to 5%), sinus headache (1% to 5%), upper respiratory tract infection (oral, topical gel: 1% to 5%)

<1%:

Cardiovascular: Chest discomfort

Endocrine & metabolic: Hot flash

Gastrointestinal: Anorexia, dysphagia

Nervous system: Voice disorder

Postmarketing:

Cardiovascular: Cardiac arrhythmia (Ref), hypertension (Ref), prolonged QT interval on ECG (Ref), tachycardia

Dermatologic: Fixed drug eruption (lip) (Ref), hypohidrosis (Ref)

Endocrine & metabolic: Heatstroke (Ref)

Gastrointestinal: Decreased gastrointestinal motility (Ref)

Hepatic: Increased liver enzymes (Ref)

Hypersensitivity: Anaphylaxis, angioedema

Nervous system: Agitation (Ref), balance impairment (Ref), delirium (Ref), delusion (Ref), hallucination (Ref), hypertonia (Ref), memory impairment (Ref), mood disorder (Ref), movement disorder (Ref), paresthesia (Ref), psychotic reaction (Ref), seizure (Ref)

Ophthalmic: Glaucoma (Ref), mydriasis

Contraindications

Hypersensitivity to oxybutynin or any component of the formulation; patients with or at risk for uncontrolled narrow-angle glaucoma, urinary retention, gastric retention or conditions with severely decreased GI motility.

OTC labeling: When used for self-medication, do not use if you have pain or burning when urinating, blood in urine, unexplained lower back or side pain, cloudy or foul-smelling urine; in males; age <18 years; only experience accidental urine loss when cough, sneeze, or laugh; diagnosis of urinary or gastric retention; glaucoma; hypersensitivity to oxybutynin.

Canadian labeling: Additional contraindications (not in US labeling): Transdermal: Myasthenia gravis.

Warnings/Precautions

Concerns related to adverse effects:

• Exertional heat illness: May increase the risk of this illness with intense exertion in the heat.

Disease-related concerns:

• Dementia: Use with caution in patients with dementia treated with cholinesterase inhibitors; may aggravate symptoms of disease.

• Hepatic impairment: Use with caution in patients with hepatic impairment (limited experience).

• Hiatal hernia: Use with caution in patients with hiatal hernia.

• Hyperthyroidism: Use with caution in patients with hyperthyroidism; may exacerbate condition.

• Myasthenia gravis: Avoid use in patients with myasthenia gravis; may exacerbate condition. Discontinue therapy if signs/symptoms occur.

• Parkinson disease: Use with caution in patients with Parkinson disease; may aggravate symptoms of disease.

• Renal impairment: Use with caution in patients with renal impairment (limited experience).

Dosage form specific issues:

• ER formulation: The ER formulation consists of drug within a nondeformable matrix; following drug release/absorption, the matrix/shell is expelled in the stool. The use of nondeformable products in patients with known stricture/narrowing of the GI tract has been associated with symptoms of obstruction (rare).

• Topical gel: To minimize transferring medication to others, cover treatment area with clothing after gel has dried. Discontinue use if skin irritation occurs. Contains ethanol; do not expose to open flame or smoking until gel has dried.

• Transdermal patch: May contain conducting metal (eg, aluminum); remove patch prior to MRI.

Other warnings/precautions:

• OTC labeling: Other causes of frequent urination (UTI, diabetes, early pregnancy, other serious conditions) may need to be considered prior to use. Patients should contact a health care provider if symptoms do not improve within 2 weeks of initial use or for new or worsening symptoms.

Warnings: Additional Pediatric Considerations

Some dosage forms may contain propylene glycol; in neonates, large amounts of propylene glycol delivered orally, intravenously (eg, >3,000 mg/day), or topically have been associated with potentially fatal toxicities which can include metabolic acidosis, seizures, renal failure, and CNS depression; toxicities have also been reported in children and adults including hyperosmolality, lactic acidosis, seizures, and respiratory depression; use caution (AAP 1997; Shehab 2009).

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Gel, Transdermal, as chloride:

Gelnique: 10% (1 g [DSC]) [contains alcohol, usp]

Patch Twice Weekly, Transdermal:

Oxytrol: 3.9 mg/24 hr (1 ea, 8 ea)

Oxytrol For Women: 3.9 mg/24 hr (1 ea, 4 ea, 8 ea)

Solution, Oral, as chloride:

Generic: 5 mg/5 mL (5 mL, 473 mL)

Tablet, Oral, as chloride:

Generic: 2.5 mg, 5 mg

Tablet Extended Release 24 Hour, Oral, as chloride:

Ditropan XL: 5 mg [DSC], 10 mg [DSC]

Generic: 5 mg, 10 mg, 15 mg

Generic Equivalent Available: US

May be product dependent

Pricing: US

Patch, twice-weekly (Oxytrol For Women Transdermal)

3.9 mg/24 hrs (per each): $3.30

Patch, twice-weekly (Oxytrol Transdermal)

3.9 mg/24 hrs (per each): $101.98

Solution (oxyBUTYnin Chloride Oral)

5 mg/5 mL (per mL): $22.87

Tablet, 24-hour (oxyBUTYnin Chloride ER Oral)

5 mg (per each): $1.86 - $6.24

10 mg (per each): $1.99 - $3.29

15 mg (per each): $2.39 - $3.37

Tablets (oxyBUTYnin Chloride Oral)

2.5 mg (per each): $2.80

5 mg (per each): $0.44 - $0.76

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Patch Twice Weekly, Transdermal:

Oxytrol: 3.9 mg/24 hr ([DSC])

Solution, Oral, as chloride:

Generic: 5 mg/5 mL (500 mL)

Tablet, Oral, as chloride:

Generic: 2.5 mg, 5 mg

Tablet Extended Release 24 Hour, Oral, as chloride:

Ditropan XL: 5 mg [DSC], 10 mg [DSC] [contains polysorbate 80]

Administration: Pediatric

Oral: May be administered with or without food. Extended-release tablets must be swallowed whole with liquid; do not chew, divide, or crush; take at approximately the same time each day.

Intravesical: Immediately prior to administration, crush the appropriate number of immediate-release tablets based on dose and dissolve in sterile water or saline to a final concentration of 5 mg/mL (Ref); after emptying bladder, administer directly into the bladder via catheter (Ref).

Transdermal: Apply to clean, dry, smooth (fold-free) intact skin on abdomen, hip, or buttock; do not apply to areas treated with oils, lotions, or powders. Do not apply to areas with cuts, scrapes, or other irritation (ie, rashes). Do not cut the patch. Rotate site of application with each administration and avoid application to the same site within 7 days. Wear patch under clothing; do not expose to sunlight.

Administration: Adult

Oral: ER tablets: Administer without regard to meals. Must be swallowed whole with liquid; do not crush, divide, or chew; take at approximately the same time each day.

Bariatric surgery: Some institutions may have specific protocols that conflict with these recommendations; refer to institutional protocols as appropriate. Oral solution, IR tablet, topical gel, and transdermal patch formulations are available. If safety and efficacy can be effectively monitored, no change in formulation or administration is required after bariatric surgery.

Topical gel: For topical use only. Apply to clean, dry, intact skin on abdomen, thighs, or upper arms/shoulders. Rotate application sites; do not apply to the same site on consecutive days. Wash hands after use. Cover treated area with clothing after gel has dried to prevent transfer of medication to others. Do not bathe, shower, or swim until 1 hour after gel applied. Do not apply to recently shaved skin.

Transdermal: Apply to clean, dry, smooth (fold-free) skin on abdomen, hip, or buttock; do not apply to areas treated with oils, lotions, or powders. Do not apply to areas with cuts, scrapes, or other irritation (ie, rashes). Do not divide or cut the patch into pieces; do not apply damaged patches. Apply each system at a new site (avoid reapplication to same site within 7 days). Contact with water while bathing, swimming, showering, or exercising will not change the effect; however, rubbing of the patch area should be avoided during these activities. Patch should be worn under clothing; do not expose to sunlight.

Storage/Stability

Immediate release tablet and syrup: Store at 20°C to 25°C (68°F to 77°F). Protect from light.

Extended release tablet: Store at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86°F). Protect from moisture and humidity.

Topical gel: Store at 20°C to 25°C (68°C to 77°F). Protect from moisture and humidity. Keep away from open flame. Do not store outside the sealed pouch; apply immediately after removal from the protective pouch. Discard used sachets such that accidental application or ingestion by children, pets, or others are avoided.

Transdermal patch: Store at 20°C to 25°C (68°F to 77°F). Protect from moisture and humidity. Do not store outside the sealed pouch; apply immediately after removal from the protective pouch. Discard used patches such that accidental application or ingestion by children, pets, or others is avoided.

Use

Oral:

Immediate-release tablets, oral solution: Relief of symptoms of bladder instability associated with voiding in patients with uninhibited or reflex neurogenic bladder (ie, urgency, frequency, urinary leakage, urge incontinence, dysuria) (FDA approved in ages >5 years and adults); has also been used for treatment of primary focal hyperhidrosis and nocturnal enuresis.

Extended-release tablets: Treatment of symptoms of detrusor overactivity associated with a neurological condition (FDA approved in pediatric patients ages ≥6 years); treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and frequency (FDA approved in adults).

Topical:

Topical gel (Gelnique): Treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and frequency (FDA approved in adults).

Transdermal patch: Treatment of overactive bladder (Oxytrol: FDA approved in adults).

Medication Safety Issues
Sound-alike/look-alike issues:

OxyBUTYnin may be confused with oxyCODONE, OxyCONTIN, oxyMORphone

Ditropan may be confused with Detrol, diazePAM, Diprivan, dithranol

Older Adult: High-Risk Medication:

Beers Criteria: Oxybutynin is identified in the Beers Criteria as a potentially inappropriate medication in patients 65 years and older due to its strong anticholinergic properties (Beers Criteria [AGS 2023]).

Oxybutynin is identified in the Screening Tool of Older Person's Prescriptions (STOPP) criteria as a potentially inappropriate medication in older adults (≥65 years of age) for lower urinary tract symptoms in male patients with benign prostatic hyperplasia and postvoid residual volume >200 mL. In addition, some disease states of concern include chronic cognitive impairment, delirium, dementia, narrow-angle glaucoma, and chronic constipation (O’Mahony 2023).

Other safety concerns:

Transdermal patch may contain conducting metal (eg, aluminum); remove patch prior to MRI.

Metabolism/Transport Effects

Substrate of CYP3A4 (Minor); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential;

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program

Acetylcholinesterase Inhibitors: May decrease therapeutic effects of Agents with Clinically Relevant Anticholinergic Effects. Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Acetylcholinesterase Inhibitors. Risk C: Monitor

Aclidinium: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid

Acrivastine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Agents with Clinically Relevant Anticholinergic Effects: May increase anticholinergic effects of OxyBUTYnin. Risk C: Monitor

Alcohol (Ethyl): May increase CNS depressant effects of OxyBUTYnin. Risk C: Monitor

Amantadine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Benperidol: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Benperidol. Risk C: Monitor

Benztropine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Benztropine. Risk C: Monitor

Biperiden: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Biperiden. Risk C: Monitor

Bornaprine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Bornaprine. Risk C: Monitor

Botulinum Toxin-Containing Products: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Bromperidol: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Bromperidol. Risk C: Monitor

Buclizine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Buclizine. Risk C: Monitor

Cannabinoid-Containing Products: Agents with Clinically Relevant Anticholinergic Effects may increase tachycardic effects of Cannabinoid-Containing Products. Risk C: Monitor

Chlorprothixene: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Chlorprothixene. Risk C: Monitor

Cimetropium: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Cimetropium. Risk X: Avoid

CloZAPine: Agents with Clinically Relevant Anticholinergic Effects may increase constipating effects of CloZAPine. Management: Consider alternatives to this combination whenever possible. If combined, monitor closely for signs and symptoms of gastrointestinal hypomotility and consider prophylactic laxative treatment. Risk D: Consider Therapy Modification

Cyclizine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

CYP3A4 Inhibitors (Strong): May increase serum concentration of OxyBUTYnin. Risk C: Monitor

Darifenacin: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Darifenacin. Risk C: Monitor

Dicyclomine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Dicyclomine. Risk C: Monitor

Dimethindene (Systemic): Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Dimethindene (Systemic). Risk C: Monitor

DroNABinol: Agents with Clinically Relevant Anticholinergic Effects may increase tachycardic effects of DroNABinol. Risk X: Avoid

Eluxadoline: Agents with Clinically Relevant Anticholinergic Effects may increase constipating effects of Eluxadoline. Risk X: Avoid

Erythromycin (Systemic): May increase serum concentration of OxyBUTYnin. Risk C: Monitor

Fesoterodine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Fesoterodine. Risk C: Monitor

FluPHENAZine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Gastrointestinal Agents (Prokinetic): Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Gastrointestinal Agents (Prokinetic). Risk C: Monitor

Gepotidacin: May decrease anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Glucagon: Agents with Clinically Relevant Anticholinergic Effects may increase adverse/toxic effects of Glucagon. Specifically, the risk of gastrointestinal adverse effects may be increased. Risk C: Monitor

Glycopyrrolate (Oral Inhalation): Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Glycopyrrolate (Oral Inhalation). Risk X: Avoid

Glycopyrrolate (Systemic): Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Glycopyrrolate (Systemic). Risk C: Monitor

Glycopyrronium (Topical): May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid

Ipratropium (Nasal): May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Ipratropium (Oral Inhalation): May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid

Itopride: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Itopride. Risk C: Monitor

Levosulpiride: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Levosulpiride. Risk X: Avoid

Maprotiline: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Maprotiline. Risk C: Monitor

Melperone: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Methotrimeprazine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Methotrimeprazine. Risk C: Monitor

Methscopolamine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Methscopolamine. Risk C: Monitor

Mirabegron: Agents with Clinically Relevant Anticholinergic Effects may increase adverse/toxic effects of Mirabegron. Risk C: Monitor

Nitroglycerin: Agents with Clinically Relevant Anticholinergic Effects may decrease absorption of Nitroglycerin. Specifically, anticholinergic agents may decrease the dissolution of sublingual nitroglycerin tablets, possibly impairing or slowing nitroglycerin absorption. Risk C: Monitor

OLANZapine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of OLANZapine. Risk C: Monitor

Opioid Agonists: Agents with Clinically Relevant Anticholinergic Effects may increase adverse/toxic effects of Opioid Agonists. Specifically, the risk for constipation and urinary retention may be increased with this combination. Risk C: Monitor

Opipramol: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Oxatomide: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid

Perazine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Perphenazine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Perphenazine. Risk C: Monitor

Potassium Chloride: Agents with Clinically Relevant Anticholinergic Effects may increase ulcerogenic effects of Potassium Chloride. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride. Risk X: Avoid

Potassium Citrate: Agents with Clinically Relevant Anticholinergic Effects may increase ulcerogenic effects of Potassium Citrate. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium citrate. Risk X: Avoid

Pramlintide: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. These effects are specific to the GI tract. Risk X: Avoid

Promethazine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Promethazine. Risk C: Monitor

Propantheline: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Propantheline. Risk C: Monitor

Propiverine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

QuiNIDine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Ramosetron: Agents with Clinically Relevant Anticholinergic Effects may increase constipating effects of Ramosetron. Risk C: Monitor

Revefenacin: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Revefenacin. Risk X: Avoid

Rivastigmine: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Rivastigmine. Rivastigmine may decrease therapeutic effects of Agents with Clinically Relevant Anticholinergic Effects. Management: Use of rivastigmine with an anticholinergic agent is not recommended unless clinically necessary. If the combination is necessary, monitor for reduced anticholinergic effects. Risk D: Consider Therapy Modification

Scopolamine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Scopolamine. Risk C: Monitor

Secretin: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Secretin. Management: Avoid concomitant use of anticholinergic agents and secretin. Discontinue anticholinergic agents at least 5 half-lives prior to administration of secretin. Risk D: Consider Therapy Modification

Sofpironium: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Sofpironium. Risk X: Avoid

Thiazide and Thiazide-Like Diuretics: Agents with Clinically Relevant Anticholinergic Effects may increase serum concentration of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor

Thiothixene: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Thiothixene. Risk C: Monitor

Tiapride: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Tiapride. Risk C: Monitor

Tiotropium: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Tiotropium. Risk X: Avoid

Tolterodine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Tolterodine. Risk C: Monitor

Topiramate: Agents with Clinically Relevant Anticholinergic Effects may increase adverse/toxic effects of Topiramate. Risk C: Monitor

Trimethobenzamide: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Trimethobenzamide. Risk C: Monitor

Trospium: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Trospium. Risk C: Monitor

Umeclidinium: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid

Zuclopenthixol: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Zuclopenthixol. Risk C: Monitor

Dietary Considerations

Food causes a slight delay in the absorption of the oral solution and bioavailability is increased by ~25%. Absorption of the extended release tablet is not affected by food. May be taken without regard to meals.

Pregnancy Considerations

Adverse events were not observed in animal reproduction studies.

Information related to the use of oxybutynin in pregnant patients treated for neurogenic bladder (Andretta 2019; Beghin 2016) or excessive sweating (Harley 2020) is limited.

Monitoring Parameters

Signs and symptoms of anticholinergic reactions (eg, dry mouth, constipation, dizziness).

Mechanism of Action

Direct antispasmodic effect on smooth muscle, also inhibits the action of acetylcholine on smooth muscle (exhibits 1/5 the anticholinergic activity of atropine, but has 4-10 times the antispasmodic activity); does not block effects at skeletal muscle or at autonomic ganglia; increases bladder capacity, decreases uninhibited contractions, and delays desire to void, therefore, decreases urgency and frequency

Pharmacokinetics (Adult Data Unless Noted)

Onset of action: Oral: Immediate release: 30 to 60 minutes

Peak effect: Immediate release: 3 to 6 hours; Extended release: 3 days

Duration: Oral: Immediate release: 6 to 10 hours; Extended release: Up to 24 hours; Transdermal 96 hours

Absorption: Oral: Rapid and well absorbed; Transdermal: High

Distribution: IV: Vd: 193 L

Protein binding: >99% primarily to alpha-1 acid glycoprotein

Metabolism: Hepatic via CYP3A4; Oral: High first-pass metabolism; forms active and inactive metabolites

Bioavailability: Oral: Immediate release: 6% (range: 1.6% to 10.9%)

Half-life elimination: IV: ~2 hours (parent drug), 7 to 8 hours (metabolites); Oral: Immediate release: ~2 to 3 hours; Extended release: ~13 hours; Transdermal: 64 hours

Time to peak, serum: Oral: Immediate release: ~60 minutes; Extended release: 4 to 6 hours; Transdermal: 24 to 48 hours

Excretion: Urine (<0.1% as metabolites and unchanged drug)

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Apo-oxybutynin | Ditropan | Oxybutynin | Pms-oxybutynin;
  • (AR) Argentina: Delak | Ditropan | Ditropan ud | Oxi Q | Oxi q lr | Oxibutinina ferring | Oxibutinina Vannier | Oxitina | Oxyurin | Retebem | Retemicon | Soxsup | Urequin;
  • (AT) Austria: Detrusan | Ditropan | Oxybutynin | Oxybutynin hexal pharma;
  • (AU) Australia: Ditropan | Oxybutynin Sandoz | Oxytrol;
  • (BD) Bangladesh: Uricon;
  • (BE) Belgium: Ditropan | Driptane | Oxybutynin Ratiopharm | Oxybutynine bexal | Oxybutynine eurogenerics | Oxybutynine hcl merck-generics | Oxybutynine Sandoz;
  • (BR) Brazil: Cloridrato de Oxibutinina | Dry | Frenurin | Incontinol | Nourin | Retemic | Retemic UD;
  • (CH) Switzerland: Ditropan | Kentera;
  • (CI) Côte d'Ivoire: Xytinin;
  • (CL) Chile: Odranal | Oxiburin | Urazol | Uricont | Urocontinent;
  • (CN) China: Ao ning | Oxybutynin | Shuang miao | Yi jing;
  • (CO) Colombia: Delifon | Lyrinel | Mutum | Mutum cr | Oxibutin | Oxibutinina | Sinorin | Uropran;
  • (CZ) Czech Republic: Ditropan | Kentera | Uroxal;
  • (DE) Germany: Cystonorm | Dridase | Kentera | Oxyb | Oxybase | Oxybugamma | Oxybutin | Oxybuton | Oxybutynin | Oxybutynin al | Oxybutynin Billix | Oxybutynin hexal | Oxybutynin Maxmedic | Oxybutynin Ratiopharm | Oxybutyninhydrochlorid Sandoz | Oxymedin | Ryol | Spasyt;
  • (DO) Dominican Republic: Driptane | Reteven LP | Sutropan | Urginal | Urginal UD;
  • (EC) Ecuador: Mutum | Mutum cr;
  • (EE) Estonia: Cystrin | Driptane;
  • (EG) Egypt: Detronin | Detrusan | Oxurate | Oxybin | Uripan;
  • (ES) Spain: Ditropan | Dresplan | Kentera;
  • (FI) Finland: Cystrin | Oksibutin sandoz | Oxybase | Oxybutynin generic | Oxybutynin mylan | Spasmoxyl;
  • (FR) France: Ditropan | Driptane | Oxybutynine | Oxybutynine accord | Oxybutynine g gam | Oxybutynine merck | Oxybutynine Ratiopharm | Oxybutynine Sandoz | Zatur;
  • (GB) United Kingdom: Contimin | Cystrin | Ditropan | Kentera | Lyrinel | Oxybutynin | Oxybutynin Accord | Oxybutynin arrow | Oxybutynin cox | Oxybutynin kent | Oxybutynin Sandoz | Promictuline | Urimin;
  • (GR) Greece: Ditropan | Lyrinel | Lyrinel XL;
  • (HK) Hong Kong: Apo-Oxybutynine | Pms-oxybutynin;
  • (HR) Croatia: Driptane;
  • (HU) Hungary: Ditropan | Huma-oxybutynin | Uroxal;
  • (IE) Ireland: Cystrin | Ditropan | Kentera | Lyrinel | Oxybutynin | Oxybutynin nicobrand | Renamel;
  • (IL) Israel: Lyrinel | Novitropan | Oxybutynin GM;
  • (IN) India: Cystran | Nocturin | Oxybutin | Oxylax | Oxyspas | Tropan;
  • (IQ) Iraq: Oxybutin;
  • (IT) Italy: Ditropan | Kentera | Lyrinel | Ossibutinina | Ossibutinina cloridrato mylan generics | Oxibutinina eg;
  • (JO) Jordan: Ditropan | Dreptageed;
  • (JP) Japan: Brocell | Cobapolas | Delaiv | Delaiv choseido | Esuomin | Fandeheede | Fandeheede yoshindo | Halarase | Halarase maruko | Halarase ohara | Harblasse | Herton | Inobase mita | Inobase tatumi | Letecrin | Lofreon | Neluos | Neoxy | Orivate sawai | Orivate yoshitomi | Oxybutynin HCL | Palnaxol | Pollakisu | Porabutin | Porabutin iwaki | Poratile | Postinin | Urgent | Volanta;
  • (KE) Kenya: Oxinus;
  • (KR) Korea, Republic of: Cystrin | Ditropan | Lailinel oros | Obutin | Obutine | Oksitin | Oxybutin | Oxynin | Oyrobin | Urinin | Urotinin | Utinin;
  • (KW) Kuwait: Apo-oxybutynin | Uripan;
  • (LB) Lebanon: Ditropan | Driptane;
  • (LT) Lithuania: Cystrin | Driptane | Lyrinel | Novitropan | Oxybutynin Accord | Oxybutynine Mylan;
  • (LU) Luxembourg: Ditropan;
  • (LV) Latvia: Cystrin | Driptane | Novitropan | Oxybutynin hydrochloride accord;
  • (MA) Morocco: Ditropan | Oxybut | Urosta;
  • (MX) Mexico: Inprax | Lyrinel | Nefryl | Tavor | Tavor cr;
  • (MY) Malaysia: Driptane | Voxytane;
  • (NL) Netherlands: Dridase | Kentera | Oxybutynine HCl | Oxybutynine Hcl A | Oxybutynine hcl cf | Oxybutynine Hcl Katwijk | Oxybutynine Hcl Merck | Oxybutynine Hcl PCH | Oxybutynine Hcl Sandoz | Oxybutynine hcl unichem;
  • (NO) Norway: Dridase | Kentera | Lyrinel XL | Oxybutynin macure | Oxybutynine biogaran;
  • (NZ) New Zealand: Apo-oxybutynin | Oxybutynin | Oxybutynin alchemy | Oxytrol;
  • (PE) Peru: Oxibutinina clorhidrato | Reteven | Socliden | Uricont | Uritina | Uroxivan;
  • (PH) Philippines: Driptane | Lyrinel;
  • (PK) Pakistan: Butyn | Cystrin | Oxitrin | Taivor;
  • (PL) Poland: Cystrin | Ditropan | Driptane | Kentera | Oxybutynin hydrochloride accord | Oxybutyninum aflofarm | Uralex;
  • (PR) Puerto Rico: Ditropan | Gelnique | Oxybutynin | Oxybutynin chloride | Oxybutynin chloride er | Oxybutynin chloride extended release | Oxytrol | Oxytrol for women;
  • (PT) Portugal: Ditropan | Oxibutinina;
  • (PY) Paraguay: Socliden | Uroflax | Uroflax cr;
  • (QA) Qatar: Ditropan | Lyrinel XL | Uropan;
  • (RO) Romania: Ditropan | Driptane;
  • (RU) Russian Federation: Driptane | Novitropan;
  • (SA) Saudi Arabia: Apo-oxybutynin | Ditropan | Pms-oxybutynin;
  • (SE) Sweden: Ditropan | Kentera | Oxybase | Oxybutinin accord | Oxybutynin 2care4 | Oxybutynin ebb | Oxybutynin mylan | Oxybutynin Stada;
  • (SG) Singapore: Obutin;
  • (SI) Slovenia: Ditropan;
  • (SK) Slovakia: Ditropan | Eurin | Kentera | Uroxal;
  • (SR) Suriname: Oxybutynine hcl apotex | Oxybutynine hcl teva | Oxybutynine Mylan;
  • (TH) Thailand: Diatropan | Diutropan | Lyrinel;
  • (TN) Tunisia: Ditropan | Driptane | Oxybtan;
  • (TR) Turkey: Kentera | Uropan;
  • (TW) Taiwan: Benlate | Blasec | Clonice | Ditropan | Newin | Oablok | Oubile | Oxbu | Oxipan | Oxyban | Oxybutynin | Oxypan | Oxytynin | Par Yih | Pintylin | Repinin | Urocon | Uronin;
  • (UA) Ukraine: Dream | Drimtan-Apo | Driptan | Sibutin;
  • (UY) Uruguay: Ditropan ud | Gradual | Incontin | Oxotine | Retebem | Socliden;
  • (VE) Venezuela, Bolivarian Republic of: Reteven;
  • (ZA) South Africa: Ditropan | Lenditro | Lyrinel | Merck-oxybutynin | Micro-Oxybutynin | Oxyrest | Oxyspas | Rolab-oxybutynin | Urihexal
  1. 2023 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052-2081. doi:10.1111/jgs.18372 [PubMed 37139824]
  2. Adubofour KO, Kajiwara GT, Goldberg CM, King-Angell JL. Oxybutynin-induced heatstroke in an elderly patient. Ann Pharmacother. 1996;30(2):144-147. doi:10.1177/106002809603000207 [PubMed 8835047]
  3. Alrawashdeh H, Madi L, Ahmed Elhada AH, Ahmed A, Serheed D. A case of probable oxybutynin-induced increase in liver enzymes. Ther Clin Risk Manag. 2018;14:1657-1660. doi:10.2147/TCRM.S169868 [PubMed 30237720]
  4. Amark P, Eksborg S, Juneskans O, Bussman G, Palm C. Pharmacokinetics and effects of intravesical oxybutynin on the paediatric neurogenic bladder. Br J Urol. 1998;82(6):859-864. doi:10.1046/j.1464-410x.1998.00888.x [PubMed 9883225 ]
  5. American Academy of Pediatrics Committee on Drugs. "Inactive" ingredients in pharmaceutical products: update (subject review). Pediatrics. 1997;99(2):268-278. doi:10.1542/peds.99.2.268 [PubMed 9024461]
  6. Andretta E, Landi LM, Cianfrocca M, Manassero A, Risi O, Artuso G. Bladder management during pregnancy in women with spinal-cord injury: an observational, multicenter study. Int Urogynecol J. 2019;30(2):293-300. doi:10.1007/s00192-018-3620-8 [PubMed 29600402]
  7. Apo-oxybutynin (oxybutynin) [product monograph]. Weston, Ontario, Canada: Apotex Inc; January 2022.
  8. Armstrong RB, Dmochowski RR, Sand PK, Macdiarmid S. Safety and tolerability of extended-release oxybutynin once daily in urinary incontinence: combined results from two phase 4 controlled clinical trials. Int Urol Nephrol. 2007;39(4):1069-77. doi:10.1007/s11255-006-9157-7 [PubMed 17333521]
  9. Beghin D, Vauzelle-Gardier C, Elefant E. Pregnancy outcome after in utero exposure to oxybutynin. Reprod Toxicol. 2016;60:177-178. https://doi.org/10.1016/j.reprotox.2016.03.018
  10. Berkenwald A, Pires J, Ellsworth P. Evaluating use of higher dose oxybutynin in combination with desmopressin for refractory nocturnal enuresis. J Pediatr Urol. 2016;12(4):220.e1-220.e2206. doi:10.1016/j.jpurol.2016.05.029 [PubMed 27373215]
  11. Branson JA, Dale RC. Transient bilateral blindness and posterior reversible encephalopathy syndrome: a rare complication of enuresis treatment. J Paediatr Child Health. 2008;44(6):380-2. doi:10.1111/j.1440-1754.2008.01337.x [PubMed 18476934]
  12. Buyse G, Verpoorten C, Vereecken R, Casaer P. Intravesical application of a stable oxybutynin solution improves therapeutic compliance and acceptance in children with neurogenic bladder dysfunction. J Urol. 1998a;160(3 Pt 2):1084-1087. doi:10.1097/00005392-199809020-00031 [PubMed 9719281]
  13. Buyse G, Waldeck K, Verpoorten C, Björk H, Casaer P, Andersson KE. Intravesical oxybutynin for neurogenic bladder dysfunction: less systemic side effects due to reduced first pass metabolism. J Urol. 1998b;160(3 Pt 1):892-896. [PubMed 9720583 ]
  14. Cartwright PC, Coplen DE, Kogan BA, Volinn W, Finan E, Hoel G. Efficacy and safety of transdermal and oral oxybutynin in children with neurogenic detrusor overactivity. J Urol. 2009;182(4):1548-1554. doi:10.1016/j.juro.2009.06.058 [PubMed 19683731]
  15. Casal-Beloy I, García-Novoa MA, García González M, Acea Nebril B, Somoza Argibay I. Transcutaneous sacral electrical stimulation versus oxibutynin for the treatment of overactive bladder in children. J Pediatr Urol. 2021;17(5):644.e1-644.e10. doi:10.1016/j.jpurol.2021.06.011 [PubMed 34176749]
  16. Chancellor M, Boone T. Anticholinergics for overactive bladder therapy: central nervous system effects. CNS Neurosci Ther. 2012;18(2):167-74. doi:10.1111/j.1755-5949.2011.00248.x [PubMed 22070184]
  17. Chancellor MB, Appell RA, Sathyan G, Gupta SK. A comparison of the effects on saliva output of oxybutynin chloride and tolterodine tartrate. Clin Ther. 2001;23(5):753-60. doi:10.1016/s0149-2918(01)80024-2 [PubMed 11394733]
  18. Chu FM, Dmochowski RR, Lama DJ, Anderson RU, Sand PK. Extended-release formulations of oxybutynin and tolterodine exhibit similar central nervous system tolerability profiles: a subanalysis of data from the OPERA trial. Am J Obstet Gynecol. 2005;192(6):1849-54; discussion 1854-5. doi:10.1016/j.ajog.2005.03.036 [PubMed 15970828]
  19. Ciftci I, Arslan D, Peru H, Cimen D, Oran B, Gunduz M. Does oxybutynin hydrochloride cause arrhythmia in children with bladder dysfunction? Med Arch. 2013;67(3):202-4. doi:10.5455/medarh.2013.67.202-204 [PubMed 23848044]
  20. Corcos J, Casey R, Patrick A, Andreou C, Miceli PC, Reiz JL, Harsanyi Z, Darke AC; Uromax Study Group. A double-blind randomized dose-response study comparing daily doses of 5, 10 and 15 mg controlled-release oxybutynin: balancing efficacy with severity of dry mouth. BJU Int. 2006;97(3):520-7. doi:10.1111/j.1464-410X.2005.06031.x [PubMed 16469019]
  21. Davila GW, Daugherty CA, Sanders SW; Transdermal Oxybutynin Study Group. A short-term, multicenter, randomized double-blind dose titration study of the efficacy and anticholinergic side effects of transdermal compared to immediate release oral oxybutynin treatment of patients with urge urinary incontinence. J Urol. 2001;166(1):140-5. [PubMed 11435842]
  22. Del Boz J, Millán-Cayetano JF, Blázquez-Sánchez N, de Troya M. Individualized dosing of oral oxybutynin for the treatment of primary focal hyperhidrosis in children and teenagers. Pediatr Dermatol. 2016;33(3):327-331. doi:10.1111/pde.12857 [PubMed 27122197]
  23. Ditropan XL (oxybutynin) [prescribing information]. Titusville, NJ: Janssen Pharmaceuticals Inc; received April 2021.
  24. D'Souza AO, Smith MJ, Miller LA, Doyle J, Ariely R. Persistence, adherence, and switch rates among extended-release and immediate-release overactive bladder medications in a regional managed care plan. J Manag Care Pharm. 2008;14(3):291-301. doi:10.18553/jmcp.2008.14.3.291 [PubMed 18439051]
  25. Expert opinion. Senior Renal Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.
  26. Ferrara P, D'Aleo CM, Tarquini E, Salvatore S, Salvaggio E. Side-effects of oral or intravesical oxybutynin chloride in children with spina bifida. BJU Int. 2001;87(7):674-678. doi:10.1046/j.1464-410x.2001.02152.x [PubMed 11350411 ]
  27. Gelnique (oxybutynin) gel [prescribing information]. Madison, NJ: Allergan USA, Inc; March 2019.
  28. Gelnique (oxybutynin) [product monograph]. Markham, Ontario, Canada: Allergan Pharma; March 2017.
  29. Ghaleiha A, Jahangard L, Sherafat Z, et al. Oxybutynin reduces sweating in depressed patients treated with sertraline: a double-blind, placebo-controlled, clinical study. Neuropsychiatr Dis Treat. 2012;8:407-12. doi:10.2147/NDT.S36329 [PubMed 23028229]
  30. Gleason JM, Daniels C, Williams K, et al. Single center experience with oxybutynin transdermal system (patch) for management of symptoms related to non-neuropathic overactive bladder in children: an attractive, well tolerated alternative form of administration. J Pediatr Urol. 2014;10(4):753-757. doi:10.1016/j.jpurol.2013.12.017 [PubMed 24477421 ]
  31. Gormley EA, Lightner DJ, Burgio KL, et al. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline. American Urological Association website. https://www.auanet.org/guidelines/overactive-bladder-(oab)-guideline#x14217. Published 2012. Updated 2019. Accessed July 2, 2021.
  32. Götz AK, Reinhold SW, Szecsey A, Banas B, Krämer BK. Severe anticholinergic drug-induced delirium in a young adult after renal transplantation. Transpl Int. 2009;22(2):249-50. doi:10.1111/j.1432-2277.2008.00759.x [PubMed 18786150]
  33. Gözüküçük A, Kılıç M, Çakıroğlu B. Desmopressin versus desmopressin + oxybutynin in the treatment of children with nocturnal enuresis. J Pediatr Urol. 2021;17(4):451.e1-451.e6. doi:10.1016/j.jpurol.2021.04.001 [PubMed 33931318]
  34. Guerra LA, Moher D, Sampson M, Barrowman N, Pike J, Leonard M. Intravesical oxybutynin for children with poorly compliant neurogenic bladder: a systematic review. J Urol. 2008;180(3):1091-1097. doi:10.1016/j.juro.2008.05.056 [PubMed 18639290]
  35. Gulsun M, Pinar M, Sabanci U. Psychotic disorder induced by oxybutynin: Presentation of two cases. Clin Drug Investig. 2006;26(10):603-6. doi:10.2165/00044011-200626100-00007 [PubMed 17163294]
  36. Haddad A, Arwani M, Sabbagh O. A novel association between oxybutynin use and bilateral acute angle closure glaucoma: a case report and literature review. Cureus. 2018;10(6):e2732. doi:10.7759/cureus.2732 [PubMed 30087808]
  37. Haferkamp A, Staehler G, Gerner HJ, Dörsam J. Dosage escalation of intravesical oxybutynin in the treatment of neurogenic bladder patients. Spinal Cord. 2000;38(4):250-254. doi:10.1038/sj.sc.3100995 [PubMed 10822396]
  38. Harley JAT. Oxybutynin for methadone-induced sweating in pregnancy. Australas Psychiatry. 2020:1039856220965055. doi:10.1177/1039856220965055 [PubMed 33052696]
  39. Hussain RM, Hartigan-Go K, Thomas SH, Ford GA. Effect of oxybutynin on the QTc interval in elderly patients with urinary incontinence. Br J Clin Pharmacol. 1996;41(1):73-5. doi:10.1111/j.1365-2125.1996.tb00161.x [PubMed 8824696]
  40. Jain D, Dhua A, Ravisankar V, Chellam L, Joshi M. Acute angle closure glaucoma after hypospadias surgery: a vision-threatening complication of oxybutynin. J Indian Assoc Pediatr Surg. 2015;20(3):161-2. doi:10.4103/0971-9261.154662 [PubMed 26166994]
  41. Katz IR, Sands LP, Bilker W, et al. Identification of medications that cause cognitive impairment in older people: the case of oxybutynin chloride. J Am Geriatr Soc. 1998;46(1):8-13. doi:10.1111/j.1532-5415.1998.tb01006.x [PubMed 9434659]
  42. Kay GG, Ebinger U. Preserving cognitive function for patients with overactive bladder: evidence for a differential effect with darifenacin. Int J Clin Pract. 2008;62(11):1792-800. doi:10.1111/j.1742-1241.2008.01849.x [PubMed 18699842]
  43. Kazi A, Moorani KN, Zehra S, Zaidi IH. Comparative response of desmopressin versus combination therapy (desmopressin + oxybutynin) in children with nocturnal enuresis. Pak J Med Sci. 2020;36(6):1263-1269. doi:10.12669/pjms.36.6.1957 [PubMed 32968391]
  44. Kennelly MJ. A comparative review of oxybutynin chloride formulations: pharmacokinetics and therapeutic efficacy in overactive bladder. Rev Urol. 2010;12(1):12-19. [PubMed 20428289 ]
  45. Kroll P. Pharmacotherapy for pediatric neurogenic bladder. Paediatr Drugs. 2017;19(5):463-478. doi:10.1007/s40272-017-0249-x [PubMed 28712052]
  46. Lackner TE, Wyman JF, McCarthy TC, Monigold M, Davey C. Randomized, placebo-controlled trial of the cognitive effect, safety, and tolerability of oral extended-release oxybutynin in cognitively impaired nursing home residents with urge urinary incontinence. J Am Geriatr Soc. 2008;56(5):862-70. doi:10.1111/j.1532-5415.2008.01680.x [PubMed 18410326]
  47. Lee AS, Viseshsindh W, Long CJ, et al. How early is early? Effect of oxybutynin on bladder dynamics within the first year of life in patients with spina bifida. J Pediatr Urol. 2020;16(2):168.e1-168.e6. doi:10.1016/j.jpurol.2019.12.008 [PubMed 32115375]
  48. Lerner LB, McVary KT, Barry MJ, et al. Management of lower urinary tract symptoms attributed to benign prostatic hyperplasia: AUA guideline part I, initial work-up and medical management. J Urol. 2021;206(4):806-817. doi:10.1097/JU.0000000000002183 [PubMed 34384237]
  49. Lukacz ES. Urgency urinary incontinence/overactive bladder (OAB) in females: Treatment. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed May 24, 2022.
  50. Meek PD, Evang SD, Tadrous M, Roux-Lirange D, Triller DM, Gumustop B. Overactive bladder drugs and constipation: a meta-analysis of randomized, placebo-controlled trials. Dig Dis Sci. 2011;56(1):7-18. doi:10.1007/s10620-010-1313-3 [PubMed 20596778]
  51. Millán-Cayetano JF, Del Boz J, Rivas-Ruiz F, Blázquez-Sánchez N, Hernández Ibáñez C, de Troya-Martín M. Oral oxybutynin for the treatment of hyperhidrosis: outcomes after one-year follow-up. Australas J Dermatol. 2017;58(2):e31-e35. doi:10.1111/ajd.12473 [PubMed 27029500]
  52. Nelson LS. Initial evaluation of the patient: vital signs and toxic syndromes. In: Nelson LS, Hoffman RS, Howland MA, Lewin NA, Goldfrank LR, Smith SW, eds. Goldfrank's Toxicologic Emergencies. 11th ed. McGraw-Hill; 2019.
  53. Nishtala PS, Chyou TY. Risk of delirium associated with antimuscarinics in older adults: a case-time-control study. Pharmacoepidemiol Drug Saf. 2022;31(8):883-891. doi:10.1002/pds.5480 [PubMed 35587029]
  54. Nye AM, Clinard VB, Barnes CL. Medication nonadherence secondary to drug-induced memory loss. Consult Pharm. 2010;25(2):117-21. doi:10.4140/TCP.n.2010.117 [PubMed 20211824]
  55. O'Mahony D, Cherubini A, Guiteras AR, et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 3. Eur Geriatr Med. 2023;14(4):625-632. doi:10.1007/s41999-023-00777-y [PubMed 37256475]
  56. Oxybutynin extended release tablet (oxybutynin) [prescribing information]. Philadelphia, PA: Lannett Company, Inc; April 2021.
  57. Oxybutynin syrup (oxybutynin) [prescribing information]. Philadelphia, PA: Lannett Company, Inc; February 2020.
  58. Oxybutynin tablet (oxybutynin) [prescribing information]. East Brunswick, NJ: Strides Pharma Inc; November 2021.
  59. Oxytrol (oxybutynin) transdermal patch [prescribing information]. North Chicago, IL: AbbVie Inc; May 2024.
  60. Oxytrol (oxybutynin) [product monograph]. Markham, Ontario, Canada: Allergan Pharma; March 2018.
  61. Oxytrol for Women (oxybutynin) transdermal system [prescribing information]. Madison, NJ: Allergan USA, Inc; received May 2020.
  62. Pemberton MN, Yar R, Sloan P. Fixed drug eruption to oxybutynin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106(3):e19-21. doi:10.1016/j.tripleo.2008.05.004 [PubMed 18602302]
  63. Qaseem A, Dallas P, Forciea MA, et al; Clinical Guidelines Committee of the American College of Physicians. Nonsurgical management of urinary incontinence in women: a clinical practice guideline from the American College of Physicians [published correction appears in Ann Intern Med. 2014;161(10):764]. Ann Intern Med. 2014;161(6):429-440. doi:10.7326/M13-2410. [PubMed 25222388]
  64. Rawashdeh YF, Austin P, Siggaard C, et al. International Children's Continence Society's recommendations for therapeutic intervention in congenital neuropathic bladder and bowel dysfunction in children. Neurourol UrodynR. 2012;31(5):615-620. doi:10.1002/nau.22248 [PubMed 22532368]
  65. Refer to manufacturer's labeling.
  66. Schollhammer M, Brenaut E, Menard-Andivot N, et al. Oxybutynin as a treatment for generalized hyperhidrosis: a randomized, placebo-controlled trial. Br J Dermatol. 2015;173(5):1163-1168. doi:10.1111/bjd.13973. [PubMed 26114588]
  67. Shehab N, Lewis CL, Streetman DD, Donn SM. Exposure to the pharmaceutical excipients benzyl alcohol and propylene glycol among critically ill neonates. Pediatr Crit Care Med. 2009;10(2):256-259. doi:10.1097/PCC.0b013e31819a383c [PubMed 19188870]
  68. Smith CC, Pariser D. Primary focal hyperhidrosis. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed May 9, 2020.
  69. Staskin DR, MacDiarmid SA. Using anticholinergics to treat overactive bladder: the issue of treatment tolerability. Am J Med. 2006;119(3 Suppl 1):9-15. doi:10.1016/j.amjmed.2005.12.011 [PubMed 16483863]
  70. Stein R, Bogaert G, Dogan HS, et al. EAU/ESPU guidelines on the management of neurogenic bladder in children and adolescent part I diagnostics and conservative treatment. Neurourol Urodyn. 2020;39(1):45-57. doi:10.1002/nau.24211 [PubMed 31724222]
  71. Stoniute A, Madhuvrata P, Still M, Barron-Millar E, Nabi G, Omar MI. Oral anticholinergic drugs versus placebo or no treatment for managing overactive bladder syndrome in adults. Cochrane Database Syst Rev. 2023;5(5):CD003781. doi:10.1002/14651858.CD003781.pub3 [PubMed 37160401]
  72. Sze C, Drangsholt S, Stoddard MD, et al. Adverse events for overactive bladder medications from a public federal database. Female Pelvic Med Reconstr Surg. 2022;28(7):429-435. doi:10.1097/SPV.0000000000001190 [PubMed 35536677]
  73. van den Heijkant M, De Coster K, Jansen K, Bogaert G. Can oral fesoterodine be an alternative for intravesical oxybutynin instillations in children with neuropathic bladder dysfunction? Urol Int. 2019;103(2):202-210. doi:10.1159/000499757 [PubMed 31117096]
  74. Wagg A, Dale M, Tretter R, Stow B, Compion G. Randomised, multicentre, placebo-controlled, double-blind crossover study investigating the effect of solifenacin and oxybutynin in elderly people with mild cognitive impairment: the SENIOR study. Eur Urol. 2013;64(1):74-81. doi:10.1016/j.eururo.2013.01.002 [PubMed 23332882]
  75. Wolosker N, de Campos JR, Kauffman P, et al. A randomized placebo-controlled trial of oxybutynin for the initial treatment of palmar and axillary hyperhidrosis. J Vasc Surg. 2012;55(6):1696-1700. doi:10.1016/j.jvs.2011.12.039. [PubMed 22341836]
  76. Wolosker N, Schvartsman C, Krutman M, et al. Efficacy and quality of life outcomes of oxybutynin for treating palmar hyperhidrosis in children younger than 14 years old. Pediatr Dermatol. 2014a;31(1):48-53. doi:10.1111/pde.12142 [PubMed 23627681]
  77. Wolosker N, Teivelis MP, Krutman M, et al. Long-term efficacy of oxybutynin for palmar and plantar hyperhidrosis in children younger than 14 years. Pediatr Dermatol. 2014b;32(5):663-667. doi:10.1111/pde.12385 [PubMed 25490865]
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