Oxybutynin

Registered South African indications:

• Overactive bladder
• Nocturnal enuresis

Contraindications

• Hypersensitivity to the active ingredient or any its excipients
• Patients with closed-angle glaucoma or shallow anterior chamber
• Partial or complete obstruction of the gastrointestinal tract
• Paralytic ileus or pyloric stenosis
• Intestinal atony of the elderly or debilitated person
• Megacolon
• Toxic megacolon complicating ulcerative colitis
• Severe colitis
• Myasthenia gravis
• Patients with obstructive uropathy
• Patients with unstable cardiovascular status in acute haemorrhage
• Patients with hypotonic neurogenic bladder
• Patients with prostatic enlargement
• Pregnancy
• Lactation

Cautions

• Renal impairment
• Hepatic impairment 
• Elderly
• Children (<5 years)
• Parkinson's disease
• Severe gastrointestinal motility disorders
• Intestinal atony
• Ulcerative colitis
• Hyperthyroidism
• Congestive cardiac failure
• Cardiac arrhythmia
• Coronary heart disease
• Hypertension
• Cognitive disorders
• Prostatic hypertrophy
• Gastro-oesophageal reflux
• High temperatures may induce heat prostration
• Dental pathologies
• Coadministration with CNS anticholinergic agents

Forms avail. in SA and covered in this monograph: immediate release tab (IR), extended release tab(ER)

Overactive/ unstable bladder due to detrusor hyperreflexia or detrusor instability

• Oral (IR tab): 2.5-5mg, 8-12hrly; Max: 20mg/24hrs
• Oral (ER tab): Initial: 5mg, dly for 1 week; Titrate by 5mg at intervals of 1 week until optimal response; Max: 20mg/24hrs 

Paed. forms avail. in SA and covered in this monograph: immediate release tab (IR), extended release (ER)

Overactive/ unstable bladder due to detrusor hyperreflexia or detrusor instability

Younger than 5 years 

• Not established for use

Older than 5 years

• Oral (IR tab): 2.5-5mg, 8-12hrly; Max: 15mg/24hrs
• Oral (ER tab): Initial: 5mg, dly; Titrate by 5mg at intervals of 1 week until optimal response; Max: 15mg/24hrs

Nocturnal enuresis

Younger than 5 years 

• Not established for use 

Older than 5 years

• Oral (IR tab): 2.5-5mg, 8-12hrly; Max:15mg/24hrs

Pregnancy

• Contraindicated

Breastfeeding

• Contraindicated

Renal Impairment

• Caution; no dose adjustment recommended

Hepatic Impairment

• Caution; no dose adjustment recommended

Elderly

• Caution; no dose adjustment recommended
  Oral (IR tab): Initiate at lower end of dosage range; Titrate gradually to obtain a clinical response provided the side effects are well tolerated

Porphyria Information

• Probably porphyrinogenic (PRP)

Drugs in Sport

• Permitted - No warnings

Central Nervous System Disorders

• Confusion
• Agitation 
• Anxiety
• Hallucinations
• Nightmares
• Paranoia
• Cognitive disorders
• Depression 
• Dependence
• Dizziness
• Headache 
• Convulsions
• Drowsiness 
• Disorientation

Cardiovascular Disorders

• Tachycardia
• Arrhythmia

Gastrointestinal Disorders

• Constipation 
• Nausea and vomiting 
• Dry mouth
• Diarrhoea
• Abdominal discomfort
• Anorexia
• Decreased appetite
• Dysphagia
• Gastroesophageal reflux disease
• Pseudo-obstruction 

Genitourinary Disorders

• Urinary retention
• Difficulty in micturition

Skin and Subcutaneous Tissue Disorders

• Dry skin
• Angioedema 
• Rash
• Urticaria
• Hypohidrosis
• Photosensitivity

Immune, Blood and Lymphatic System Disorders

• Urinary tract infection

Sensory Disorders

• Vision blurred
• Dry eyes
• Closed-angle glaucoma
• Mydriasis
• Ocular hypertension

Others

• Heat stroke

• CYP3A4 inhibitors
• Cholinesterase inhibitors 
• CNS anticholinergic agents
• Amantidine
• Biperiden
• Levodopa
• Antihistamines
• Antipsychotics
• Quinidine
• Digitalis
• Tricyclic antidepressants
• Atropine
• Alcohol

None routine

Tablet 5mg  - EML (Hospital)

Oxybutynin has both direct antispasmodic action on the smooth muscle of the bladder detrusor muscle as well as an anticholinergic action in blocking the muscarinic effects of acetylcholine on smooth muscle. These properties cause relaxation of the detrusor muscle of the bladder in patients with an unstable bladder. Oxybutynin increases bladder capacity and reduces the incidence of spontaneous contractions of the detrusor muscle.

Tablet 5mg

• Ditropan (Sanofi)
• Lenditro (Pharmacare)
• Mylan oxybutynin (Mylan)
• Oxyrest (iPharma)
• Sandoz oxybutynin (Sandoz)
• Urihexal (Sandoz)

Tablet SRT 5mg

• Lyrinel (Janssen) originator

Tablet SRT 10mg

• Lyrinel (Janssen) originator