Oxybutynin chloride
Oxybutynin chloride (Ditropan)
Oxybutynin chloride
(ox-ee- BYOU-tih-nin)
Pregnancy Category: B Albert Oxybutynin Apo-Oxybutynin Ditropan Ditropan XL Gen-Oxybutynin Novo-Oxybutynin Nu-Oxybutyn Oxybutyn PMS-Oxybutynin (Rx)

Classification: Antispasmodic

Action/Kinetics: Causes increased vesicle capacity, decreases frequency of uninhibited contractions of the detrusor muscle, and delays initial urgency to void by exerting a direct antispasmodic effect. Has no effect at either the neuromuscular junction or autonomic ganglia. Has 4-10 times the antispasmodic effect of atropine but only one-fifth the anticholinergic activity. Onset: 30-60 min; Time to peak effect: 3-6 hr; duration: 6-10 hr. Eliminated through the urine.

Uses: Neurogenic bladder disease characterized by urinary retention, urinary overflow, incontinence, nocturia, urinary frequency or urgency, reflex neurogenic bladder.

Contraindications: Glaucoma (angle closure), untreated narrow anterior chamber angles, GI obstruction, paralytic ileus, intestinal atony (in elderly or debilitated), megacolon, toxic megacolon complicating ulcerative colitis, severe colitis, myasthenia gravis, obstructive uropathy, unstable CV status in acute hemorrhage.

Special Concerns: Use with caution when increased cholinergic effect is undesirable and in the elderly. Safe use in children less than 5 years of age has not been determined. Use with caution in geriatric clients; during lactation; in clients with autonomic neuropathy, renal, or hepatic disease; and in clients with hiatal hernia with reflex esophagitis. Heat stroke and fever (due to decreased sweating) may occur if given at high environmental temperatures.

Side Effects: GI: N&V;, constipation, bloated feeling, decreased GI motility. CNS: Drowsiness, insomnia, weakness, dizziness, restlessness, hallucinations. EENT: Dry mouth, decreased lacrimation, mydriasis, amblyopia, cycloplegia. CV: Tachycardia, palpitations, vasodilation. Miscellaneous: Decreased sweating, urinary hesitancy and retention, impotence, suppression of lactation, severe allergic reactions drug idiosyncrasies, urticaria, and other dermal manifestations. NOTE: The drug may aggravate symptoms of prostatic hypertrophy, hypertension, coronary heart disease, CHF, hyperthyroidism, cardiac arrhythmias, and tachycardia.

Overdose Management: Symptoms: Intense CNS disturbances (restlessness, psychoses), circulatory changes (flushing, hypotension) and failure, respiratory failure, paralysis, coma. Treatment: Stomach lavage, physostigmine (0.5-2 mg IV; repeat as necessary up to maximum of 5 mg). Supportive therapy, if necessary. Counteract excitement with sodium thiopental (2%) or chloral hydrate (100-200 mL of 2% solution) rectally. Artificial respiration may be necessary if respiratory muscles become paralyzed.

Drug Interactions: See Cholinergic Blocking Agents.

How Supplied: Syrup: 5 mg/5 mL; Tablet: 5 mg; Tablet, Long-Acting: 5 mg, 10 mg, 15 mg

Dosage
?Syrup, Tablets
Adults: 5 mg b.i.d.-t.i.d. Maximum dose: 5 mg q.i.d. Children, over 5 years: 5 mg b.i.d. Maximum dose: 5 mg t.i.d.
?Tablets, Long-Acting
Adults, initial: 5 mg once daily. Increase, in 5- mg increments, up to a maximum of 30 mg/day.