Classes
DEA Class; Rx
Common Brand Names; Ditropan XL
- Antispasmodic Agents, Urinary
Description
Combination of a short-acting antimuscarinic agent (ipratropium), with a short-acting beta-agonist (SABA, albuterol)
Primarily used in the treatment of COPD in adults, also used off-label for acute asthma exacerbation in adult and pediatric patients
Available as an oral inhalation or nebulizer solution
Indications
For the treatment of overactive bladder (OAB) or neurogenic bladder with symptoms of urge urinary incontinence, urinary urgency, and urinary frequency.
Contraindications
Hypersensitivity
Gastric or urinary obstruction or retention, paralytic ileus, severe ulcerative colitis
Uncontrolled narrow-angle glaucoma
Relative contraindications: Myasthenia gravis, tachycardia secondary to cardiac insufficiency or thyrotoxicosis
Adverse Effects
- Dry mouth (21-71%)
- Constipation (7-15%)
- Somnolence (2-14%)
- Nausea (2-12%)
- Asthenia (6-10%)
- Dizziness (6-10%)
- Headache (6-10%)
- Blurred vision (6-10%)
- Dry eyes (6-10%)
- Diarrhea (6-10%)
- Nausea (6-10%)
- Pain (6-10%)
- Rhinitis (6-10%)
- Anorexia
- Fluid retention
- Hot flush
- Dysphonia
- Dysphagia
- Frequent bowel movements
- Chest discomfort
- Thirst
Warnings
Caution in controlled angle-closure glaucoma; mild-to-moderate ulcerative colitis, hyperthyroidism; partial obstructive uropathy; benign prostatic hyperplasia
Caution in hepatic or renal impairment
May increase risk of heat prostration during hot weather
May cause memory loss
Angioedema necessitating hospitalization and emergency medical treatment has occurred with first or subsequent doses of oral oxybutynin; if angioedema develops, oxybutynin-containing products should be discontinued and appropriate therapy promptly provided
Caution with gastrointestinal obstructive disorders or decreased intestinal motility because of the risk of gastric retention
May aggravate symptoms of decreased gastrointestinal motility in patients with autonomic neuropathy
Caution with GERD and/or those taking drugs that can cause or exacerbate esophagitis (eg, bisphosphonates)
Pregnancy and Lactation
There are no studies with topical or oral oxybutynin use in pregnant women to inform a drug associated risk for birth defects or miscarriage
There is no information on presence of drug in human milk, effects on breastfed child, or on milk production
Maximum Dosage
20 mg/day PO for immediate-release dosage forms; 30 mg/day PO for extended-release Ditropan XL.
20 mg/day PO for immediate-release dosage forms; 30 mg/day PO for extended-release Ditropan XL.
15—20 mg/day PO for immediate-release dosage forms; 20 mg/day PO for extended-release Ditropan XL.
>= 6 years: 15 mg/day PO for immediate-release dosage forms; 20 mg/day PO for extended-release Ditropan XL.
5 years: 15 mg/day PO for immediate-release dosage forms.
1—4 years: Safety and efficacy have not been established.
How supplied
Oxybutynin chloride
tablet
5mg
tablet, extended-release
5mg
10mg
15mg
syrup
5mg/5mL
transdermal patch
3.9mg/day
topical gel
10%; supplied as 100mg/1g unit (1.14mL) sachet
