OxybutyninOxybutynin Chloride

About Oxybutynin

Oxybutynin relaxes the bladder muscle by blocking muscarinic receptors. The tablets and liquid are labeled for symptoms of bladder instability (urgency, frequency, leakage, urge incontinence and painful urination) in people with an uninhibited or reflex neurogenic bladder: adults usually take 5 mg two or three times a day, up to four times, frail older adults may start at 2.5 mg two or three times a day, and children over 5 take 5 mg twice a day, up to three times. The extended-release tablets are labeled for overactive bladder with urge incontinence, urgency and frequency, starting at 5 or 10 mg once a day and rising by 5 mg at about weekly intervals to no more than 30 mg, and for children 6 and older with symptoms of detrusor overactivity from a neurological condition such as spina bifida, from 5 mg up to 20 mg a day. The prescription Oxytrol patch is labeled for overactive bladder with urge incontinence, urgency and frequency in men.

There is no boxed warning. Oxybutynin must not be taken with urinary retention, gastric retention or other severely slowed gut movement, uncontrolled narrow-angle glaucoma, a risk of any of these, or an allergy to it. Angioedema (swelling of the face, lips, tongue or throat) has been reported; swelling of the tongue or throat can be life-threatening and means stopping it at once. Anticholinergic effects on the brain, such as hallucinations, agitation, confusion and sleepiness, are watched for, particularly in the first few months after starting or raising the dose, and people should not drive until they know how it affects them. It is used with caution in dementia treated with cholinesterase inhibitors, Parkinson’s disease, myasthenia gravis, bladder outflow obstruction, and gut obstruction, ulcerative colitis or reflux. Because it reduces sweating, heat prostration (fever and heat stroke) can occur in high temperatures. The most common side effects of the extended-release tablets are dry mouth, constipation, diarrhea, headache, sleepiness and dizziness.

Extended-release tablets must be swallowed whole, so they are not for children under 6 or children who cannot do that, and something that looks like a tablet (the empty shell) may appear in the stool. The Oxytrol patch delivers 3.9 mg a day and is changed twice a week; its most common side effects are skin reactions where it is worn and dry mouth, and bathing, swimming or exercise does not change its effect. Oxytrol for Women, the same strength changed every 4 days, is sold over the counter to women 18 and older; its label says men, and anyone with painful urination, blood in the urine or leaks only on coughing, sneezing or laughing, should not use it.

Taking Oxybutynin

How to take it

Take tablets or liquid two to four times a day, as prescribed. Swallow extended-release tablets whole with liquid once a day, with or without food; do not chew, divide or crush them. Apply a patch to dry, intact skin on the abdomen, hip or buttock twice a week, every 3 or 4 days (Oxytrol for Women every 4 days), at a new site each time and not on the same site within 7 days; do not cut it.

If you miss a dose

Take a missed tablet or liquid dose as soon as you remember, unless it is almost time for the next one; then skip it. Do not take a double dose. For a patch, replace it on a different spot as soon as you remember, and never wear more than one at a time.

Storage

At room temperature, away from excess heat and moisture, out of reach of children. Keep patches sealed in their pouches until use.

Interactions to know about

Other anticholinergic drugs, and medicines that cause dry mouth, constipation or drowsiness, add to its effects, and alcohol can increase drowsiness. The strong CYP3A4 inhibitor ketoconazole raised its levels, and the labels advise caution with itraconazole, miconazole, erythromycin and clarithromycin. It may weaken prokinetic drugs such as metoclopramide, and is used with caution alongside drugs that can irritate the esophagus, such as bisphosphonates.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Oxybutynin differs from pharmacy to pharmacy

Immediate-release and extended-release tablets each come from many generic makers, and the liquid from fewer, so quotes for the same prescription differ by each pharmacy’s fee and markup and by whether oxybutynin is on its flat-price generic list. The pharmacist fills the form written, and the prescription Oxytrol patch, which has no generic, is quoted as a brand.

Ways to pay less for Oxybutynin without insurance

• Ask whether oxybutynin is on the pharmacy’s flat-price generic list, and compare more than one pharmacy.
• Once your dose is settled, ask the prescriber whether a ninety-day supply suits you.
• If you use the prescription patch, which has no generic, ask the prescriber whether a generic tablet would suit you; the pharmacist cannot switch forms alone.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Oxybutynin

1. 1.Is my tablet immediate-release or extended-release, and how often do I take it?
2. 2.Do any of my medicines add to dry mouth, constipation or drowsiness?
3. 3.How do I avoid overheating in hot weather while I take it?
4. 4.Where should I put my patch, and how often do I change it?

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