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oxybutynin chloride

(ox i byoo' ti nin)


Albert Oxybutynin (CAN), Apo-Oxybutynin (CAN), Ditropan, Ditropan XL,
Novo-Oxybutynin (CAN), Oxytrol

Pregnancy Category B

Drug classes
Anticholinergic
Urinary antispasmodic

Therapeutic actions
Acts directly to relax smooth muscle and inhibits the effects of acetylcholine at
muscarinic receptors; reported to be less potent an anticholinergic than atropine but more
potent as antispasmodic and devoid of antinicotinic activity at skeletal neuromuscular
junctions or autonomic ganglia.

Indications
• Relief of symptoms of bladder instability associated with voiding in patients with
uninhibited neurogenic and reflex neurogenic bladder
• ER tablets: Treatment of signs and symptoms of overactive bladder (incontinence,
urgency, frequency)

Contraindications and cautions


• Contraindicated with allergy to oxybutynin, pyloric or duodenal obstruction,
obstructive intestinal lesions or ileus, intestinal atony, megacolon, colitis,
obstructive uropathies, glaucoma, myasthenia gravis, CV instability in acute
hemorrhage.
• Use cautiously with hepatic, renal impairment; pregnancy; lactation.

Available forms
Tablets—5 mg; syrup—5 mg/5 mL; ER tablets—5, 10, 15 mg; transdermal patch—
3.9 mg/day

Dosages
ADULTS
5 mg PO bid or tid. Maximum dose is 5 mg qid. ER tablets—5 mg PO daily, up to a
maximum of 30 mg/day; transdermal patch—one patch per day applied to dry, intact skin
on the abdomen, hip, or buttock every 3–4 days.
PEDIATRIC PATIENTS > 5 YR
5 mg PO bid. Maximum dose is 5 mg tid.

Pharmacokinetics
Route Onset Peak Duration
Oral 30–60 min 3–6 hr 6–10 hr
Transdermal 24–48 hr Varies 96 hr
Metabolism: Hepatic; T1/2: Unknown
Distribution: Crosses placenta; may enter breast milk
Excretion: Urine

Adverse effects
• CNS: Drowsiness, dizziness, blurred vision, dilatation of the pupil, cycloplegia,
increased ocular tension, weakness
• CV: Tachycardia, palpitations
• GI: Dry mouth, nausea, vomiting, constipation, bloated feeling
• GU: Urinary hesitancy, retention, impotence
• Hypersensitivity: Allergic reactions including urticaria, dermal effect
• Other: Decreased sweating, heat prostration in high environmental temperatures
secondary to loss of sweating

Interactions
Drug-drug
• Decreased effectiveness of phenothiazines with oxybutynin
• Decreased effectiveness of haloperidol and development of tardive dyskinesia
• Increased toxicity if combined with amantadine, nitrofurantoin

Nursing considerations
Assessment
• History: Allergy to oxybutynin, intestinal obstructions or lesions, intestinal atony,
obstructive uropathies, glaucoma, myasthenia gravis, CV instability in acute
hemorrhage, hepatic or renal impairment, pregnancy, lactation
• Physical: Skin color, lesions; T; orientation, affect, reflexes; ophthalmologic
exam, ocular pressure measurement; P, rhythm, BP; bowel sounds, liver
evaluation; renal and liver function tests, cystometry

Interventions
• Arrange for cystometry and other diagnostic tests before and during treatment.
• Arrange for ophthalmologic exam before therapy and periodically during therapy.

Teaching points
• Take this drug as prescribed.
• If using the transdermal patch, apply to dry, intact skin on the abdomen, hip, or
buttock every 3–4 days (twice weekly). Remove the old system before applying a
new one. Select a new site for application of each new system.
• Periodic bladder exams will be needed during this treatment to evaluate
therapeutic response.
• These side effects may occur: Dry mouth (suck sugarless lozenges and use
frequent mouth care); GI upset; blurred vision; drowsiness (avoid driving or
performing tasks that require alertness); decreased sweating (avoid high
temperatures; serious complications can occur because you will be heat
intolerant).
• Report blurred vision, fever, rash, nausea, vomiting.
Adverse effects in Italic are more common; those in Bold are life-threatening.