Drug reference

Oxybutynin hydrochloride

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 843, 844

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Urinary frequency | Urinary urgency | Urinary incontinence | Neurogenic bladder instability ▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES ▶Child 5–11 years: Initially 2.5–3 mg twice daily, increased to 5 mg 2–3 times a day ▶Child 12–17 years: Initially 5 mg 2–3 times a day, increased if necessary up to 5 mg 4 times a day ▶Adult: Initially 5 mg 2–3 times a day, increased if necessary up to 5 mg 4 times a day ▶Elderly: Initially 2.5–3 mg twice daily, increased if tolerated to 5 mg twice daily, adjusted according to response ▶BY MOUTH USING MODIFIED-RELEASE TABLETS ▶Child 5–17 years: Initially 5 mg once daily, adjusted in steps of 5 mg every week, adjusted according to continued → response; maximum 15 mg per day ▶Adult: Initially 5 mg once daily, increased in steps of 5 mg every week, adjusted according to response; maximum 20 mg per day Urinary frequency | Urinary urgency | Urinary incontinence ▶BY TRANSDERMAL APPLICATION USING PATCHES ▶Adult: Apply 1 patch twice weekly, patch is to be applied to clean, dry unbroken skin on abdomen, hip or buttock. Patch should be removed every 3–4 days and site replacement patch on a different area. The same area should be avoided for 7 days Nocturnal enuresis associated with overactive bladder Genito-urinary system ▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES ▶Child 5–17 years: 2.5–3 mg twice daily, increased to 5 mg 2–3 times a day, last dose to be taken before bedtime ▶BY MOUTH USING MODIFIED-RELEASE TABLETS ▶Child 5–17 years: Initially 5 mg once daily, adjusted in steps of 5 mg every week, adjusted according to response; maximum 15 mg per day DOSE EQUIVALENCE AND CONVERSION ▶Patients taking immediate-release oxybutynin may be transferred to the nearest equivalent daily dose of Lyrinel ® XL

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Cautions

Acute porphyrias p. 1120

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Prescribing And Dispensing Information

▶In adults The need for continuing therapy for urinary incontinence should be reviewed every 4–6 weeks until symptoms stabilise, and then every 6–12 months. ▶In children The need for therapy for urinary indications should be reviewed soon after it has been commenced and then at regular intervals; a response usually occurs within 6 months but may take longer.

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National Funding Access Decisions

Scottish Medicines Consortium (SMC) decisions ▶With transdermal use The Scottish Medicines Consortium has advised (August 2005) that Kentera ® should be restricted for use in patients who beneﬁt from oral oxybutynin but cannot tolerate its side-effects.

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Safety

Interactions

→Appendix 1: oxybutynin

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Side Effects

GENERAL SIDE-EFFECTS ▶Common or very common Diarrhoea SPECIFIC SIDE-EFFECTS ▶Common or very common ▶With oral use Dry eye ▶With transdermal use Gastrointestinal discomfort. increased risk of infection ▶Uncommon ▶With oral use Abdominal discomfort. appetite decreased. dysphagia ▶With transdermal use Back pain. hot ﬂush. injury ▶Frequency not known ▶With oral use Anxiety. arrhythmia. cognitive disorder. depressive symptom. drug dependence. gastrointestinal disorders. glaucoma. hallucination. heat stroke. hypohidrosis. mydriasis. nightmare. paranoia. photosensitivity reaction. seizure. urinary tract infection

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Pregnancy

Manufacturers advise avoid unless essential—toxicity in animal studies.

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Breast Feeding

Manufacturers advise avoid—present in milk in animal studies.

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Hepatic Impairment

Manufacturer advises caution.

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Renal Impairment

Manufacturer advises caution.

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Dose and formulations

Directions For Administration

▶With transdermal use Apply patches to clean, dry, unbroken skin on abdomen, hip or buttock, remove after every 3–4 days and site replacement patch on a different area (avoid using same area for 7 days).

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Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: oral suspension, oral solution Modified-release tablet CAUTIONARY AND ADVISORY LABELS 3, 25 ▶Lyrinel XL (Janssen-Cilag Ltd) Oxybutynin hydrochloride 5 mg Lyrinel XL 5mg tablets | 30 tablet P £13.77 DT = £13.77 Oxybutynin hydrochloride 10 mg Lyrinel XL 10mg tablets | 30 tablet P £27.54 DT = £27.54 Tablet CAUTIONARY AND ADVISORY LABELS 3 ▶Oxybutynin hydrochloride (Non-proprietary) Oxybutynin hydrochloride 2.5 mg Oxybutynin 2.5mg tablets | 56 tablet P £6.58 DT = £2.03 | 84 tablet P £2.96–£7.71 Oxybutynin hydrochloride 3 mg Oxybutynin 3mg tablets | 56 tablet P £17.91 DT = £17.82 Oxybutynin hydrochloride 5 mg Oxybutynin 5mg tablets | 56 tablet P £13.85 DT = £2.18 | 84 tablet P £3.27–£20.77 ▶Cystrin (Sanofi) Oxybutynin hydrochloride 5 mg Cystrin 5mg tablets | 84 tablet P £21.99 ▶Ditropan (Sanofi) Oxybutynin hydrochloride 2.5 mg Ditropan 2.5mg tablets | 84 tablet P £1.60 Oxybutynin hydrochloride 5 mg Ditropan 5mg tablets | 84 tablet P £2.90 Oral solution CAUTIONARY AND ADVISORY LABELS 3 ▶Oxybutynin hydrochloride (Non-proprietary) Oxybutynin hydrochloride 500 microgram per 1 ml Oxybutynin 2.5mg/5ml oral solution sugar free sugar-free | 150 ml P £214.84 DT = £214.77 Oxybutynin hydrochloride 1 mg per 1 ml Oxybutynin 5mg/5ml oral solution sugar free sugar-free | 150 ml P £235.53 DT = £235.53 Transdermal patch CAUTIONARY AND ADVISORY LABELS 3 ▶Kentera (Orion Pharma (UK) Ltd) Oxybutynin 3.9 mg per 24 hour Kentera 3.9mg/24hours patches | 8 patch P £27.20 DT = £27.20 eiiii F 820

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Clinical care

Patient And Carer Advice

▶With transdermal use Patients or carers should be given advice on how to administer oxybutynin transdermal patches. Medicines for Children leaflet: Oxybutynin for daytime urinary symptoms www.medicinesforchildren.org.uk/oxybutynin- daytime-urinary-symptoms

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Dose text by age group

Child 5–11 years

Initially 2.5–3 mg twice daily,

First-line fragment. Read the complete Indications and Dose section above.

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Child 12–17 years

Initially 5 mg 2–3 times a day,

First-line fragment. Read the complete Indications and Dose section above.

PDF page 843

Adult

Initially 5 mg 2–3 times a day, increased if

First-line fragment. Read the complete Indications and Dose section above.

PDF page 843

Elderly

Initially 2.5–3 mg twice daily, increased if

First-line fragment. Read the complete Indications and Dose section above.

PDF page 843

Child 5–17 years

Initially 5 mg once daily, adjusted in

First-line fragment. Read the complete Indications and Dose section above.

PDF page 843

Adult

Initially 5 mg once daily, increased in steps of

First-line fragment. Read the complete Indications and Dose section above.

PDF page 844

Adult

Apply 1 patch twice weekly, patch is to be

First-line fragment. Read the complete Indications and Dose section above.

PDF page 844

Child 5–17 years

2.5–3 mg twice daily, increased to

First-line fragment. Read the complete Indications and Dose section above.

PDF page 844

Child 5–17 years

Initially 5 mg once daily, adjusted in

First-line fragment. Read the complete Indications and Dose section above.

PDF page 844

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Oxybutynin hydrochloride

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 843, 844

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF pages 843, 844

Cautions

Acute porphyrias p. 1120

PDF page 844

Prescribing And Dispensing Information

PDF page 844

National Funding Access Decisions

PDF page 844

Safety

Interactions

→Appendix 1: oxybutynin

PDF page 844

Side Effects

PDF page 844

Pregnancy

Manufacturers advise avoid unless essential—toxicity in animal studies.

PDF page 844

Breast Feeding

Manufacturers advise avoid—present in milk in animal studies.

PDF page 844

Hepatic Impairment

Manufacturer advises caution.

PDF page 844

Renal Impairment

Manufacturer advises caution.

PDF page 844

Dose and formulations

Directions For Administration

PDF page 844

Medicinal Forms

PDF page 844

Clinical care

Patient And Carer Advice

PDF page 844

Dose text by age group

Child 5–11 years

Initially 2.5–3 mg twice daily,

First-line fragment. Read the complete Indications and Dose section above.

PDF page 843

Child 12–17 years

Initially 5 mg 2–3 times a day,

First-line fragment. Read the complete Indications and Dose section above.

PDF page 843

Adult

Initially 5 mg 2–3 times a day, increased if

First-line fragment. Read the complete Indications and Dose section above.

PDF page 843

Elderly

Initially 2.5–3 mg twice daily, increased if

First-line fragment. Read the complete Indications and Dose section above.

PDF page 843

Child 5–17 years

Initially 5 mg once daily, adjusted in

First-line fragment. Read the complete Indications and Dose section above.

PDF page 843

Adult

Initially 5 mg once daily, increased in steps of

First-line fragment. Read the complete Indications and Dose section above.

PDF page 844

Adult

Apply 1 patch twice weekly, patch is to be

First-line fragment. Read the complete Indications and Dose section above.

PDF page 844

Child 5–17 years

2.5–3 mg twice daily, increased to

First-line fragment. Read the complete Indications and Dose section above.

PDF page 844

Child 5–17 years

Initially 5 mg once daily, adjusted in

First-line fragment. Read the complete Indications and Dose section above.

PDF page 844

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.