Names and pronunciation
(ox-i-byoo′ti-nin) Ditropan XL, Gelnique, Oxytrol
Source page 997
Loading InternPractice…
Individual generic drug information
Extracted information for oxybutynin only.
(ox-i-byoo′ti-nin) Ditropan XL, Gelnique, Oxytrol
Source page 997
Func. class.: Anticholinergic, urinary antispasmodic
Source page 997
Chem. class.: Synthetic tertiary amine
Source page 997
Do not confuse: Ditropan/diazePAM/Diprivan
Source page 997
ACTION: Relaxes smooth muscles in urinary tract by inhibiting acetylcholine at postganglionic sites
Source page 997
USES: Antispasmodic for neurogenic bladder, overactive bladder in females (OTC)
Source page 997
Extracted information for oxybutynin only.
CONTRAINDICATIONS: Hyper- sensitivity, GI obstruction, urinary reten- tion, glaucoma, severe colitis, myasthe- nia gravis, unstable CV disease Precautions: Pregnancy, breastfeed- ing, children <12 yr, geriatric patients, suspected glaucoma, cardiac disease, dementia O
Source page 997
SIDE EFFECTS CNS: Anxiety, restlessness, dizziness, somnolence, insomnia, nervousness, sei- zures, headache, drowsiness, confusion CV: Palpitations, sinus tachycardia, hypertension, peripheral edema, QT prolongation EENT: Blurred vision, dry eyes, increased intraocular tension, dry mouth, dry throat GI: Nausea, vomiting, anorexia, abdominal pain, constipation, dyspep- sia, diarrhea, taste perversion, GERD GU: Dysuria, impotence, urinary reten- tion, hesitancy MISC: Hyperthermia, anaphylaxis, angio- edema
Source page 998
INTERACTIONS • Altered pharmacokinetic parameters: CYP3A4 inhibitors Increase: CNS depression—benzodiaze- pines, sedatives, hypnotics, opioids Increase: levels of atenolol, digoxin, nitrofurantoin Increase: anticholinergic effects—antihista- mines, amantadine, other anticholinergics Increase or decrease: levels of pheno- thiazines Decrease: levels of acetaminophen, halo- peridol, levodopa Decrease: effects of oxybutynin— CYP3A4 inducers
Source page 998
Extracted information for oxybutynin only.
DOSAGE AND ROUTES Overactive bladder • Adults: PO IR 5 mg bid-tid, max: 5 mg qid • Geriatric: PO IR 2.5 mg bid-tid, max: 5 mg qid • Child 5-12 yr: PO IR 5 mg bid, max: 5 mg tid • Adults: PO EXT REL 5-10 mg daily, adjust weekly by 5-mg increments max: 30 mg/day • Child/adolescent 6-17 yr: PO EXT REL 5 mg daily, adjust weekly by 5-mg increments, max: 20 mg/day; symptoms of detrusor overactivity associated with a neurologic condition (spina bifida) • Adults: TD apply 1 patch (3.9 mg/ day) twice weekly to the abdomen, hip, or buttock; rotate patch site at each ap- plication • Adults: TOP Apply the contents of 1 sachet/actuation of the metered-dose pump daily; apply to the abdomen, upper arms/shoulders, or thighs; rotate sites of application; the same site should not be used on consecutive days
Source pages 997, 998
Available forms: Syr 5 mg/5 mL; tabs 5 mg; ext rel tabs 5, 10, 15 mg; TD 3.9 mg/ day; top gel 10% (Gelnique)
Source page 998
Administer: PO route • Do not crush, break, or chew ext rel tabs • Without regard to meals Topical route • Wash hands; apply to clean, dry intact skin on abdomen, upper arms/shoul- ders, thighs; avoid navel, rotate sites • Squeeze contents into palm of hand or directly on site, rub gently • Do not bathe, exercise, swim for 1 hr after application • Allow to dry before putting on clothing • Do not be near flame, fire, or smoke until gel has dried • Delivers 100 mg Transdermal route • Apply to clean, dry intact skin on abdo- men, hip, buttock; use firm pressure; not affected by showering/bathing; rotate sites • Delivers 3.9 mg/day
Source page 998
Extracted information for oxybutynin only.
Assess: • Urinary patterns: distention, nocturia, frequency, urgency, incontinence, I&O ratios; cystometry to diagnose dysfunc- tion, urinary tract infections should be treated • Allergic reactions: rash, urticaria; if these occur, product should be discon- tinued; angioedema: swelling of face, tongue, throat • QT prolongation: ECG for QT prolonga- tion, ejection fraction; assess for chest pain, palpitations, dyspnea • CNS effects: confusion, anxiety; anti- cholinergic effects in geriatric patients • Pregnancy/breastfeeding: use only if benefit outweighs risks; cautious use in breastfeeding, excretion unknown • Beers: avoid in older adults; delirium risk is increased
Source page 998
Evaluate: • Absence of dysuria, frequency, noctu- ria, incontinence
Source page 998
CLINICAL CONSIDERATIONS
Source page 998
Patient and caregiver information: • To avoid hazardous activities because dizziness, blurred vision may occur • To avoid OTC medications with alco- hol, other CNS depressants • To avoid hot weather, strenuous activity because product decreases perspiration • About the correct application of each product form • Transdermal: change patch 2×/wk; do not use same site within 7 days; dispose of and use container not accessible to pets/children • To open patch immediately before using • Do not use during MRI, remove • Topical gel • Rotate sites • Apply to clean, dry skin on abdomen, upper arm/shoulders/thighs • Gel is flammable HIGH ALERT
Source pages 998, 999
Extracted information for oxybutynin only.
PHARMACOKINETICS Onset 1⁄2-1 hr, peak 3-6 hr, duration 6-10 hr; metabolized by liver, excreted in urine; terminal half-life 2-3 hr
Source page 998
Filter the extracted dose blocks for this individual drug.
Overactive bladder
• Adults: PO IR 5 mg bid-tid, max: 5 mg qid
Candidate age grouping · source pages 997, 998
Overactive bladder
• Geriatric: PO IR 2.5 mg bid-tid, max: 5 mg qid
Candidate age grouping · source pages 997, 998
Overactive bladder
• Child 5-12 yr: PO IR 5 mg bid, max: 5 mg tid
Candidate age grouping · source pages 997, 998
Overactive bladder
• Adults: PO EXT REL 5-10 mg daily, adjust weekly by 5-mg increments max: 30 mg/day
Candidate age grouping · source pages 997, 998
Overactive bladder
• Child/adolescent 6-17 yr: PO EXT REL 5 mg daily, adjust weekly by 5-mg increments, max: 20 mg/day; symptoms of detrusor overactivity associated with a neurologic condition (spina bifida)
Candidate age grouping · source pages 997, 998
Overactive bladder
• Adults: TD apply 1 patch (3.9 mg/ day) twice weekly to the abdomen, hip, or buttock; rotate patch site at each ap- plication
Candidate age grouping · source pages 997, 998
Overactive bladder
• Adults: TOP Apply the contents of 1 sachet/actuation of the metered-dose pump daily; apply to the abdomen, upper arms/shoulders, or thighs; rotate sites of application; the same site should not be used on consecutive days
Candidate age grouping · source pages 997, 998