oxybutynin (Rx)

Brand and Other Names:Ditropan XL

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 5mg

tablet, extended-release

  • 5mg
  • 10mg
  • 15mg

syrup

  • 5mg/5mL

Overactive Bladder

Relief of symptoms (eg, urge incontinence, frequency, urgency) in patients with uninhibited neurogenic or reflex neurogenic bladder

Immediate-release: 5 mg PO twice/three times daily; not to exceed 5 mg PO four times daily

Extended-release: 5-10 mg/day PO; may be increased by 5 mg/day at weekly intervals; not to exceed 30 mg/day

Dose Modifications

Renal Impairment

  • Not studied; use caution

Hepatic Impairment

  • Not studied; use caution

Dosage Forms & Strengths

tablet

  • 5mg

tablet, extended-release

  • 5mg
  • 10mg
  • 15mg

syrup

  • 5mg/5mL

Detrusor Overactivity

Bladder overactivity associated with a neurologic condition (eg, spina bifida)

≥5 years (immediate-release): 5 mg PO q12hr; may be increased to 5 mg PO q8hr

≥6 years (extended-release): 5 mg/day PO initially; may be increased by 5 mg/day at weekly intervals; not to exceed 20 mg/day

Overactive Bladder

Relief of symptoms (eg, urge incontinence, frequency, urgency) in patients with uninhibited neurogenic or reflex neurogenic bladder

Immediate-release: Initiate at lower dosage in frail elderly; 2.5 mg PO q8-12hr initially; may be increased to 5 mg q8-12hr if warranted

Extended-release: 5-10 mg PO qDay; pharmacokinetics similar to adults in elderly up to age 78 yr

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Interactions

Interaction Checker

and oxybutynin

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              Serious - Use Alternative (7)

              • lonafarnib

                oxybutynin will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown.

              • metoclopramide intranasal

                oxybutynin, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.

              • olopatadine intranasal

                oxybutynin and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

              • potassium chloride

                potassium chloride, oxybutynin. Other (see comment). Avoid or Use Alternate Drug. Comment: Patients using drugs with extensive anticholinergic effects should avoid concomitant use with solid oral dosage forms of potassium chloride. May use effervescent potassium preparations as alternatives. .

              • pramlintide

                pramlintide, oxybutynin. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.

              • ropeginterferon alfa 2b

                ropeginterferon alfa 2b and oxybutynin both increase Other (see comment). Avoid or Use Alternate Drug. Narcotics, hypnotics or sedatives can produce additive neuropsychiatric side effects. Avoid use and monitor patients receiving the combination for effects of excessive CNS toxicity.

              • secretin

                oxybutynin decreases effects of secretin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Concomitant use of anticholinergic drugs may cause a hyporesponse to stimulation testing with secretin. Discontinue anticholinergic drugs at least 5 half-lives before administering secretin.

              Monitor Closely (128)

              • abobotulinumtoxinA

                abobotulinumtoxinA increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects.

              • aclidinium

                oxybutynin and aclidinium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • amantadine

                oxybutynin, amantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Potential for increased anticholinergic adverse effects.

              • amitriptyline

                oxybutynin and amitriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • amoxapine

                oxybutynin and amoxapine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • anticholinergic/sedative combos

                anticholinergic/sedative combos and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • aripiprazole

                oxybutynin decreases levels of aripiprazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin decreases levels of aripiprazole by pharmacodynamic antagonism. Use Caution/Monitor.

                aripiprazole increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • atracurium

                atracurium and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • atropine

                atropine and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • atropine IV/IM

                atropine IV/IM and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • avapritinib

                oxybutynin will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • axitinib

                oxybutynin increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • belladonna alkaloids

                belladonna alkaloids and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • belladonna and opium

                belladonna and opium and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • benperidol

                oxybutynin decreases levels of benperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin decreases levels of benperidol by pharmacodynamic antagonism. Use Caution/Monitor.

                benperidol increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • benztropine

                benztropine and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor. Additive anticholinergic adverse effects may be seen with concurrent use.

              • bethanechol

                bethanechol increases and oxybutynin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • carbachol

                carbachol increases and oxybutynin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • carbamazepine

                carbamazepine will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

                oxybutynin will increase the level or effect of carbamazepine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor plasma levels when used concomitantly

              • cenobamate

                cenobamate, oxybutynin. Either increases effects of the other by sedation. Use Caution/Monitor.

              • cevimeline

                cevimeline increases and oxybutynin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • chlorpromazine

                oxybutynin decreases levels of chlorpromazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin decreases levels of chlorpromazine by pharmacodynamic antagonism. Use Caution/Monitor.

                chlorpromazine increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • cimetidine

                cimetidine will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • cisatracurium

                cisatracurium and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • clarithromycin

                clarithromycin will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • clomipramine

                oxybutynin and clomipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • clozapine

                oxybutynin decreases levels of clozapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin decreases levels of clozapine by pharmacodynamic antagonism. Use Caution/Monitor.

                clozapine increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • cyclizine

                cyclizine and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • cyclobenzaprine

                cyclobenzaprine and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • daridorexant

                oxybutynin and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.

              • darifenacin

                darifenacin and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • desipramine

                oxybutynin and desipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • dicyclomine

                dicyclomine and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • difelikefalin

                difelikefalin and oxybutynin both increase sedation. Use Caution/Monitor.

              • diltiazem

                diltiazem will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • diphenhydramine

                diphenhydramine and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • donepezil

                donepezil increases and oxybutynin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • donepezil transdermal

                donepezil transdermal, oxybutynin. Either decreases effects of the other by pharmacodynamic antagonism. Use Caution/Monitor.

              • dosulepin

                oxybutynin and dosulepin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • doxepin

                oxybutynin and doxepin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • droperidol

                oxybutynin decreases levels of droperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin decreases levels of droperidol by pharmacodynamic antagonism. Use Caution/Monitor.

                droperidol increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • echothiophate iodide

                echothiophate iodide increases and oxybutynin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • erythromycin base

                erythromycin base will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • erythromycin ethylsuccinate

                erythromycin ethylsuccinate will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • erythromycin lactobionate

                erythromycin lactobionate will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • erythromycin stearate

                erythromycin stearate will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • fesoterodine

                fesoterodine and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • finerenone

                oxybutynin will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or weak CYP3A4 inhibitors. Adjust finererone dosage as needed.

              • flavoxate

                flavoxate and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • flibanserin

                oxybutynin will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors.

              • fluphenazine

                oxybutynin decreases levels of fluphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin decreases levels of fluphenazine by pharmacodynamic antagonism. Use Caution/Monitor.

                fluphenazine increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • galantamine

                galantamine increases and oxybutynin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • glycopyrrolate

                glycopyrrolate and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • glycopyrrolate inhaled

                glycopyrrolate inhaled and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • haloperidol

                oxybutynin decreases effects of haloperidol by pharmacodynamic antagonism. Use Caution/Monitor.

                oxybutynin decreases levels of haloperidol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                haloperidol increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • henbane

                henbane and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • homatropine

                homatropine and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • huperzine A

                huperzine A increases and oxybutynin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • hyoscyamine

                hyoscyamine and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • hyoscyamine spray

                hyoscyamine spray and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • iloperidone

                oxybutynin decreases levels of iloperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin decreases levels of iloperidone by pharmacodynamic antagonism. Use Caution/Monitor.

                iloperidone increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • imipramine

                oxybutynin and imipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • ipratropium

                ipratropium and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor. Due to the poor systemic absorption of ipratropium, interaction unlikely at regularly recommended dosages.

              • isavuconazonium sulfate

                oxybutynin will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • itraconazole

                itraconazole will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • ivacaftor

                oxybutynin increases levels of ivacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor when coadministered with weak CYP3A4 inhibitors .

              • ketoconazole

                ketoconazole will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • lemborexant

                oxybutynin will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification.

              • letermovir

                letermovir increases levels of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • levoketoconazole

                levoketoconazole will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • lofepramine

                oxybutynin and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • lomitapide

                oxybutynin increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.

              • loxapine

                oxybutynin decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor.

                loxapine increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • loxapine inhaled

                loxapine inhaled increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

                oxybutynin decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.

              • maprotiline

                oxybutynin and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • meclizine

                meclizine and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • methscopolamine

                methscopolamine and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • metoclopramide

                oxybutynin decreases effects of metoclopramide by pharmacodynamic antagonism. Use Caution/Monitor. May antagonize prokinetic effects.

              • midazolam intranasal

                oxybutynin will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.

                midazolam intranasal, oxybutynin. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.

              • nefazodone

                nefazodone will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • neostigmine

                neostigmine increases and oxybutynin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • nitrofurantoin

                oxybutynin increases levels of nitrofurantoin by unspecified interaction mechanism. Use Caution/Monitor.

              • nortriptyline

                oxybutynin and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • olanzapine

                oxybutynin decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor.

                olanzapine increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • onabotulinumtoxinA

                onabotulinumtoxinA and oxybutynin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • orphenadrine

                oxybutynin and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • oxybutynin topical

                oxybutynin and oxybutynin topical both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • oxybutynin transdermal

                oxybutynin and oxybutynin transdermal both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • paliperidone

                oxybutynin decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor.

                paliperidone increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • pancuronium

                oxybutynin and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • perphenazine

                oxybutynin decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor.

                perphenazine increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • physostigmine

                physostigmine increases and oxybutynin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • pilocarpine

                pilocarpine increases and oxybutynin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • pimozide

                oxybutynin decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor.

                pimozide increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • pralidoxime

                oxybutynin and pralidoxime both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • prochlorperazine

                oxybutynin decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor.

                prochlorperazine increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • promethazine

                oxybutynin decreases levels of promethazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin decreases levels of promethazine by pharmacodynamic antagonism. Use Caution/Monitor.

                promethazine increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • propantheline

                oxybutynin and propantheline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • protriptyline

                oxybutynin and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • pyridostigmine

                pyridostigmine increases and oxybutynin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • quetiapine

                oxybutynin decreases levels of quetiapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin decreases levels of quetiapine by pharmacodynamic antagonism. Use Caution/Monitor.

                quetiapine increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • rapacuronium

                oxybutynin and rapacuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • ribociclib

                ribociclib will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • rifabutin

                rifabutin will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • rifampin

                rifampin will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • rimantadine

                oxybutynin, rimantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced CNS side effects.

              • risperidone

                oxybutynin decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor.

                risperidone increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • rivastigmine

                oxybutynin and rivastigmine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • rocuronium

                oxybutynin and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • scopolamine

                oxybutynin and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • solifenacin

                oxybutynin and solifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • St John's Wort

                St John's Wort will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • stiripentol

                stiripentol, oxybutynin. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.

              • succinylcholine

                succinylcholine increases and oxybutynin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.

              • tazemetostat

                oxybutynin will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • thioridazine

                oxybutynin decreases levels of thioridazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin decreases levels of thioridazine by pharmacodynamic antagonism. Use Caution/Monitor.

                thioridazine increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • thiothixene

                oxybutynin decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor.

                thiothixene increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • tinidazole

                oxybutynin will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • tiotropium

                oxybutynin and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • tolterodine

                oxybutynin and tolterodine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • trazodone

                oxybutynin and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • trifluoperazine

                oxybutynin decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor.

                trifluoperazine increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • trihexyphenidyl

                oxybutynin and trihexyphenidyl both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.

              • trimipramine

                oxybutynin and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • trospium chloride

                oxybutynin and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • vecuronium

                oxybutynin and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.

              • ziprasidone

                oxybutynin decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor.

                ziprasidone increases effects of oxybutynin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.

              • zotepine

                oxybutynin decreases levels of zotepine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

                oxybutynin decreases levels of zotepine by pharmacodynamic antagonism. Use Caution/Monitor.

              Minor (77)

              • acetaminophen

                oxybutynin decreases levels of acetaminophen by unspecified interaction mechanism. Minor/Significance Unknown.

              • acetaminophen IV

                oxybutynin decreases levels of acetaminophen IV by unspecified interaction mechanism. Minor/Significance Unknown.

              • acetaminophen rectal

                oxybutynin decreases levels of acetaminophen rectal by unspecified interaction mechanism. Minor/Significance Unknown.

              • amantadine

                amantadine increases effects of oxybutynin by pharmacodynamic synergism. Minor/Significance Unknown.

              • amobarbital

                amobarbital will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • aprepitant

                aprepitant will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • armodafinil

                armodafinil will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • artemether/lumefantrine

                artemether/lumefantrine will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • atazanavir

                atazanavir will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • atenolol

                atenolol increases levels of oxybutynin by decreasing metabolism. Minor/Significance Unknown.

              • bosentan

                bosentan will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • budesonide

                budesonide will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • butabarbital

                butabarbital will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • butalbital

                butalbital will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • chlorpromazine

                oxybutynin increases toxicity of chlorpromazine by unspecified interaction mechanism. Minor/Significance Unknown.

              • conivaptan

                conivaptan will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • cortisone

                cortisone will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • darifenacin

                darifenacin will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • darunavir

                darunavir will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • dasatinib

                dasatinib will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • deferasirox

                deferasirox will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • dexamethasone

                dexamethasone will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • DHEA, herbal

                DHEA, herbal will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • digoxin

                oxybutynin increases levels of digoxin by unspecified interaction mechanism. Minor/Significance Unknown.

              • dimenhydrinate

                dimenhydrinate increases toxicity of oxybutynin by pharmacodynamic synergism. Minor/Significance Unknown. Additive anticholinergic effects.

              • donepezil

                donepezil decreases effects of oxybutynin by pharmacodynamic antagonism. Minor/Significance Unknown.

              • dronedarone

                dronedarone will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • efavirenz

                efavirenz will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • eslicarbazepine acetate

                eslicarbazepine acetate will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • etravirine

                etravirine will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • fluconazole

                fluconazole will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • fludrocortisone

                fludrocortisone will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • fluphenazine

                oxybutynin increases toxicity of fluphenazine by unspecified interaction mechanism. Minor/Significance Unknown.

              • fosamprenavir

                fosamprenavir will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • fosaprepitant

                fosaprepitant will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • fosphenytoin

                fosphenytoin will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • galantamine

                galantamine decreases effects of oxybutynin by pharmacodynamic antagonism. Minor/Significance Unknown.

              • grapefruit

                grapefruit will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • griseofulvin

                griseofulvin will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • hydrocortisone

                hydrocortisone will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • indinavir

                indinavir will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • isoniazid

                isoniazid will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • lapatinib

                lapatinib will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • levodopa

                oxybutynin, levodopa. Other (see comment). Minor/Significance Unknown. Comment: Anticholinergic agents may enhance the therapeutic effects of levodopa; however, anticholinergic agents can exacerbate tardive dyskinesia. In high dosage, anticholinergics may decrease the effects of levodopa by delaying its GI absorption. .

              • lumefantrine

                lumefantrine will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • marijuana

                marijuana will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • methylprednisolone

                methylprednisolone will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • metronidazole

                metronidazole will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • miconazole vaginal

                miconazole vaginal will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • nelfinavir

                nelfinavir will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • nevirapine

                nevirapine will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • nifedipine

                nifedipine will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • nilotinib

                nilotinib will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • oxcarbazepine

                oxcarbazepine will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • pentobarbital

                pentobarbital will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • perphenazine

                oxybutynin increases toxicity of perphenazine by unspecified interaction mechanism. Minor/Significance Unknown.

              • phenobarbital

                phenobarbital will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • phenytoin

                phenytoin will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • posaconazole

                posaconazole will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • prednisone

                prednisone will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • primidone

                primidone will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • prochlorperazine

                oxybutynin increases toxicity of prochlorperazine by unspecified interaction mechanism. Minor/Significance Unknown.

              • promazine

                oxybutynin increases toxicity of promazine by unspecified interaction mechanism. Minor/Significance Unknown.

              • promethazine

                oxybutynin increases toxicity of promethazine by unspecified interaction mechanism. Minor/Significance Unknown.

              • quinupristin/dalfopristin

                quinupristin/dalfopristin will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • rifapentine

                rifapentine will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • ritonavir

                ritonavir will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • rufinamide

                rufinamide will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • ruxolitinib

                oxybutynin will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • ruxolitinib topical

                oxybutynin will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • secobarbital

                secobarbital will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • thioridazine

                oxybutynin increases toxicity of thioridazine by unspecified interaction mechanism. Minor/Significance Unknown.

              • topiramate

                topiramate will decrease the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • trifluoperazine

                oxybutynin increases toxicity of trifluoperazine by unspecified interaction mechanism. Minor/Significance Unknown.

              • verapamil

                verapamil will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • voriconazole

                voriconazole will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • zafirlukast

                zafirlukast will increase the level or effect of oxybutynin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

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              Adverse Effects

              >10%

              Dry mouth (21-71%)

              Constipation (7-15%)

              Somnolence (2-14%)

              Nausea (2-12%)

              1-10%

              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%)

              <1%

              Anorexia

              Fluid retention

              Hot flush

              Dysphonia

              Dysphagia

              Frequent bowel movements

              Chest discomfort

              Thirst

              Frequency Not Defined

              Cycloplegia

              Impairment of mental alertness

              Memory impairment

              Mydriasis

              Tachycardia

              QT prolongation

              Postmarketing reports

              Hallucinations

              Confusion

              Delirium

              Urinary tract infection

              Palpitations

              Nasal congestion

              Hypertension

              Concomitant use with carbamazepine

              • Vomiting
              • Drowsiness
              • Unsteadiness
              • Slurred speech
              • Nystagmus
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              Warnings

              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

              Cautions

              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)

              Caution with myasthenia gravis because of decreased cholinergic activity

              Caution with other anticholinergics (antimuscarinics); may increase risk for xerostomia, constipation, headache, dizziness, and blurred vision

              Somnolence reported with oxybutynin-containing products; use caution with activities requiring mental alertness

              May aggravate Parkinson disease symptoms

              Hallucinations or confusion may occur; monitor

              May exacerbate symptoms of heart failure, hypertension, and/or cardiac arrhythmias; use with caution

              May aggravate symptoms of dementia in patients cholinesterase inhibitors; use with caution

              Use with caution in patients with hiatal hernia

              The use of the extended release formulation has been associated (rare) with symptoms of obstruction in patients with known stricture/narrowing of the GI tract

              Before using over the counter product, consider other causes of frequent urination, including early pregnancy, diabetes, and other serious conditions; contact healthcare provider if symptoms do not improve with 2 weeks of initial use

              Avoid use in patients with myasthenia gravis because of decreased cholinergic activity; if experiencing exacerbation of symptoms of myasthenia gravis, oxybutynin-containing product should be discontinued and appropriate therapy promptly provided

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              Pregnancy & Lactation

              Pregnancy

              There are no studies with topical or oral oxybutynin use in pregnant women to inform a drug associated risk for birth defects or miscarriage; no adverse developmental outcomes observed in animal reproduction studies when administered to pregnant rats and rabbits during organogenesis at approximately 50 and 1 times, respectively, the maximum human dose based on body surface area

              Lactation

              There is no information on presence of drug in human milk, effects on breastfed child, or on milk production; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed child from therapy or from the underlying maternal condition

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Exerts antispasmodic and antimuscarinic effects on smooth muscle; delays desire to void, increases bladder capacity, and decreases uninhibited contraction; decreases frequency and urgency

              Absorption

              Bioavailability: 6% (~1.5-2 times higher for extended-release)

              Onset: 30-60 min

              Peak effect: 3-6 hr

              Duration: 6-10 hr

              Peak plasma time: <1 hr (immediate-release); 12 hr (extended release)

              Peak plasma concentration: Immediate-release, 3.6 ng/mL (R-) and 7.8 ng/mL (S-); extended-release, 1 ng/mL (R-) and 1.8 ng/mL (S-)

              Distribution

              Vd: 193 L

              Metabolism

              Metabolized in liver and gut by CYP3A4; converted to active metabolite N-desethyloxybutynin (DEO) by GI metabolic pathways, which are bypassed in transdermal delivery, resulting in lower DEO ratio

              Metabolites: DEO (active)

              Elimination

              Half-life: 2-3 hr (immediate-release); 12-13 hr (extended-release)

              Excretion: Urine

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              Oxytrol transdermal
              -
              3.9 mg/24 hr transdermal system
              Oxytrol transdermal
              -
              3.9 mg/24 hr transdermal system
              Gelnique transdermal
              -
              10 % (100 mg/gram) gel
              Gelnique transdermal
              -
              10 % (100 mg/gram) gel

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              oxybutynin transdermal

              OXYBUTYNIN - TRANSDERMAL

              (OX-i-BUE-ti-nin)

              COMMON BRAND NAME(S): Oxytrol

              USES: Oxybutynin is used to treat an overactive bladder. By relaxing the muscles in the bladder, oxybutynin improves symptoms such as the inability to control urination (incontinence), feeling that one has to urinate (urgency), and having to go to the bathroom often (frequency). This medication belongs to the class of drugs known as antispasmodics.This medication is not recommended for use in children younger than 5 years of age. Consult your doctor for more information.Unless otherwise directed by your doctor, the over-the-counter product should only be used by adult women who have symptoms of overactive bladder for at least 2 months.For over-the-counter products, carefully read the package instructions to make sure the product is right for you. Check the ingredients on the label even if you have used the product before. The manufacturer may have changed the ingredients. Also, products with similar names may contain different ingredients meant for different purposes. Taking the wrong product could harm you.

              HOW TO USE: If you are taking the over-the-counter product to self treat, read all directions on the product package before taking this medication. If your doctor has prescribed this medication, read the Patient Information Leaflet if available from your pharmacist before you start using oxybutynin and each time you get a refill. If your doctor has prescribed this medication, take it as directed. If you have any questions, consult your doctor or pharmacist.Apply one patch to your skin as directed by your doctor, usually every 3 to 4 days. If you are self-treating, apply one patch to your skin every 4 days. Follow the dosing schedule carefully.Remember to remove the old patch before applying a new patch.Apply the new patch to a different area of skin to prevent skin irritation. Do not apply a patch to the same area within 7 days.Before applying the patch, wash the area you will be using for the patch gently and thoroughly with soap and water. Rinse and dry with a clean dry towel.Do not open the sealed pouch container until you are ready to apply the patch. Open the pouch and remove the protective liner from the patch to expose the adhesive. Apply the patch to an area of clean, dry, smooth skin on the stomach (abdomen), hips, or buttocks. Press firmly to be sure the patch stays on. Apply to an area of skin that is under clothing and protected from sunlight. Avoid applying the patch on your waistline, since tight clothing may rub the patch off, or on areas where sitting may loosen it. Do not apply the patch to oily/red/cut/irritated/broken skin or skin covered with lotion or powder. Do not cut the patch into smaller sizes unless otherwise directed.Contact with water (such as swimming, bathing) will not change the way the patch works. Avoid rubbing the patch area during these activities.If the area around the patch becomes red, itchy, or irritated, try a new site. If irritation continues or becomes worse, tell your doctor promptly.If the patch falls off, reapply it or apply a new patch to a new area and continue on your same schedule.When it is time to apply a new patch, remove the old one and dispose of it properly in the trash. Fold the sticky sides of the patch together and throw it away where it cannot be accidentally worn or swallowed by others, especially a child or pet.The length of treatment is determined by your doctor, who may have you stop using the medication sometimes to see if you still need to use it.Use this medication regularly to get the most benefit from it. To help you remember, try to always change the patch on the same 2 days of the week. Do not increase your dose or use this drug more often or for longer than prescribed. Your condition will not improve any faster, and your risk of side effects will increase.Tell your doctor if your condition lasts or gets worse. If you are self-treating, tell your doctor if your condition does not improve after 2 weeks. If you think you may have a serious medical problem, get medical help right away.

              SIDE EFFECTS: Skin redness/itching/irritation at the application site, dry mouth, drowsiness, dizziness, blurred vision, headache, weakness, nausea or constipation may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.To relieve dry mouth, suck (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water or use a saliva substitute.To prevent constipation, eat dietary fiber, drink enough water, and exercise. You may also need to take a laxative. Ask your pharmacist which type of laxative is right for you.If your doctor has directed you to use this medication, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: vision problems (including eye pain), difficulty urinating, signs of kidney infection (such as burning/painful/frequent urination, lower back pain), fast/irregular heartbeat, mental/mood changes (such as confusion, hallucinations), fever, flushed/hot/dry skin, signs of stomach/intestinal blockage (such as nausea/vomiting that doesn't stop, severe stomach pain, severe constipation).A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before using oxybutynin, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: active internal bleeding, blockage/slowed movement of the stomach/intestines (such as gastric retention, paralytic ileus), certain bladder problems (urinary retention, bladder outflow obstruction, stress incontinence), glaucoma (narrow-angle), a certain muscle disease (myasthenia gravis), liver disease, high blood pressure, heart problems (such as coronary artery disease, congestive heart failure, arrhythmias), stomach/intestinal disease (such as acid reflux, hiatal hernia, ulcerative colitis, intestinal atony), kidney disease, loss of mental abilities (dementia), enlarged prostate, overactive thyroid (hyperthyroidism), a certain nervous system disorder (autonomic neuropathy), Parkinson's disease.In addition, before you self treat with this medication, tell your doctor if you have any of these signs of a more serious condition: signs of a bladder/kidney infection (such as burning/pain when you urinate, fever, pink/bloody urine), signs of diabetes (such as increased thirst, dizziness/fainting, vision changes, increased urination, wounds that are slow to heal).This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).This medication may make you sweat less, making you more likely to get heat stroke. Avoid doing things that may cause you to overheat, such as hard work or exercise in hot weather, or using hot tubs. When the weather is hot, drink a lot of fluids and dress lightly. If you overheat, quickly look for a place to cool down and rest. Get medical help right away if you have a fever that does not go away, mental/mood changes, headache, or dizziness.If you are going to have an MRI test, tell testing personnel that you are using this patch. Some patches may contain metals that can cause serious burns during an MRI. Ask your doctor whether you will need to remove your patch before the test and apply a new patch afterward, and how to do so properly.Older adults may be more sensitive to the side effects of this drug, especially drowsiness, confusion, constipation, trouble urinating. Drowsiness and confusion can increase the risk of falling.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: pramlintide, drugs that can irritate the esophagus/stomach (such as potassium tablets/capsules, oral bisphosphonates including alendronate, etidronate).Tell your doctor or pharmacist if you are using other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that can cause drowsiness, constipation or blurred vision. Ask your pharmacist about using those products safely.

              OVERDOSE: This medication patch may be harmful if chewed or swallowed. If someone has overdosed, remove the patch if possible. For serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: unusual excitement, agitation, fast/irregular heartbeat.

              NOTES: If your doctor has prescribed this medication for you, do not share it with others.Keep all medical and lab appointments.

              MISSED DOSE: If you are using this product on a regular schedule and forget to change the patch on the right day, remove the old patch and apply a new one as soon as you remember. Continue to follow your original schedule for changing the patch. Do not double the dose to catch up.

              STORAGE: Store at room temperature in the original sealed pouch away from heat, light, and moisture. Different brands of this medication have different storage needs. Check the product package for instructions on how to store your brand, or ask your pharmacist. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed (See also How to Use section). Consult your pharmacist or local waste disposal company.

              Information last revised January 2023. Copyright(c) 2023 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.