New Topical Gel for the Treatment of Overactive Bladder

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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Update: The oxybutynin 3% gel was released in spring 2012, under the name Gelnique instead of Anturol.

The FDA has just approved the first topical gel for the treatment of overactive bladder (OAB) and this could bring relief for those experiencing side effects from the current oral medications. A topical oxybutynin 3% gel called Anturol will be available in the upcoming months for the treatment of overactive bladder associated with urinary urgency, frequency, and urge incontinence.

Anturol is a clear gel available in a metered-dose pump. The active ingredient is delivered through the skin (transdermally), so it is not metabolized by the liver, which results in fewer side effects, such as dry mouth and constipation.

Currently, Vesicare, Toviaz, Detrol LA, and Ditropan XL (oral oxybutynin) are medications taken by mouth for overactive bladder that tend to have side effects like constipation and dry mouth, so this may be a good alternative.

The approval of this Anturol (oxybutynin) gel was granted because studies showed patients who used it had less OAB symptoms including urinary incontinence.

Anturol was well-tolerated in the study. The most frequently reported treatment-related adverse events were dry mouth (12.1% vs. 5% with placebo) and redness at the site, which was rare. It is applied once daily to the thigh, abdomen, upper arm, or shoulder.

While I imagine it will be more expensive when it first launches (though Toviaz and Vesicare are pricey too), it is a tempting switch for those experiencing dry mouth and constipation from their current oral OAB meds.

Dr O.

Oxybutynin and oxybutynin er are currently available in liquid and tablet form, for as little as $4 for a 30-day supply. They’re considered Tier 1 drugs by most insurance companies, falling under the lowest co-pay. Ditropan XL may not be covered by some insurance companies, as oxybutynin is available as a generic alternative, but Toviaz and Vesicare are typically Tier 2 or Tier 3 medications, meaning a moderate to high co-pay. Cash prices for Ditropan XL run about $125 – $150 for a 30-day supply, while Toviaz and Vesicare are a bit more expensive at $150 – $200 for a 30-day supply.

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