oxybutynin ER
Oxybutynin is used to treat overactive bladder (OAB). Oral oxybutynin is available as a short-acting tablet and solution that is taken 2 to 4 times a day. It also comes as a long-acting tablet that's taken once daily (brand name Ditropan XL). Some common side effects of oxybutynin include dry mouth, constipation, and dizziness. Older adults typically lower doses of this medication to lower the risk for side effects.
What is Oxybutynin?
What is Oxybutynin used for?
- Overactive bladder
- Incontinence in children due to a neurologic (brain) condition, such as spina bifida
How Oxybutynin works
Oxybutynin is an anticholinergic and antimuscarinic medication that relaxes the muscles in your bladder. Relaxed bladder muscles have fewer spasms, and this eases your need to urinate.
Drug facts
Side effects of Oxybutynin
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Dry mouth (up to 71%)
- Dizziness (up to 17%)
- Constipation (up to 15%)
- Sleepiness (up to 14%)
- Nausea (up to 12%)
- Blurry vision (up to 10%)
Less Common Side Effects
- Difficulty urinating
- Headache
- Diarrhea
- Urinary tract infection
- Feeling nervous
- Heartburn
Oxybutynin serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Angioedema (severe swelling): swelling of the face, lips, tongue, or throat
More on Oxybutynin side effects
The following Oxybutynin side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
Clumsiness or unsteadiness
confusion
convulsions
dizziness
drowsiness (severe)
fainting
fast, slow, or irregular heartbeat
flushing or redness of the face
hallucinations (seeing, hearing, or feeling things that are not there)
troubled breathing
unusual excitement, nervousness, restlessness, or irritability
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Acid or sour stomach
belching
decreased sweating
difficulty having a bowel movement (stool)
drowsiness
dryness of the eyes, mouth, nose, or throat
indigestion
stomach discomfort, upset, or pain
Less common or rare
Blurred vision
decreased flow of breast milk
decreased sexual ability
difficulty in swallowing
feeling of warmth or heat
headache
increased sensitivity of the eyes to light
nausea or vomiting
trouble with sleeping
unusual tiredness or weakness
Incidence not known
Observed during clinical practice with oxybutynin; estimates of frequency cannot be determined
Bloating or swelling of the face, arms, hands, lower legs, or feet
decreased interest in sexual intercourse
inability to have or keep an erection
loss in sexual ability, desire, drive, or performance
rapid weight gain
tingling of the hands or feet
unusual weight gain or loss
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Oxybutynin
Pros
- Works well to improve symptoms of OAB
- Available as a convenient, once-daily tablet (Ditropan XL)
- Can be used in children as young as 5 years old
- Available as an oral liquid, good for people who have trouble swallowing tablets
Cons
- Commonly causes dry mouth as a side effect
- Higher risk of side effects in people age 65 and older
- Can cause dizziness and drowsiness
- Shouldn't be used by people who have untreated narrow-angle glaucoma, difficulty urinating, or movement problems with the stomach or intestines
Pharmacist tips for Oxybutynin
- Oxybutynin works best if it's taken at the same time(s) every day. You can take the medication with or without food.
- If you're taking the extended-release version of oxybutynin (Ditropan XL), don't break, crush, or chew the tablet.
- Side effects like dizziness, drowsiness, and blurred vision are common with oxybutynin. Avoid driving or any activities that require a lot of concentration until you know how this medication affects you. Taking the extended-release tablet before bed can help reduce the side effects you feel during the day.
- Drinking alcohol can worsen side effects of oxybutynin, like drowsiness and dizziness. You're recommended to avoid drinking alcohol while you're taking oxybutynin.
- You're more likely to experience side effects, like dizziness and drowsiness, if you're 65 years or older. This raises your risk of falling. Because of this, your provider will have you start with a very low dose of oxybutynin. Let your provider know if these side effects are severe..
- Dry mouth is a common reason people stop taking oxybutynin. Some things you can do to help with the dry mouth include sucking on ice, chewing gum, or rinsing your mouth with cold water. There are also mouthwashes, sprays, and lozenges available that can help manage this side effect.
- If you're taking short-acting oxybutynin and you experience very serious dry mouth, let your provider know. They might recommend the longer-acting version oxybutynin (Ditropan XL) for you because it's less likely to cause dry mouth.
- Oxybutynin can lower your body's ability to sweat, which is what your body does when it gets too hot. Be extra careful when you're exercising and during hot weather while you're taking this medication. This can raise your risk of overheating or having a heat stroke.
Common questions about Oxybutynin
In general, your body absorbs oxybutynin in 1 to 6 hours after you take it, depending on whether you're taking the short-acting or long-acting form. Keep in mind that if you're starting oxybutynin for the first time, it might take a few months before you and your provider find a dose that works for you. This is because your provider will have you start at a lower dose, then raise it slowly over time to see if your body can tolerate the side effects, such as dry mouth, constipation. If oxybutynin works for you, you should expect to feel less of an urge to go to the bathroom, and less urine leakage throughout the day. Your provider might recommend you to keep a void diary at the start of treatment so you can track how well oxybutynin is working.
Weight gain isn't a side effect reported by people who took oxybutynin in clinical trials. But few people did note holding on to more fluids, which might cause weight gain. Talk to your provider if you have concerns about your weight.
No. Oxybutynin isn't a narcotic, and it doesn't have potential for dependence or addiction. It won't directly help with pain, though it might give you some bladder pain relief by relaxing the muscles in the bladder.
The long-acting version of oxybutynin (Ditropan XL) is taken once daily, but you can take it at any time of the day, as long as it's about the same time every day. This will help keep the levels of medication steady in your body. If you have side effects like dizziness or drowsiness right after you take your dose, taking it at night might make it less likely to feel these effects during the day. The short-acting version of oxybutynin is taken 2 to 4 times a day, so it's best to space the doses out evenly during the time you're awake.
Don't suddenly stop taking oxybutynin without first talking with your provider. Stopping anticholinergic medications, such as oxybutynin, might lead to rebound symptoms, such as nausea, sweating, and the urge the urinate more often. If you want to stop oxybutynin, your provider can help you do so safely.
Dry mouth is a very common side effect of oxybutynin. The risk of having dry mouth goes up with higher doses of the medication. If you experience dry mouth, talk to your provider about what you can do to get relief. They can recommend possible options, such as chewing sugar-free gum or sipping cool liquids throughout the day.
Both oxybutynin and Myrbetriq (mirabegron) are used to treat overactive bladder, but they do so in different ways. (1) One main difference is side effects. Oxybutynin can cause more bothersome side effects than Myrbetriq (mirabegron), such as dry mouth and drowsiness. Oxybutynin might not be the best choice for older adults who are at higher risk for falls from these side effects. (2) Another difference is formulation. While Myrbetriq (mirabegron) is only available as the oral form, oxybutynin is also available in a patch and gel, in addition to the oral form. Talk with your provider if you've more questions about the differences between these medications.
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Risks and warnings for Oxybutynin
Oxybutynin can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Swelling of face, lips, tongue (angioedema)
Angioedema (swelling of the face, lips, tongue, throat, or other organs) can happen at any time while you're taking oxybutynin, and can make it difficult to breathe in more serious cases. Talk to your healthcare provider if you've any head or neck swelling that doesn't go away.
Hallucinations, drowsiness, and confusion
- Risk factors: Having nervous system conditions like Parkinson's disease | Taking medications for dementia | Taking higher doses of oxybutynin
Oxybutynin can cause side effects like confusion, drowsiness, and hallucinations. These side effects usually show up within the first few months of taking this medication or when your dose is raised. It's more common if you're taking higher doses of oxybutynin, are taking anticholinesterase medications for dementia, or if you have another condition that affects your nervous system like Parkinson's disease. Be careful driving or performing activities that require you to be alert until you know how the medication affects you. Tell your provider if you notice any of these side effects, as you might need a lower dose of oxybutynin or a different medication.
Worsening of other conditions
- Risk factors: History of myasthenia gravis | History of problems urinating | Certain gut-related conditions
Because of how this medication works and its possible side effects, oxybutynin can make symptoms of other medical conditions worse. For this reason, it should be used carefully if you have myasthenia gravis, trouble urinating, or certain conditions that affect your stomach and intestines, including ulcerative colitis or acid reflux.
Heat exhaustion
- Risk factors: Being outside in hot weather | Low fluids in the body | Exercising
Oxybutynin lowers your body's ability to sweat and respond to hot temperatures. This can cause your body to overheat, which can be dangerous in hot weather. It is possible for those taking oxybutynin to have heat exhaustion or a heat stroke during hot weather or while exercising. Stay well-hydrated in these situations and avoid hot temperatures if you can.
Oxybutynin dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 10mg | 30 tablets | $8.50 | $0.28 |
| 15mg | 90 tablets | $21.57 | $0.24 |
| 5mg | 90 tablets | $19.37 | $0.22 |
Typical dosage for Oxybutynin
-
- Adults: The typical starting dose is 5 mg to 10 mg by mouth once daily. The maximum dose is 30 mg daily.
- Children (ages 6 years and older): The typical starting dose is 5 mg by mouth once daily. The maximum dose is 20 mg daily.
-
Immediate-release tablets, oral syrup, and oral solution:
- Adults: The typical starting dose is 2.5 mg to 5 mg by mouth 2 to 3 times a day. The maximum dose is 5 mg by mouth 4 times a day.
- Children (older than 5 years old): The typical starting dose is 5 mg by mouth 2 times a day. The maximum dose is 5 mg by mouth 3 times a day.
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Interactions between Oxybutynin and other drugs
More on Oxybutynin interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Potassium
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Bupropion
- Clozapine
- Donepezil
- Glucagon
- Glycopyrrolate
- Glycopyrronium Tosylate
- Methacholine
- Quetiapine
- Revefenacin
- Scopolamine
- Secretin Human
- Tiotropium
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
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Oxybutynin contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Oxybutynin will not be safe for you to take.
- Difficulty urinating
- Movement problems in the stomach or intestines
- Uncontrolled narrow angle glaucoma
What are alternatives to Oxybutynin?
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