Oxybutynin Chloride

It exerts direct antispasmodic effect on smooth muscle and inhibits the muscarinic action of acetylcholine on smooth muscle. It also has a moderate anticholinergic effect, but exhibits four to ten times the antispasmodic effect.

Indications

Urinary incontinence, urgency and frequency due to neurogenic bladder disorders or Idiopathic detrusor instability. Catheter or transurethral surgery induced bladder spasm. Nocturnal enuresis.

Dosage

Adult: 5mg 2 or 3 times a day may be increased to a maximum of 5 mg 4 times daily. Elderly : 2.5 mg twice a day. May be titrated upward to a maximum of 5 mg two times a day. Children : Not recommended below age 5 years. Neurogenic bladder : 2.5 mg twice a day. May be titrated upwards to 5 mg 2 to 3 times a day. Noctural enuresis : 2.5 mg twice a day. May be titrated upwards to 5 mg two or three times a day.

Contra-Indications

Patients with intestinal obstruction or atony, severe ulcerative colitis or toxic megacolon, significant bladder outflow obstruction, glaucoma, myasthenia gravis.

Special Precautions

Frail elderly, hepatic or renal impairment, neuropathy, hyperthyroidism, cardiac disease where increase in rate is undesirable, prostatic hypertrophy, hiatus hernia with reflux oesophagitis, pregnancy and breast feeding, porphyria.

Side Effects

Dry mouth, constipation, blurred vision, nausea, abdominal discomfort, facial flushing, difficulty in micturition & drowsiness.

Drug Interactions

Co-administration with other anticholinergic drugs may cause increased anticholinergic effect. Occasional instances of interactions with phenothiazines, amantadine, butyrophenones, L-dopa, digitalis and tricyclic antidepressants.