Oxybutynin (Ditropan) 💊
💊 Oxybutynin is used for urge incontinence rather than stress incontinence.
It can be trialled in short courses for urge or mixed stress/urge incontinence.
📖 About
Always check the BNF link here for up-to-date guidance.
- Antimuscarinic drug → reduces involuntary bladder contractions.
- One of the oldest agents in this class; higher CNS side-effect burden than newer alternatives (e.g. tolterodine, solifenacin).
⚙️ Mechanism of Action
- Muscarinic acetylcholine receptor antagonist.
- Relaxes detrusor muscle → increases bladder storage capacity.
- Reduces urgency, frequency, and urge leakage.
🎯 Indications
- Urinary frequency, urgency, and urge incontinence 🚻.
- May help in mixed stress/urge incontinence.
- Particularly useful when bladder overactivity is demonstrated.
💊 Dose
- Oxybutynin (Ditropan) 2.5–5 mg twice or three times daily.
- Maximum dose: 20 mg/day.
- Modified-release formulations available for once-daily dosing (may reduce side effects).
🔗 Interactions
- Avoid combining with other antimuscarinic agents (e.g. tricyclic antidepressants, antihistamines) → ↑ side effects.
- Caution with drugs prolonging the QT interval (risk additive).
⚠️ Cautions
- Myasthenia gravis (may worsen symptoms).
- Significant bladder outflow obstruction (risk of urinary retention 💧).
- Elderly: higher risk of confusion, delirium, cognitive decline 🧠.
⚠️ Side Effects
- Dry mouth, constipation, blurred vision 👁️.
- Urinary retention 💧.
- Tachycardia, flushing, palpitations ❤️.
- Cognitive impairment, confusion, hallucinations (elderly especially).
- QT interval prolongation → arrhythmia risk.
📚 References
- BNF – Oxybutynin
- NICE NG123 – Urinary incontinence and pelvic organ prolapse in women.
- Oxford Handbook of Urology.
