From the Guidelines
Oxybutynin is not the preferred treatment for urinary incontinence due to its high risk of discontinuation due to adverse effects, and alternative anticholinergic medications such as solifenacin or tolterodine should be considered first. The treatment of urinary incontinence with oxybutynin, an anticholinergic medication, is effective but associated with a higher risk of adverse effects compared to other pharmacologic therapies 1. The typical starting dose of oxybutynin is 5 mg taken orally twice daily, though some patients may begin with 2.5 mg two to three times daily to minimize side effects.
Key Considerations
- Oxybutynin works by blocking muscarinic receptors in the bladder, reducing involuntary detrusor muscle contractions and increasing bladder capacity.
- Common side effects include dry mouth, constipation, blurred vision, and drowsiness.
- This medication should be used cautiously in elderly patients and those with glaucoma, gastrointestinal obstructive disorders, or urinary retention.
- Patients should be advised to take the medication regularly, stay well-hydrated (though avoiding excessive fluids), and implement behavioral techniques such as scheduled voiding and pelvic floor exercises to maximize treatment effectiveness.
- Nonpharmacologic therapies, such as pelvic floor muscle training, bladder training, and weight loss, are also effective in managing urinary incontinence and may be considered as first-line treatment or in combination with pharmacologic therapies 1.
Alternative Treatments
- Solifenacin is associated with the lowest risk for discontinuation due to adverse effects and may be a preferred alternative to oxybutynin 1.
- Tolterodine has a similar efficacy to oxybutynin but with fewer harms and may also be considered as an alternative treatment 1.
- Darifenacin has a risk for discontinuation due to adverse effects similar to placebo and may be another option for patients who cannot tolerate other anticholinergic medications 1.
From the FDA Drug Label
Oxybutynin chloride extended release tablets are once-daily controlled-release tablets indicated for the treatment of overactive bladder with symptoms of urge urinary incontinence, urgency, and frequency. Oxybutynin chloride exerts a direct antispasmodic effect on smooth muscle and inhibits the muscarinic action of acetylcholine on smooth muscle. Oxybutynin thus decreases urgency and the frequency of both incontinent episodes and voluntary urination
The treatment for urinary incontinence with oxybutynin is to take oxybutynin chloride extended release tablets once daily to help control symptoms of overactive bladder, including urge urinary incontinence, urgency, and frequency 2, 2.
- Key benefits of oxybutynin include:
- Decreasing urgency
- Reducing the frequency of incontinent episodes
- Decreasing the frequency of voluntary urination Oxybutynin works by relaxing bladder smooth muscle and increasing bladder capacity, which helps to reduce symptoms of urinary incontinence 2.
From the Research
Treatment of Urinary Incontinence with Oxybutynin
Oxybutynin is an anticholinergic medication used to treat urinary incontinence. The treatment options and efficacy of oxybutynin are discussed below:
- Efficacy of Oxybutynin: Oxybutynin has been shown to be effective in improving urinary symptoms, including reducing the number of voids per 24 hours and urge incontinence episodes per 24 hours 3, 4.
- Formulations of Oxybutynin: Oxybutynin is available in various formulations, including immediate-release tablets, controlled-release tablets, and transdermal patches. The controlled-release tablet formulation has been shown to be as effective and well-tolerated as the immediate-release formulation, but with the advantage of once-daily dosing 4.
- Transdermal Oxybutynin: Transdermal oxybutynin has been developed to minimize side effects, particularly dry mouth, associated with oral oxybutynin therapy. Transdermal oxybutynin has been shown to be effective and well-tolerated, with significantly reduced side effects compared to oral oxybutynin 5, 6, 7.
- Advantages of Transdermal Oxybutynin: Transdermal oxybutynin offers several advantages, including reduced side effects, improved patient compliance, and convenient twice-weekly application.
- Comparison with Other Treatments: Oxybutynin has been compared to other treatments, such as tolterodine, and has been shown to have comparable efficacy, but with different tolerability profiles 3.