From the Guidelines
Oxybutynin immediate-release (IR) tablets can be crushed, while the extended-release (ER) formulations should not be crushed. This is based on the understanding that crushing extended-release formulations would destroy their controlled-release mechanism, potentially leading to increased side effects 1. If a patient has difficulty swallowing tablets, oxybutynin IR tablets can be crushed and mixed with food or liquid for easier administration.
Key Considerations
- Oxybutynin IR tablets are designed to dissolve quickly in the stomach, making them suitable for crushing if necessary.
- Extended-release formulations, such as Ditropan XL and Oxytrol, contain special coatings or matrix systems that gradually release the medication over time and should not be crushed.
- Crushing extended-release formulations could lead to the release of the entire dose at once, causing increased side effects such as dry mouth, constipation, and drowsiness.
Alternative Options
- For patients who cannot swallow tablets, oxybutynin is also available as a syrup formulation (5 mg/5 mL), providing an alternative option for administration.
- The pediatric dosage of cyproheptadine, which is sometimes used in the management of certain conditions, can be crushed and administered via a nasogastric tube if necessary, as per the dosage guidelines of 0.25 mg/kg per day 1.
From the Research
Forms of Oxybutynin
- Immediate-release oxybutynin can be crushed 2
- Controlled-release formulations, such as OROS oxybutynin chloride, should not be crushed as it may alter the release characteristics of the medication 3, 4
- Transdermal oxybutynin is a patch formulation that does not require crushing 5
Considerations for Crushing Oxybutynin
- Crushing immediate-release oxybutynin may be necessary for patients who have difficulty swallowing tablets, but it is essential to consult with a healthcare provider or pharmacist before doing so 2
- The pharmacokinetics and pharmacodynamics of oxybutynin may be affected by crushing the tablet, and this should be taken into consideration when making decisions about dosage forms 3, 4