From the Guidelines
Ditropan (oxybutynin) should be considered as a second-line therapy for overactive bladder symptoms, including frequent urination, urgency, and urinary incontinence, due to its effectiveness in reducing symptoms, although it is commonly associated with non-life-threatening side effects 1. The typical starting dose for adults is 5 mg taken orally 2-3 times daily, with a maximum recommended dose of 30 mg per day. For extended-release formulations (Ditropan XL), the usual starting dose is 5-10 mg once daily, which may be increased to a maximum of 30 mg daily. Some key points to consider when prescribing Ditropan include:
- Common side effects include dry mouth, constipation, blurred vision, drowsiness, and dizziness 1
- Patients should take this medication with water and may take it with food to reduce stomach upset
- Older adults may be more sensitive to side effects and might require lower doses
- Patients should avoid alcohol while taking Ditropan as it may increase drowsiness
- This medication is not recommended for those with certain conditions including urinary retention, uncontrolled narrow-angle glaucoma, or severe gastrointestinal disorders like ulcerative colitis It's also important to note that, according to a more recent study, oxybutynin was associated with the highest risk for discontinuation due to adverse effects compared to other pharmacologic therapies 1.
From the FDA Drug Label
Oxybutynin chloride is indicated for the relief of symptoms of bladder instability associated with voiding in patients with uninhibited neurogenic or reflex neurogenic bladder (i.e., urgency, frequency, urinary leakage, urge incontinence, dysuria). The primary use of Ditropan, which contains oxybutynin, is for the relief of symptoms of bladder instability. Key symptoms include:
- Urgency
- Frequency
- Urinary leakage
- Urge incontinence
- Dysuria 2
From the Research
Overview of Ditropan
- Ditropan, also known as oxybutynin, is a medication used to treat overactive bladder symptoms 3, 4, 5, 6, 7.
- It is an anticholinergic drug that works by relaxing the muscles in the bladder, reducing the urgency and frequency of urination.
Efficacy of Ditropan
- Studies have shown that Ditropan is effective in reducing the number of micturitions per 24 hours and decreasing incontinence episodes in patients with detrusor overactivity 3, 4, 7.
- However, the efficacy of Ditropan may vary depending on the dose and formulation used, with extended-release preparations potentially having fewer side effects than immediate-release preparations 3, 4.
Comparison with Other Medications
- Ditropan has been compared to other anticholinergic medications, such as tolterodine, solifenacin, and fesoterodine, in terms of efficacy and side effects 3, 4, 5, 6.
- Some studies have found that tolterodine and solifenacin may have similar efficacy to Ditropan, but with potentially fewer side effects, such as dry mouth 3, 5, 6.
- Fesoterodine has been shown to have superior efficacy to extended-release tolterodine, but with a higher risk of withdrawal due to adverse events and dry mouth 3.