Formulary
Oxybutynin hydrochloride: Indications, Dosing, Side Effects and Interactions
Oxybutynin hydrochloride clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 6 min read
Oxybutynin hydrochloride: Indications, Dosing, Side Effects and Interactions
Oxybutynin hydrochloride clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Urinary frequency,Urinary urgency,Urinary incontinence,Neurogenic bladder instability**
- **Child** (By Mouth Using Immediate-Release Medicines): 12-17 years Initially 5 mg 2-3 times a day, increased if necessary up to 5 mg 4 times a day.
- **Adult** (By Mouth Using Immediate-Release Medicines): Initially 5 mg 2-3 times a day, increased if necessary up to 5 mg 4 times a day.
- **Elderly** (By Mouth Using Immediate-Release Medicines): Initially 2.5-3 mg twice daily, increased if tolerated to 5 mg twice daily, dose to be adjusted according to response.
- **Child** (By Mouth Using Modified-Release Tablets): 5-17 years Initially 5 mg once daily, dose can be adjusted in steps of 5 mg every week according to response up to a maximum of 15 mg per day.
- **Adult** (By Mouth Using Modified-Release Tablets): Initially 5 mg once daily, dose can be adjusted in steps of 5 mg every week according to response up to a maximum of 20 mg per day.
**Urinary frequency,Urinary urgency,Urinary incontinence**
- **Adult** (By Transdermal Application Using Patches): Apply 1 patch twice weekly, patch is to be applied to clean, dry unbroken skin on abdomen, hip or buttock. Patch should be removed every 3-4 days and site replacement patch on a different area. The same area should be avoided for 7 days.
**Nocturnal enuresis associated with overactive bladder**
- **Child** (By Mouth Using Immediate-Release Medicines): 5-17 years 2.5-3 mg twice daily, last dose to be taken before bedtime, increased to 5 mg 2-3 times a day, last dose to be taken before bedtime.
- **Child** (By Mouth Using Modified-Release Tablets): 5-17 years Initially 5 mg once daily, dose can be adjusted in steps of 5 mg every week according to response up to a maximum of 15 mg per day.
**Urinary frequency, Urinary urgency, Urinary incontinence, Neurogenic bladder instability for oxybutynin hydrochloride**
- **Child 2-4 years** (By mouth using immediate-release medicines): 1.25-2.5 mg 2-3 times a day.
- **Child 5-11 years** (By mouth using immediate-release medicines): Initially 2.5-3 mg twice daily, increased to 5 mg 2-3 times a day.
- **Child 12-17 years** (By mouth using immediate-release medicines): Initially 5 mg 2-3 times a day, increased if necessary up to 5 mg 4 times a day.
- **Child 5-17 years** (By mouth using modified-release tablets): Initially 5 mg once daily, dose can be adjusted in steps of 5 mg every week according to response up to a maximum of 15 mg per day.
**Neurogenic detrusor overactivity (under expert supervision) for oxybutynin hydrochloride**
- **Child 6-11 years** (By intravesical instillation): Initially 2 mg once daily, higher starting doses may be necessary-consult product literature, increased if necessary up to 10 mg 3 times a day, dose to be adjusted according to response.
- **Child 12-17 years** (By intravesical instillation): Initially 5 mg twice daily, higher starting doses may be necessary-consult product literature, increased if necessary up to 10 mg 4 times a day, dose to be adjusted according to response.
**Nocturnal enuresis associated with overactive bladder for oxybutynin hydrochloride**
- **Child 5-17 years** (By mouth using immediate-release medicines): 2.5-3 mg twice daily, last dose to be taken before bedtime, increased to 5 mg 2-3 times a day, last dose to be taken before bedtime.
- **Child 5-17 years** (By mouth using modified-release tablets): Initially 5 mg once daily, dose can be adjusted in steps of 5 mg every week according to response up to a maximum of 15 mg per day.
Cautions
For all antimuscarinics (systemic) Acute myocardial infarction (in adults); arrhythmias (may be worsened); autonomic neuropathy; cardiac insufficiency (due to association with tachycardia); cardiac surgery (due to association with tachycardia); children (increased risk of side-effects) (in children); conditions characterised by tachycardia; congestive heart failure (may be worsened); coronary artery disease (may be worsened); diarrhoea; elderly (especially if frail) (in adults); gastro-oesophageal reflux disease; hiatus hernia with reflux oesophagitis; hypertension; hyperthyroidism (due to association with tachycardia); individuals susceptible to angle-closure glaucoma; prostatic hyperplasia (in adults); pyrexia; ulcerative colitis Cautions, further information Elderly In adults: Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria to aid medication reviews (see Prescribing in the elderly for information). Potentially inappropriate: if treating extrapyramidal side-effects of antipsychotic medications (risk of antimuscarinic toxicity) with delirium or dementia (risk of exacerbation of cognitive impairment), angle-closure glaucoma (contra-indicated; risk of acute exacerbation of glaucoma), or chronic prostatism (risk of urinary retention) if two or more antimuscarinic drugs prescribed concomitantly (risk of increased antimuscarinic toxicity) Cautions For oxybutynin hydrochloride Acute porphyrias
Contraindications
For all antimuscarinics (systemic) Angle-closure glaucoma; gastro-intestinal obstruction; intestinal atony; myasthenia gravis (but some antimuscarinics may be used to decrease muscarinic side-effects of anticholinesterases); paralytic ileus; pyloric stenosis; severe ulcerative colitis; significant bladder outflow obstruction; toxic megacolon; urinary retention
Side effects
For all antimuscarinics (systemic) Common or very common Constipation; dizziness; drowsiness; dry mouth; dyspepsia; flushing; headache; nausea; palpitations; skin reactions; tachycardia; urinary disorders; vision disorders; vomiting Rare or very rare Angioedema; confusion (more common in elderly) Side-effects For oxybutynin hydrochloride General side-effects: Common or very common Diarrhoea Specific side-effects: Common or very common With oral use Dry eye With transdermal use Gastrointestinal discomfort (in adults); increased risk of infection (in adults) Uncommon With oral use Abdominal discomfort; appetite decreased; dysphagia With transdermal use Back pain (in adults); hot flush (in adults); injury (in adults) Frequency not known With intravesical use Abnormal sensation in eye; agoraphobia; akathisia; anticholinergic syndrome; apathy; chest discomfort; cognitive disorder; concentration impaired; consciousness impaired; dry eye; fatigue; feeling cold; gastrointestinal discomfort; haematuria; hallucination; hyperprolactinaemia; hypotension; increased risk of infection; insomnia; proteinuria; seizure; supraventricular tachycardia; sweat changes; taste altered; thirst; vertigo With oral use Anxiety; arrhythmia; cognitive disorder; depressive symptom; drug dependence; gastrointestinal disorders; glaucoma; hallucination; heat stroke; hypohidrosis; mydriasis; nightmare; paranoia; photosensitivity reaction; seizure; urinary tract infection Side-effects, further information Since systemic absorption can follow transdermal use, also consider the side-effects of systemic antimuscarinics.
Interactions
**Other interactions (2):**
- The anticholinergic activity of oxybutynin is increased by concurrent use of other anticholinergics or medicinal products with anticholinergic activity, such as amantadine and other anticholinergic...
- Patients should be informed that alcohol may enhance the drowsiness caused by anticholinergic agents such as oxybutynin (see section 4.7).
Pregnancy
Manufacturers advise avoid unless essential-toxicity in animal studies.
Breast feeding
Specialist sources indicate probably compatible (limited information available). High plasma-protein binding suggests limited excretion into milk and poor oral bioavailability suggests limited absorption by the infant; monitor breast-fed infants for adverse reactions.
Hepatic impairment
Manufacturer advises caution.
Renal impairment
Manufacturer advises caution.
Medicinal forms
Solution,Tablet,Tablet,Solution,Patch,Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
Inside MedNext for this topic
- 411 MedNext-authored chapters
- 80,000+ MCQ bank
- 15 study modes
- Growing visual cheat sheets
Study modes
- Notes
- MCQ
- Audio
- Video
- Visual
- 3D Anatomy
- Trace
- Flashcards
- Mnemonics
- Image Bank
- Clinical
- Microscopy
- Audio QBank
- Cadaver
- Book Match
Continue reading
Subject HubPharmacology Hub
All pharmacology resources in one place.
Drug SchedulesIndian Drug Schedules
Schedule H, H1, X and G classifications.
FormularyBrowse all drugs
Search 1,850+ drug profiles.
Study Oxybutynin hydrochloride in the MedNext app
Challenge yourself with targeted pharmacology MCQs on this drug class. Every explanation links back to the chapter that teaches the concept.
Start drug challengeExplore the full formulary

