Oxybutynin Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Urinary Incontinence

Initial:
Immediate release tablet or Syrups: 5 mg 2 to 3 times daily.
Extended release tablets: 5 mg once daily.
Transdermal System: 3.9 mg/day, applied twice weekly (every 3 to 4 days).

Oxybutynin 3% transdermal gel:
3 pumps (84 mg/day) applied once daily to clean, dry, intact skin on the abdomen, or upper
arms/shoulders, or thighs. Apply immediately after actuating the dose.

Oxybutynin 10% transdermal gel:
1 gram unit dose (1.14 mL) 100 mg/g oxybutynin chloride gel once daily to dry, intact skin on the abdomen, upper arms, shoulders, or thighs.

Usual Adult Dose for Urinary Frequency

Initial:
Immediate release tablet or Syrups: 5 mg 2 to 3 times daily.
Extended release tablets: 5 mg once daily.
Transdermal System: 3.9 mg/day, applied twice weekly (every 3 to 4 days).

Oxybutynin 3% transdermal gel:
3 pumps (84 mg/day) applied once daily to clean, dry, intact skin on the abdomen, or upper
arms/shoulders, or thighs. Apply immediately after actuating the dose.

Oxybutynin 10% transdermal gel:
1 gram unit dose (1.14 mL) 100 mg/g oxybutynin chloride gel once daily to dry, intact skin on the abdomen, upper arms, shoulders, or thighs.

Usual Pediatric Dose for Urinary Incontinence

Immediate Release:
Greater than 1 to 5 years: 0.2 mg/kg per dose, 2 to 4 times daily.
Greater than 5 years: 5 mg 2 times daily, up to 5 mg 3 times daily.

Extended Release:
Greater than or equal to 6 years: 5 mg once daily

Study (n=56) - Extended Release:
Greater than 5 years: 5 mg once daily, titrated upwards according to response.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Data not available

Dose Adjustments

Adult:
Immediate release tablet or syrup maximum dosage to 5 mg 4 times daily.

Extended release tablet may be adjusted weekly in 5 mg increments to a maximum of 30 mg once daily.

Pediatric:

Immediate release tablet or syrup maximum dosage to 5 mg 4 times daily.

Extended release tablet may be adjusted weekly in 5 mg increments to a maximum of 20 mg once daily.

Precautions

Oxybutynin exerts anticholinergic effects and its use is contraindicated in patients with untreated angle closure glaucoma. It is contraindicated in patients with lower urinary obstruction due to the risk of urinary retention, in gastrointestinal (GI) obstructions such as pyloric or duodenal obstruction, or ileus, achalasia, GI hemorrhage, megacolon, toxic megacolon associated with ulcerative colitis, or severe colitis. Oxybutynin is contraindicated during acute hemorrhage associated with an unstable cardiovascular condition.

The extended-release formulation of oxybutynin is contained within a nondeformable material that is eliminated from the body and should be administered cautiously in patients with severe gastrointestinal narrowing or stricture.

Oxybutynin when administered during periods of high environmental temperature can reduce sweating and result in fever and heat stroke.

Oxybutynin should be used cautiously in patients with autonomic neuropathy, gastroesophageal reflux, GI obstructive disorders, ulcerative colitis, intestinal atony, prostatic hypertrophy, hyperthyroidism, heart disease, coronary heart disease, congestive heart failure, cardiac arrhythmias, hiatal hernia, tachycardia, hypertension, hepatic or renal disease, and myasthenia gravis.

Oxybutynin is associated with anticholinergic central nervous system (CNS) effects. A variety of CNS anticholinergic effects have been observed, including hallucinations, agitation, confusion and somnolence. Patients should be monitored for signs of anticholinergic CNS effects, particularly in the first few months after beginning therapy or increasing the dose. A dose reduction or drug discontinuation should be considered if a patient experiences anticholinergic CNS effects.

Drowsiness and blurred vision may affect mental alertness and work performance. Alcohol and other sedative medications may exacerbate the drowsiness.

Oxybutynin should be given with caution to patients with clinically significant bladder outflow obstruction because of the risk of urinary retention.

Dose selection for elderly patients should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.

Oxybutynin therapy should be used with caution in patients with preexisting dementia treated with cholinesterase inhibitors due to the risk of aggravation of symptoms.

The safety and efficacy of oxybutynin in pediatric patients under 5 years has not been determined; therefore, oxybutynin is not recommended in this age group. The safety and efficacy of oxybutynin topical gel have not been established in pediatric patients (less than 18 years of age).

Dialysis

Data not available

Other Comments

Take tablets or syrup with milk or food to decrease GI distress.

Swallow extended release tablets whole; do not chew, crush, or divide. Extended release tablets may be taken with or without food, at the same time each day. The tablet shell does not dissolve and may appear in the stool.

The transdermal system should be applied on the abdomen, hip or buttock to skin that is dry and intact. Application sites should be rotated to avoid local skin reactions. Do not apply system in the same site within 7 days.

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