Oxytrol for Women Disease Interactions

Agents with anticholinergic activity can exacerbate many of the manifestations of autonomic neuropathy, including tachycardia, anhidrosis, bladder atony, obstipation, dry mouth and eyes, cycloplegia and blurring of vision, and sexual impotence in males. Therapy with antimuscarinic agents and higher dosages of antispasmodic agents (e.g., dicyclomine or oxybutynin) should be administered cautiously in patients with autonomic neuropathy.

The use of drugs with antiperistaltic activity (primarily antidiarrheal and antimuscarinic agents, but also antispasmodic agents such as dicyclomine or oxybutynin at high dosages) is contraindicated in patients with diarrhea due to pseudomembranous enterocolitis or enterotoxin-producing bacteria. These drugs may prolong and/or worsen diarrhea associated with organisms that invade the intestinal mucosa, such as toxigenic E. coli, Salmonella and Shigella, and pseudomembranous colitis due to broad-spectrum antibiotics. Other symptoms and complications such as fever, shedding of organisms and extraintestinal illness may also be increased or prolonged. In general, because antiperistaltic agents decrease gastrointestinal motility, they may delay the excretion of infective gastroenteric organisms or toxins and should be used cautiously in patients with any infectious diarrhea, particularly if accompanied by high fever or pus or blood in the stool. Some cough and cold and other combination products may occasionally include antimuscarinic agents for their drying effects and may, therefore, require careful selection when necessary.

The use of oxybutynin is contraindicated in patients with uncontrolled angle-closure (narrow angle) or narrow anterior chamber glaucoma. Oxybutynin exerts anticholinergic activity (1/5 that of atropine) and can result in increased intraocular pressure and loss of accommodation.

The use of oxybutynin is contraindicated in patients with GI obstruction, ileus, atony, megacolon, toxic megacolon associated with ulcerative colitis, severe colitis, and obstructive uropathy. Oxybutynin exerts direct antispasmodic effects on smooth muscles and possesses anticholinergic activity (1/5 that of atropine).

The use of oxybutynin is contraindicated in patients with myasthenia gravis. Oxybutynin exerts direct antispasmodic effects on smooth muscle and inhibits the muscarinic action of acetylcholine on smooth muscle (1/5 the anticholinergic activity of atropine).

Oxybutynin is associated with anticholinergic central nervous system (CNS) effects. If a patient experiences anticholinergic CNS effects, dose reduction or drug discontinuation should be considered. Oxybutynin should be used with caution in patients with Parkinson's disease and in patients with preexisting dementia treated with cholinesterase inhibitors due to the risk of aggravation of symptoms.