Oxybutynin ER
DITROPAN XL
What it isOxybutynin extended-release (DITROPAN XL, 1998) antagonizes muscarinic and H1 receptors; overactive bladder.
Why this oneIts apparent half-life ~13 h (vs ~2 h IR) smooths exposure and reduces dry mouth versus immediate release.
What limits itDry mouth, constipation, urinary retention, and cognitive impairment give it the heaviest anticholinergic burden among bladder drugs.
FDA-approved for
- overactive bladder (1998)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Overactive bladder (urge urinary incontinence, urgency, frequency) | Adults | 5 or 10 mg PO once daily | 30 mg/day | |
| Detrusor overactivity associated with a neurological condition (e.g., spina bifida) | Peds ≥6 yr | 5 mg PO once daily | 20 mg/day |
Titration Adjust in 5 mg increments, generally at ~weekly intervals
Renal Undefined
Hepatic Undefined
Instructions
- Swallow whole with liquid; do not chew, divide, or crush
- May be taken with or without food
- Not recommended in children who cannot swallow the tablet whole or under age 6
Contraindications
- Urinary retention
- Gastric retention and other severe decreased gastrointestinal motility conditions
- Uncontrolled narrow-angle glaucoma
Cautions
- Angioedema (may occur after the first dose)
- Anticholinergic CNS effects (hallucinations, agitation, confusion, somnolence)
- Aggravation of symptoms in dementia on cholinesterase inhibitors, Parkinson's disease, myasthenia gravis
- Decreased GI motility in autonomic neuropathy
- Urinary retention with bladder outflow obstruction
- GI obstructive disorders / GERD
Adverse reactions
- Dry mouth
- Constipation
- Diarrhea
- Headache
- Somnolence
- Dizziness
- Blurred vision
Pregnancy No adequate data on use in pregnant women
Lactation No data on presence in human milk or effects on the breastfed infant
NO BOXED WARNINGS
Principal riskAnticholinergic burden, worst of the bladder agents
Classes and tags
Clinical profile
Mechanism of action: Oxybutynin ER ballicule
Open Oxybutynin ER in the interactive console ↗
Memory aids: mascots and interaction avatars
“Mad as a hatter” → BBB-crossing anticholinergic
