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Antimuscarinic (overactive bladder)

Oxybutynin hydrochloride

Brand names: Ditropan, Cystrin, Lyrinel XL

Adult dose

Dose: PO IR: 5mg BD-TDS (max 5mg QDS). MR: 5–20mg OD. Patch (Kentera): 36mg patch twice weekly
Route: PO/Transdermal
Frequency: BD-QDS or OD

Clinical pearls

  • Mirabegron preferred in older adults to reduce cognitive risk
  • MR / patch better tolerated

Contraindications

  • Urinary retention
  • GI obstruction
  • Glaucoma
  • Myasthenia gravis
  • Severe ulcerative colitis

Side effects

  • Dry mouth (very common)
  • Constipation
  • Confusion in elderly (avoid in dementia)
  • Urinary retention
  • Tachycardia
  • Anticholinergic burden

Interactions

  • Other antimuscarinics — additive cognitive/anticholinergic load

Reference: BNF; NICE NG123; https://bnf.nice.org.uk/drugs/oxybutynin-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.