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Indications:

Oxybutynin is indicated for the relief of symptoms of bladder instability associated with voiding in patients with neurogenic bladder i.e.: urgency, frequency, leakage, incontinence and dysuria.

Contraindications:

It is contraindicated for patients with intestinal obstruction, toxic megacolon, severe ulcerative colitis, closed angle glaucoma,myasthenia gravis and urinary obstruction.

Adverse reactions:

Most side effects encountered with Oxybutynin administration are due to its anticholinergic and antispasmodic activity. These effects include dizziness, flushing, confusion, clumsiness and palpitations. Drowsiness, respiratory depression or troubles in breathing can be observed. Transient blurred vision, urticaria, constipation, xerostomia and anhydrosis are also rarely reported side effects.

Interactions:

The concomitant use of oxybutynin with other anticholinergic drugs or with other agents which produce dry mouth, constipation, somnolence (drowsiness), and/or other anticholinergic-like effects may increase the frequency and/or severity of such effects. Anticholinergic agents may potentially alter the absorption of some concomitantly administered drugs due to anticholinergic effects on gastrointestinal motility. This may be of concern for drugs with a narrow therapeutic index. Mean oxybutynin chloride plasma concentrations were approximately 3–4 fold higher when DITROPAN was administered with ketoconazole, a potent CYP3A4 inhibitor. Other inhibitors of the cytochrome P450 3A4 enzyme system, such as antimycotic agents (e.g., itraconazole and miconazole) or macrolide antibiotics (e.g., erythromycin and clarithromycin), may alter oxybutynin mean pharmacokinetic parameters (i.e., Cmax and AUC). The clinical relevance of such potential interactions is not known. Caution should be used when such drugs are co-administered.

Warnings:

It should be administered cautiously to patients with coronary artery diseases, congestive heart failure, cardiac arrhythmias, hypertension, autonomic neuropathy, hepatic and renal diseases. It should also be used cautiously with drugs with antimuscarinic properties: CNS depressants, parasympatholytics; ketoconazole and opiate agonists. Its use during pregnancy and breast-feeding has not been established.

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