Oxybutynin (Ditropan, Lyrinel XL)


Other names: Ditropan, Lyrinel XL

Oxybutynin is used in the treatment of bladder symptoms when you need to go to the toilet urgently or frequently.

How do I take oxybutynin?

Oxybutynin is taken by mouth (orally) as tablets, the dose and number of times a day you take the tablets will be decided by your doctor, but it is usually between two and four times a day. It can be taken before, during or after a meal.

You may not see an immediate effect when you first start taking oxybutynin. Your bladder will need some time to adapt. It usually starts to have an effect within four weeks. Oxybutynin can affect the amount of urine that stays in your bladder and monitoring this before starting on medication is important. It is normal for a small amount to be retained, but the risk of urinary tract infections (UTIs) is increased if too much urine remains in the bladder.

Results vary from person to person, and often depend on how severe your symptoms were initially.

If tolerated the medication should be taken for a month so your doctor can assess how effective the treatment is for you. You should then be reassessed again after a few months. If there is no noticeable improvement the medication should be stopped.

What side effects could I get with oxybutynin?

The side effects from oxybutynin can include:

  • dry mouth
  • headache
  • dry eyes
  • constipation
  • hot flushes or facial flushing

Sucking sugar free sweets or ice cubes, or chewing sugarless gum can help alleviate a dry mouth. Saliva substitutes can also help, these can be purchased over the counter in pharmacies.

Dry eyes only usually occur for a short period, but using eye drops may help if this is a problem.

If you experience headache, initially you could try taking paracetamol regularly.

If constipation is an issue, try to make sure you're drinking plenty of fluids - around eight cups per day is recommended. A mild laxative, such as Sennakot, may help over the initial period. Also increasing the amount of soluble fibre in your diet, such as oats and oat bran, beans and peas, barley, rye and flax seed, or fruit such as bananas, pears and apples, and root vegetables (preferably without the skins), can help.

Ensuring your room is well ventilated, and wearing cotton nightwear and using cotton bedsheets, can help reduce the effects of hot flushes and facial flushing.

Oxybutynin isn't recommended if you're pregnant or breastfeeding. You shouldn't take this medication if you're being treated for glaucoma until it's established whether you have wide or narrow angle glaucoma and it's been confirmed it's safe for you to take.

Oxybutynin can also have an effect on cognition and may lead to confusion.

You should avoid or stop taking this medication if you:

  • experience changes in your vision
  • have severe abdominal pain or cramps
  • cannot pass urine or find it difficult to urinate
  • experience a new onset of lower back pain
  • experience palpitations
  • feel dizzy or faint
  • notice changes in your cognitive function or experience increased confusion.

You should stop taking oxybutynin immediately if you experience swelling of the face or tongue and a rash, and consult the person who prescribed the medication.

How does oxybutynin work?

Oxybutynin is a type of drug called an anticholinergic. These drugs block the action of the neurotransmitter (chemical messenger) acetylcholine, which transfers messages including those that start bladder contractions. It is used to try and reduce how frequently you need to empty your bladder, the sensation of urgently needing to go to the toilet and urinary incontinence. Day and night-time leaks should reduce or even stop completely.

Oxybutynin is also classed as an antispasmodic, so it also works to relax the muscles of the bladder wall, which in turn helps improve your ability to control your bladder.

Find out more

References
Nicholas RS, et al.
Anticholinergics for urinary symptoms in multiple sclerosis.
Cochrane Database of Systematic Reviews 2009;(1):CD004193.
Full article (link is external)
National Institute for Health and Care Excellence.
Urinary incontinence in neurological disease: assessment and management. Clinical Guideline 148.
London: NICE; 2012.
Full guideline (link is external)
Schapiro RT.
Bladder symptoms. In: Managing the symptoms of multiple sclerosis. 4th ed.
New York: Demos; 2003.
Burgess M.
Bladder and bowel symptoms in MS. In: Multiple sclerosis: theory and practice for nurses.
London: Whurr Publishers; 2002.
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