Ditropan (oxybutynin)

The muscle in the wall of the bladder is called the detrusor muscle. It can sometimes contract in uncontrollable spasms, and this is often referred to as having an overactive or unstable bladder. The overactive detrusor muscle can cause an increase in the number of times you need to pass urine, uncontrollable urges to pass urine, or involuntary leakage of urine (urinary incontinence).

Oxybutynin works by relaxing the detrusor muscle in the wall of the bladder. It does this by blocking receptors called cholinergic (or muscarinic) receptors that are found on the surface of the muscle cells. This prevents a natural body chemical called acetylcholine from acting on these receptors.

Normally when acetylcholine acts on these receptors, it causes the detrusor muscle to contract and the bladder to empty. By blocking acetylcholine, oxybutynin helps the muscle in the bladder wall to relax. This reduces unstable, involuntary contractions of the bladder, and thereby increases the capacity of the bladder to hold urine. In turn, this reduces the need to pass urine.

Oxybutynin is used to treat urinary frequency, urinary urgency and incontinence in people with unstable bladders. The condition may have no known cause (idiopathic bladder instability), or may be due to problems with the nerve supply to the bladder (neurogenic bladder), for example following a spinal cord injury, or as a result of conditions affecting the nervous system such as spina bifida or multiple sclerosis.

Oxybutynin can also be used to treat bedwetting in children over five years of age. In these cases the medicine is used in combination with other non-drug therapy, and only when other approaches have failed.

What is it used for?

- Urinary incontinence, urgency and frequency in adults and elderly people with unstable bladder conditions.
- Improving bladder control in children over five years of age with diseases of the nervous system that cause problems with the nerve supply to the bladder (neurogenic bladder).
- Bedwetting (nocturnal enuresis) in children over five years of age, in conjunction with non-drug approaches when these have been unsuccessful.

Warning!

- This medicine may cause drowsiness and blurred vision. If affected do not drive or operate machinary.
- Contact your doctor immediately if your experience a sudden change in your eyesight while taking this medicine, such as a reduced ability to see fine detail.
- This medicine may reduce sweating, and this may cause you to become overheated or faint in hot environments, or if you have a fever. Discuss this with your doctor.

Use with caution in

- Elderly people
- Children
- Decreased kidney function
- Decreased liver function
- Gastro-oesophageal reflux, eg due to a hiatus hernia
- Decreased motility of the stomach or intestines
- Obstruction of the outflow of urine from the bladder
- Enlarged prostate gland
- Overactive thyroid gland
- High blood pressure
- Heart failure
- Irregular heart beats (arrhythmias)
- Increased heart rate (tachycardia)
- Coronary artery disease.

Not to be used in

- Children under five years of age
- Inability to pass urine (urinary retention)
- Closed angle glaucoma
- Abnormal muscle weakness
- Blockage of the stomach or intestines (gastrointestinal obstruction)
- Paralysis or inactivity in the intestines that prevents material moving through the gut (intestinal atony or paralytic ileus)
- Severe inflammation of the bowel and back passage
- Sudden expansion of the large intestine seen in advanced ulcerative colitis or Crohn's disease (toxic megacolon)
- Hereditary blood disorders called porphyrias
- Breastfeeding.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

- The safety of this medicine for use during pregnancy has not been established. It is not recommended for use during pregnancy, unless the potential benefits to the mother outweigh any possible risks to the developing baby. Seek medical advice from your doctor.
- This medicine may pass into breast milk. It should not be used by breastfeeding mothers. Seek further medical advice from your doctor.

Label warnings

- This medication may cause drowsiness. If affected do not drive or operate machinery.

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