Skip to main content

Advertisement

SpringerLink
Log in

Oxybutynin

A Review of its Pharmacodynamic and Pharmacokinetic Properties, and its Therapeutic Use in Detrusor Instability

  • Drug Evaluation
  • Published:
Drugs & Aging Aims and scope Submit manuscript

Summary

Synopsis

Oxybutynin possesses anticholinergic and spasmolytic properties, which together form the basis for its use as a therapeutic option in patients with overactive detrusor function — either idiopathic detrusor instability (DI) or detrusor hyperreflexia. Of the symptoms of detrusor overactivity, urge incontinence is often the most distressing to the patient. Urge incontinence and other subjective parameters (urinary frequency, urgency) improve in tandem with objective (cystometric) measures (maximum detrusor pressure during filling, volume at first desire to void, maximum bladder capacity) in ambulatory, including elderly, patients treated with oxybutynin. However, on the basis of results of limited investigations, the drug appears ineffective in elderly institutionalised individuals. Relative to other anticholinergic drugs, oxybutynin appears at least as effective as propantheline and similar in efficacy to propiverine in small trials, although these results are not definitive. Further investigation of intravesical oxybutynin may lead to this route becoming an option in patients with preexisting catheters.

Adverse effects — dry mouth, constipation, blurred vision — related to the anticholinergic activity of oxybutynin occur frequently and can be sufficiently troublesome to necessitate treatment discontinuation in up to 25% of patients, depending on the dosage. Increases in residual urine volume suggesting urinary retention (undesirable in patients with idiopathic DI), also can develop in some oxybutynin recipients.

In summary, oxybutynin is one of the few drugs proven to be beneficial in some patients with overactive detrusor function. Despite the occurrence of unwanted anticholinergic effects in many patients, and apparent lack of efficacy in the elderly institutionalised population, oxybutynin should be considered for the drug of first choice in patients with detrusor overactivity, including the elderly ambulatory population, when pharmacological therapy is indicated.

Pharmacodynamic Properties

The majority of the beneficial and unwanted effects of oxybutynin in patients with detrusor instability (DI) stem from its anticholinergic properties. Oxybutynin competitively binds to parasympathetic muscarinic receptors, with a higher affinity for brain (M1) than for cardiac (M2) or ileal⋉adder receptors (M3). In addition, it antagonises detrusor contractions in vitro and in vivo. Compared with atropine, its affinity for muscarinic receptors is 10 times less in the brain and between 5 and 27 times lower in the detrusor muscle.

These anticholinergic effects of oxybutynin, together with its spasmolytic activity, are responsible for the relaxant effects of the drug on the detrusor muscle of the urinary bladder (thus reducing undesirable spontaneous contractions). The net result, as shown in both animals and humans (see Therapeutic Use, below) is a reduction in maximum detrusor pressure during filling and increases in bladder volume and capacity, but with a propensity for increases in residual urine volume. The contribution, if any, of local anaesthetic properties to the mechanism of action of the drug remains speculative.

Pharmacokinetic Properties

Wide interindividual variation in pharmacokinetic parameters is evident following oral administration of oxybutynin. The pharmacokinetic profile of the drug does not appear to be altered in healthy elderly individuals compared with young volunteers. However, the terminal plasma elimination half-life was prolonged from 2 to 3 hours in healthy elderly individuals to about 5 hours in ‘frail’ elderly individuals and its systemic bioavailability increased. The presence of food also increases the bioavailability of oxybutynin and slightly delays its rate of absorption. Hepatic biotransformation of oxybutynin yields the active metabolite N-desethyl-oxybutynin in addition to its most abundant but inactive metabolite, phenylcyclohexylglycolic acid. Active metabolites of oxybutynin may be responsible for much of the pharmacological activity of the drug.

Therapeutic Use

Oxybutynin alleviates subjective manifestations of idiopathic DI and detrusor hyperreflexia, including the distressing symptom of urge incontinence, and corrects abnormal objective measures. Subjective improvement in noncomparative trials was rated ‘excellent or good’ in 55 to 70% of patients receiving oxybutynin for up to 2 years. While this finding gives some preliminary indication of efficacy, placebo-controlled trials are vital to establish the benefit of a treatment in DI, as patients with this condition exhibit a high placebo response. As demonstrated by several such investigations in ambulatory patients, oxybutynin decreases urinary frequency, urgency and episodes of urge incontinence, in addition to increasing bladder volume at first desire to void, enhancing maximum bladder capacity and reducing maximum detrusor pressure during filling.

However, oxybutynin appears to have varying degrees of success in alleviating nocturia, and potentially detrimental increases in residual urine volume have been documented with its use. Moreover, as with other pharmacotherapy, cure is elusive. Furthermore, in contrast to unselected populations, elderly institutionalised patients have generally failed to improve during oxybutynin therapy, although patient numbers have been small. Elderly but ambulatory individuals experienced a modest subjective improvement with oxybutynin in one placebo-controlled trial, but urge incontinence was relieved to a similar extent by placebo and oxybutynin.

On the basis of limited comparisons with other anticholinergic drugs, oxybutynin appears at least as effective as propantheline and similar to propiverine in idiopathic DI. This benefit may be offset somewhat by the increases in residual urine volume which are associated with oxybutynin but apparently not with propantheline. However, urge incontinence was relieved in significantly more oxybutynin than propantheline recipients (58 vs 45%, p < 0.05) in the largest placebo-controlled trial, conducted in 154 patients. Some evidence suggests better results with oxybutynin than with propantheline in patients with detrusor hyperreflexia rather than idiopathic DI. Interestingly, intravesical administration of oxybutynin has shown promise in individuals with detrusor hyperreflexia: this route may become an option in individuals with pre-existing or intermittent catheters, and those unresponsive to or intolerant of oral therapy.

Tolerabilit

Atropine-like symptoms are frequent during oral oxybutynin therapy. Dry mouth develops in at least 50% of oxybutynin recipients, constipation in about 15%, drowsiness in about 12% and blurred vision in approximately 5%. Discomfort has been severe enough to warrant treatment discontinuation in approximately 7 to 27% of patients given oxybutynin in clinical trials. Reflux oesophagitis has been reported infrequently during oxybutynin treatment and no serious cardiac effects have been linked to its use. Intravesical oxybutynin appears to cause few systemic adverse events.

Oxybutynin may be less well tolerated than propantheline, as shown in the largest comparative trial, although smaller studies have demonstrated similar tolerability profiles for the 2 drugs, and in one study patients were more willing to tolerate the unwanted effects of oxybutynin than those of propantheline. Whether increasing age influences the severity and incidence of unwanted effects, particularly in institutionalised patients, has not been examined specifically.

Dosage and Administration

The recommended oral dosage of oxybutynin is 5mg 2 to 3 times daily, up to a maximum of 5mg 4 times daily. The dose should be titrated to maximise response and minimise adverse effects. However, a lower starting dose of 3 or 5mg twice daily is recommended in the elderly, titrated as necessary, and clinical experience has suggested that a dosage of 2.5mg 2 or 3 times daily may be a suitable starting dosage in elderly and nonelderly adults. The drug is contraindicated in patients with conditions which may be aggravated by its anticholinergic activity. Drowsiness or blurred vision may reduce patients’ ability to perform tasks requiring mental alertness.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Robinson TG, Castleden CM. Drugs in focus: 11. Oxybutynin hydrochloride. Prescr J 1994; 34(1): 27–30

    Google Scholar 

  2. Ganong WF, editor. Review of Medical Physiology. 10th ed.Ch. 9 Micturition. Los Altos, California: Lange Medical Publications, 1981: 574–6

  3. Lincoln, Burnstock. Autonomic innervation of the urinary bladder and urethra. Chapter 9: Nervous Control of the Urogenital System. In: Maggi CA, editor. The Autonomie Nervous System, v. 6. London, UK: Harwood Academic Publishers, 1993: 33–68

    Google Scholar 

  4. Davidson PJT. Stress and urge incontinence. New Zealand Practice Nurse 1994 March: 11–5

  5. Abrams P, Blaivas JG, Stanton SL, et al. Standardisation of terminology of lower urinary tract function. Neurourol Urodyn 1988; 7: 403–27

    Article  Google Scholar 

  6. Wall LL. The management of detrusor instability. Clin Obstet Gynecol 1990 Jun; 33: 367–77

    Article  PubMed  CAS  Google Scholar 

  7. Eckford SD, Keane DP. Management of detrusor instability. Br J Hosp Med 1993 Feb 17-Mar 2; 49: 282–5

    PubMed  CAS  Google Scholar 

  8. Mundy AR. The unstable bladder. Urol Clin North Am 1985 May; 12: 317–28

    PubMed  CAS  Google Scholar 

  9. Andersson KE. Current concepts in the treatment of disorders of micturition. Drugs 1988 Apr; 35: 477–94

    Article  PubMed  CAS  Google Scholar 

  10. Bent AE. Etiology and management of detrusor instability and mixed incontinence. Obstet Gynecol Clin North Am 1989 Dec; 16: 853–68

    PubMed  CAS  Google Scholar 

  11. Moore KH, Sutherst JR. Response to treatment of detrusor instability in relation to psychoneurotic status. Br J Urol 1990 Nov; 66: 486–90

    Article  PubMed  CAS  Google Scholar 

  12. Brading AF, Turner WH. The unstable bladder: towards a common mechanism. Br J Urol 1994; 73: 3–8

    Article  PubMed  CAS  Google Scholar 

  13. Brocklehurst JC. Urinary incontinence in the community — analysis of a MORI poll. BMJ 1993; 306: 832–4

    Article  PubMed  CAS  Google Scholar 

  14. Borrie MJ, Davidson HA. Incontinence in institutions: costs and contributing factors. Can Med Assoc J 1992; 147: 322–8

    CAS  Google Scholar 

  15. Jarvis GJ. Urinary incontinence in the community. Common and can often be successfully treated. BMJ 1993 Mar 27; 306: 809–10

    Article  PubMed  CAS  Google Scholar 

  16. Kletchko SL. Menopause and the urinary tract. New Zealand Practice Nurse 1994 March: 26–8

  17. Callahan CM. The costs of urinary incontinence. PharmacoEconomics 1994; 6: 183–5

    Article  PubMed  CAS  Google Scholar 

  18. Levin RM, Wein AJ. Direct measurement of the anticholinergic activity of a series of pharmacological compounds on the canine and rabbit urinary bladder. J Urol 1982 Aug; 128: 396–8

    PubMed  CAS  Google Scholar 

  19. Nilvebrant L. On the muscarinic receptors in the urinary bladder and the putative subclassification of muscarinic receptors. Acta Pharmacol Toxicol Copenh 1986; 59 Suppl 1: 1–45

    PubMed  Google Scholar 

  20. Kachur JF, Peterson JS, Carter JP, et al. R and S enantiomers of oxybutynin: pharmacological effects in guinea pig bladder and intestine. J Pharmacol Exp Ther 1988 Dec; 247: 867–72

    PubMed  CAS  Google Scholar 

  21. Peterson JS, Patton AJ, Noronha-Blob L. Mini-pig urinary bladder function: comparisons of in vitro anticholinergic responses and in vivo cystometry with drugs indicated for urinary incontinence. J Auton Pharmacol 1990 Apr; 10: 65–73

    Article  PubMed  CAS  Google Scholar 

  22. Kato K, Kitada S, Chun A, et al. In vitro intravesical instillation of anticholinergic, antispasmodic and calcium blocking agents (rabbit whole bladder model). J Urol 1989 Jun; 141: 1471–5

    PubMed  CAS  Google Scholar 

  23. Tonini M, Rizzi CA, Perucca E, et al. Depressant action of oxybutynin on the contractility of intestinal and urinary tract smooth muscle. J Pharm Pharmacol 1987; 39: 103–7

    Article  PubMed  CAS  Google Scholar 

  24. Levounis P, Constantinou CE. Analysis of the in vitro pharmacologie response of renal pelvis and detrusor smooth muscle to thiphenamil, oxybutynin and verapamil. Urol Int 1988; 43: 211–8

    Article  PubMed  CAS  Google Scholar 

  25. Atala A, Amin M. Current concepts in the treatment of genitourinary tract disorders in the older individual. Drugs Aging 1991 May; 1: 176–93

    Article  PubMed  CAS  Google Scholar 

  26. Aaltonen L, Allonen H, Iisalo E, et al. Antimuscarinic activity of oxybutynin in the human plasma quantitated by a radioreceptor assay. Acta Pharmacol Toxicol Copenh 1984 Aug; 55: 100–3

    Article  PubMed  CAS  Google Scholar 

  27. Noronha-Blob L, Kachur JF. Enantiomers of oxybutynin: in vitro pharmacological characterization at M1, M2 and M3 muscarinic receptors and in vivo effects on urinary bladder contraction, mydriasis and salivary secretion in guinea pigs. J Pharmacol Exp Ther 1991 Feb; 256: 562–7

    PubMed  CAS  Google Scholar 

  28. Yamaguchi O, Shishido K, Tamura K. Evaluation of mRNA encoding muscarinic receptor subtypes in human detrusor muscle [abstract]. Neurourol Urodyn 1994; 13: 464–5

    Google Scholar 

  29. Nilvebrant L, Sparf B. Dicyclomine, benzhexol and oxybutynine distinguish between subclasses of muscarinic binding sites. Eur J Pharmacol 1986 Apr 9; 123: 133–43

    Article  PubMed  CAS  Google Scholar 

  30. Batra S, Biörklund A, Hedlund H, et al. Identification and characterization of muscarinic cholinergic receptors in the human urinary bladder and parotid gland. J Auton Nerv Syst 1987; 20(2): 129–35

    Article  PubMed  CAS  Google Scholar 

  31. Kondo S, Morita T, Hirano S. A study on the affinities of various muscarinic antagonists to the human detrusor muscle [in Japanese]. J Smooth Muscle Res 1993 Apr; 29: 63–8

    Article  PubMed  CAS  Google Scholar 

  32. Nagy F, Hamvas A, Frang D. Idiopathic bladder hyperactivity treated with Ditropan (oxybutynin chloride). Int Urol Nephrol 1990; 22: 519–24

    Article  PubMed  CAS  Google Scholar 

  33. Malkowicz SB, Wein AJ, Ruggieri MR, et al. Comparison of calcium antagonist properties of antispasmotic agents. J Urol 1987 Sep; 138: 667–70

    PubMed  CAS  Google Scholar 

  34. Ukimura O. Effects of intravesically administered anticholinergics, β-adrenergic stimulant and α-adrenergic blocker on bladder function in unanesthetized rats. Tohoku J Exp Med 1993 Aug; 170: 251–60

    Article  PubMed  CAS  Google Scholar 

  35. Peterson JS, Noronha-Blob L. Effects of selective cholinergic antagonists and α,β-methylene ATP on guinea-pig urinary bladder contractions in vivo following pelvic nerve stimulation. J Auton Pharmacol 1989 Oct; 9: 303–13

    Article  PubMed  CAS  Google Scholar 

  36. Nishizawa O, Sugaya K, Kohama T, et al. Effect of oxybutynin on reflex micturition in the decerebrate dog as determined by urodynamic evaluation. Neurourol Urodyn 1989; 8(5): 513

    Article  CAS  Google Scholar 

  37. Mohler JL. Relaxation of intestinal bladders by intravesical oxybutynin chloride. Neurourol Urodyn 1990; 9(2): 179–87

    Article  CAS  Google Scholar 

  38. Hughes KM, Lang JCT, Lazare R, et al. Measurement of oxybutynin and its N-desethyl metabolite in plasma, and its application to pharmacokinetic studies in young, elderly and frail elderly volunteers. Xenobiotica 1992 Jul; 22: 859–69

    Article  PubMed  CAS  Google Scholar 

  39. Douchamps J, Derenne F, Stockis A, et al. The pharmacokinetics of oxybutynin in man. Eur J Clin Pharmacol 1988; 35: 515–20

    Article  PubMed  CAS  Google Scholar 

  40. Madersbacher H, Knoll M, Kiss G. Intravesical administration of oxybutynin: mode of action in controlling detrusorhyperreflexia [abstract 64]. Neurourol Urodyn 1991; 10: 375

    Google Scholar 

  41. Yong C-L, Yu D, Eden L, et al. Effect of food on the pharmacokinetics of oxybutynin in normal subjects [abstract]. Pharm Res 1991 Oct; 8 Suppl.: 320

    Google Scholar 

  42. Ouslander JG, Blaustein J, Connor A, et al. Pharmacokinetics and clinical effects of oxybutynin in geriatric patients. J Urol 1988 Jul; 140: 47–50

    PubMed  CAS  Google Scholar 

  43. Riva D, Casolati E. Oxybutynin chloride in the treatment of female idiopathic bladder instability. Results from double blind treatment. Clin Exp Obstet Gynecol 1984; 11: 37–42

    PubMed  CAS  Google Scholar 

  44. Goto M, Kato K, Kondo A, et al. Clinical effects of oxybutynin hydrochloride in the treatment of unstable bladder and overactive neurogenic bladder: a long-term clinical trial [in Japanese]. Hinyokika Kiyo 1988 Mar; 34: 541–50

    PubMed  CAS  Google Scholar 

  45. Kondo A, Takita T, Otani T, et al. Clinical effects of 1mg tablets of oxybutynin hydrochloride on patients with unstable bladders and neurogenic bladders [in Japanese]. Rinsho Iyaku 1992; 8(4): 947–63

    Google Scholar 

  46. Sonoda T, Sakurai T, Yamada K, et al. Effects of long-term administration of oxybutynin hydrochloride (KL007) for the treatment of neurogenic bladder and unstable bladder [in Japanese]. Hinyokika Kiyo 1989 Jan; 35: 167–78

    PubMed  CAS  Google Scholar 

  47. Uchibayashi T, Nakajima K, Nihino A, et al. Assessment of the use of oxybutynin hydrochloride (PollakisR tablets) in the elderly [in Japanese]. Hinyokika Kiyo 1991 Sep; 37: 1077–85

    PubMed  CAS  Google Scholar 

  48. Yamauchi K, Ohashi K, Osanai H, et al. Clinical effects of oxybutynin hydrochloride (PollakisR). Especíally for the treatment of pollakisuria, urgency and urinary incontinence [in Japanese]. Hinyokika Kiyo 1990 Dec; 36: 1485–90

    PubMed  CAS  Google Scholar 

  49. Kirkali Z, Whitaker RH. The use of oxybutynin in urological practice. Int Urol Nephrol 1987; 19: 385–91

    Article  PubMed  CAS  Google Scholar 

  50. Primus G, Pummer K. Oxybutynin hydrochloride in the management of detrusor instability. Int Urol Nephrol 1990; 22: 243–8

    Article  PubMed  CAS  Google Scholar 

  51. Griffiths DJ, McCracken PN, Harrison GM, et al. Response of geriatric urinary incontinence to treatment with oxybutynin chloride. J Geriatr Drug Ther 1992; 7(1): 57–69

    Google Scholar 

  52. Collas DM, Szonyi G, Ding YY, et al. Oxybutonin with bladder retraining for detrusor instability in the elderly — a placebo controlled trial [abstract]. Age Ageing 1994; 23 Suppl. 2: 9

    Google Scholar 

  53. Moore KH, Hay DM, Imrie AE, et al. Oxybutynin hydrochloride (3 mg) in the treatment of women with idiopathic detrusor instability. Br J Urol 1990 Nov; 66: 479–85

    Article  PubMed  CAS  Google Scholar 

  54. Ouslander J, Schnelle J, Uman G, et al. Does oxybutynin enhance the effectiveness of prompted voiding for incontinence among nursing home residents? [abstract no. A3]. J Am Geriatr Soc 1994; 42: SA1

    Google Scholar 

  55. Tapp AJ, Cardozo LD, Versi E, et al. The treatment of detrusor instability in post-menopausal women with oxybutynin chloride: a double blind placebo controlled study [see comments]. Br J Obstet Gynaecol 1990 Jun; 97: 521–6

    Article  PubMed  CAS  Google Scholar 

  56. Zorzitto ML, Holliday PJ, Jewett MA, et al. Oxybutynin chloride for geriatric urinary dysfunction: a double-blind placebocontrolled study [see comments]. Age Ageing 1989 May; 18: 195–200

    Article  PubMed  CAS  Google Scholar 

  57. Gajewski JB, Awad SA. Oxybutynin versus propantheline in patients with multiple sclerosis and detrusor hyperreflexia. J Urol 1986 May; 135: 966–8

    PubMed  CAS  Google Scholar 

  58. Holmes DM, Montz FJ, Stanton SL. Oxybutinin versus propantheline in the management of detrusor instability. A patient-regulated variable dose trial. Br J Obstet Gynaecol 1989 May; 96: 607–12

    Article  PubMed  CAS  Google Scholar 

  59. Thüroff JW, Bunke B, Ebner A, et al. Randomized, double-blind, multicenter trial on treatment of frequency, urgency and incontinence related to detrusor hyperactivity: oxybutynin versus propantheline versus placebo. J Urol 1991 Apr; 145: 813–7

    PubMed  Google Scholar 

  60. Wehnert J, Sage S. Treatment of bladder instability and urge incontinence with propiverin hydrochloride (Mictonorm) and oxybutinin chloride — a randomized cross-over trial [in German]. Aktuel Urol 1992 Jan; 23: 7–11

    Article  Google Scholar 

  61. Madersbacher H, Jilg G. Control of detrusor hyperreflexia by the intravesical instillation of oxybutynine hydrochloride. Paraplegia 1991 Feb; 29: 84–90

    Article  PubMed  CAS  Google Scholar 

  62. O’Flynn KJ, Thomas DG. Intravesical instillation of oxybutynin hydrochloride for detrusor hyper-reflexia. Br J Urol 1993 Nov; 72: 566–70

    Article  PubMed  Google Scholar 

  63. Brendler CB, Radebaugh LC, Mohler JL. Topical oxybutynin chloride for relaxation of dysfunctional bladders. J Urol 1989 Jun; 141: 1350–2

    PubMed  CAS  Google Scholar 

  64. Weese DL, Roskamp DA, Leach GE, et al. Intravesical oxybutynin chloride: experience with 42 patients. Urology 1993 Jun; 41: 527–30

    Article  PubMed  CAS  Google Scholar 

  65. Ragavan R, Ohanna F, Cosat P, et al. Intravesical administration of oxybutynin in spinal cord injury patients [abstract]. Int UrogynJ 1994; 5: 336

    Google Scholar 

  66. Kasabian NG, Vlachiotis JD, Lais A, et al. The use of intravesical oxybutynin chloride in patients with detrusor hypertonicity and detrusor hyperreflexia. J Urol 1994 Apr; 151: 944–5

    PubMed  CAS  Google Scholar 

  67. Helmer H, Kurz C, Mittermayer F, et al. Effects of local intravesical oxybutynin therapy in women with dysfunctional bladder [abstract]. Int Urogyn J 1994; 5: 330

    Google Scholar 

  68. Malone-Lee J, Lubel D, Szonyi G. Low dose oxybutynin for the unstable bladder [letter]. BMJ 1992 Apr 18; 304: 1053

    Article  PubMed  CAS  Google Scholar 

  69. Jonville AP, Dutertre JP, Autret E, et al. Side-effects of oxybutynine chloride (DitropanR) [in French]. Therapie 1992 Sep–Oct; 47: 389–92

    PubMed  CAS  Google Scholar 

  70. Baigrie RJ, Kelleher JP, Fawcett DP, et al. Oxybutynin: is it safe? Br J Urol 1988 Oct; 62: 319–22

    Article  PubMed  CAS  Google Scholar 

  71. Lee M, Sharifi R. Oxybutynin-induced reflux esophagitis. DICP 1990 Jun; 24: 583–5

    PubMed  CAS  Google Scholar 

  72. Howard LM, Markus H. Pseudo-obstruction secondary to anticholinergic drugs in Parkinson’s disease [letter]. Postgrad MedJ 1992 Jan; 68: 70–1

    Article  CAS  Google Scholar 

  73. Ouslander JG, Blaustein J, Connor A, et al. Habit training and oxybutynin for incontinence in nursing home patients: a placebo-controlled trial. J Am Geriatr Soc 1988 Jan; 36: 40–6

    PubMed  CAS  Google Scholar 

  74. Hussain RM, Hartigan-Go K, Thomas SHL, et al. Effect of oxybutynin on the QTc interval in elderly patients with urinary incontinence [abstract]. Br J Clin Pharmacol 1994 May; 37: 485P-6P

    Google Scholar 

  75. Terai T, Deguchi Y, Ohtsuka M, et al. Effects of the anticholinergic drug prifinium bromide on urinary bladder contractions in rat in vivo and in guinea-pig in vitro. Arzneimittelforschung 1991 Apr; 41: 417–20

    PubMed  CAS  Google Scholar 

  76. Marion Merrell Dow. Oxybutynin prescribing information. USA, May 1991.

  77. Smith & Nephew. Oxybutynin prescribing information. Romford, Essex, UK, 1994.

  78. Farmitalia Carlo Erba. Oxybutynin prescribing information. Milton Keynes, UK, 1994.

  79. Banerjee S, Routledge PA, Pugh S, et al. Poisoning with oxybutynin. Hum Exp Toxicol 1991 May; 10: 225–6

    Article  PubMed  CAS  Google Scholar 

  80. Cartwright PC, Snow BW. Bladder autoaugmentation: early clinical experience. J Urol 1989; 142: 505–8 Correspondence: Yvonne E. Yarker, Adis International Limited, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, Auckland 10, New Zealand.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Adis International Limited, 41 Centorian Drive, Private Bag 65901, Mairangi Bay, xAuckland 10, New Zealand

    Yvonne E. Yarker, Karen L. Goa & Andrew Fitton

Authors
  1. Yvonne E. Yarker
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Karen L. Goa
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrew Fitton
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Various sections of the manuscript reviewed by:K.- E. Andersson, Department for Clinical Pharmacology, Lund University Hospital, Lund, Sweden; A. Atala, Department of Surgery, Harvard Medical School and Division of Urology, Children’s Hospital, Boston, Massachusetts, USA; C.E. Constantinou, Department of Urology, Stanford University Medical Center, Stanford, California, USA; D.J. Griffiths, Edmonton General Hospital, Edmonton, Alberta, Canada; G.J. Jarvis, St James’s University Hospital, Leeds, England; A.P. Jonville- Béra, Centre de Pharmacovigilance, Centre Hospitalier Universitaire, Hopitaux de Tours, Tours, France; H. Madersbacher, A.ö. Landeskrankenhau (Univ.-Kliniken), Innsbruck, Austria; J. Malone- Lee, St Pancras Hospital, London, England; J.L. Mohler, University of North Carolina School of Medicine, Department of Surgery, Division of Urology, Chapel Hill, North Carolina, USA; O. Nishizawa, Department of Urology, Akita University School of Medicine, Akita City, Japan; J.G. Ouslander, Jewish Homes for the Aging of Greater Los Angeles, Victory Village, Reseda, California, USA; J.W. Thüroff, Klinik für Urologie und Kinderurologie, Klinikum der Universität Witten/Herdecke, Wuppertal-Barmen, Germany; O. Ukimura, Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan; K.W. Woodhouse, University Hospital of Wales and Cardiff Royal Group, Cardiff Royal Infirmary, Cardiff, Wales.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yarker, Y.E., Goa, K.L. & Fitton, A. Oxybutynin. Drugs & Aging 6, 243–262 (1995). https://doi.org/10.2165/00002512-199506030-00007

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00002512-199506030-00007

Keywords

Search

Navigation