Advice
Product overview
Mode of action
Oxybutynin is an antimuscarinic (anticholinergic) medicine that is licensed for the treatment of urinary incontinence, urgency and frequency in the unstable bladder, whether due to neurogenic bladder disorders (detrusor hyperreflexia) in conditions such as multiple sclerosis and spina bifida, or to idiopathic detrusor instability (motor urge incontinence; SPC: oxybutynin).
Regulatory status
Oxybutynin is not licensed for the treatment of hyperhidrosis; use of oxybutynin for this indication is off-label.
In line with the guidance from the General Medical Council (GMC) on prescribing unlicensed medicines, the prescriber should take full responsibility for determining the needs of the patient and whether using oxybutynin is suitable outside its authorised indications. Supporting information and advice is also available from the GMC.
Dosing information
Dosing information for oxybutynin for hyperhidrosis (an off-label indication) is discussed in the evidence review within this evidence summary.
For the licensed indication of urinary incontinence, urgency and frequency in the unstable bladder, the usual adult dose is 5 mg 2 or 3 times a day. This may be increased to a maximum of 5 mg 4 times a day to obtain a clinical response provided that the side effects are tolerated (SPC: oxybutynin).
Cost
Oxybutynin is available in a number of different formulations and strengths, with a considerable difference in price between the different preparations (all prices taken from the Drug Tariff, February 2017):
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oxybutynin 2.5 mg tablets cost £1.15 for 56 tablets
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oxybutynin 3 mg tablets cost £16.80 for 56 tablets
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oxybutynin 5 mg tablets cost £1.49 for 56 tablets
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oxybutynin 5 mg modified release tablets cost £13.77 for 30 tablets
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oxybutynin 2.5 mg/5 ml oral solution sugar free costs £144.50 for 150 ml
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oxybutynin 5 mg/5 ml oral solution sugar free costs £199.20 for 150 ml
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oxybutynin 3.9 mg/24 hours transdermal patches cost £27.20 for 8 patches.