Urinary incontinence, urgency or frequent urination due to instability of the bladder function due to neurogenic bladder dysfunction (detrusor hyperreflexia), as seen in diseases such as multiple sclerosis and spina bifida, or due to idiopathic instability of the detrusor function (motor urge urinary incontinence). also used to control overactive bladder, which occurs after surgery on the bladder or prostate gland, or with concomitant cystitis.
urinary incontinence, urgency or frequent urination with instability of the bladder function due to idiopathic overactive bladder or neurogenic bladder dysfunction (detrusor overactivity);
nocturnal enuresis associated with detrusor overactivity, in combination with non-preparation treatment in case of failure of other therapy.
The preparation is used orally. The tablet can be divided into two equal doses.
Adults. The usual dose is 5 mg 2-3 times a day. The dose can be increased to a maximum of 5 mg 4 times a day to obtain a clinical effect, subject to the tolerance of side effects.
Elderly patients. In elderly patients, the half-life of the preparation is increased, therefore it is recommended to use a dose of 2.5 mg 2 times a day, in particular for debilitated patients. The dose can be increased to 5 mg 2 times a day to obtain a clinical effect, provided that side effects are well tolerated.
Children over the age of 5 years. Neurogenic bladder instability, nocturnal enuresis: The usual dose is 2.5 mg twice daily. The dose can be increased to 5 mg 2-3 times a day to obtain a clinical effect, provided that side effects are well tolerated. For nocturnal enuresis, the last dose should be taken at bedtime.
Children. Children under the age of 5 years, the use of the preparation is not recommended due to insufficient data on safety and efficacy. There are limited data on the use of oxybutynin in children with monosymptomatic nocturnal enuresis (not associated with detrusor overactivity). In children over the age of 5 years, the preparation should be used with caution, as they may be more sensitive to the effects of oxybutynin, in particular regarding the manifestations of adverse reactions from the central nervous system and psyche.
Contraindications
Hypersensitivity to the active substance or to any other component of the preparation; myasthenia gravis; narrow-angle glaucoma or small anterior chamber of the eye; patients with fever or conditions of elevated ambient temperature due to the risk of provoking hyperpyrexia; children under the age of 5; esophageal dysfunction, including hiatal hernia; functional or organic gastrointestinal obstruction, including pyloric stenosis, paralytic ileus, intestinal atony; patients with ileostomy, colostomy, toxic megacolon; severe ulcerative colitis; patients with urinary tract obstruction, when urinary retention may worsen, for example with prostatic hypertrophy.
Side effects
From the digestive tract: nausea, constipation, dry mouth, discomfort in the abdomen, diarrhea, vomiting and gastroesophageal reflux.
On the part of metabolism and nutrition: loss of appetite.
From the side of the central nervous system: headache, dizziness, drowsiness, convulsions.
On the part of the psyche: agitation, hallucinations, nightmares, impaired cognitive function (confusion, disorientation, anxiety, delirium, paranoia).
From the side of the heart: tachycardia and cardiac arrhythmias.
On the part of the eyes: blurred vision, dilated pupils, increased intraocular pressure, angle-closure glaucoma and dryness of the conjunctiva.
From the side of the kidneys and urinary tract: dysuria and urinary retention.
From the side of the vessels: hot flashes (more pronounced in children than in adults).
From the skin and subcutaneous tissues: dry skin, allergic reactions, including skin rashes, urticaria, angioedema and photosensitivity.
special instructions
The preparation should be used with caution in elderly patients, who may be more sensitive to the effects of oxybutynin and may need to reduce the dose (see application). the preparation should also be used with caution in patients with autonomic neuropathy, gastrointestinal diseases, including severe gastrointestinal motility disorders, patients with liver or kidney failure or cerebrovascular insufficiency.
After taking the preparation Driptan, it is possible to increase the clinical manifestations of hyperthyroidism, coronary artery disease, chronic heart failure, hypertension, prostatic hyperplasia, cardiac arrhythmias, tachycardia.
Oxybutynin is not considered safe in patients with porphyria because it has been shown to be porphyrinogenic in animal and in vitro studies.
Long-term use of the preparation Driptan can lead to the development of dental caries due to a decrease or cessation of salivation. In this regard, it is recommended to regularly check the condition of the teeth with prolonged use of the preparation.
In the case of a urinary tract infection, antibiotic therapy should be prescribed.
Patients with rare hereditary forms of galactose intolerance, lactase deficiency or malabsorption of glucose and galactose should not take Driptan due to the lactose content.
Use during pregnancy or lactation. The safety of oxybutynin during pregnancy has not been established. Animal studies have shown reproductive toxicity at maternally toxic doses, so oxybutynin should be avoided during pregnancy unless safer alternatives are not available.
In animals, oxybutynin passes into mother's milk, so Driptan should not be administered to women during lactation.
The ability to influence the reaction rate when driving vehicles or other mechanisms. The preparation may cause decreased visual acuity or drowsiness. Patients should not drive a car or operate other mechanisms, unless previously established that the preparation does not impair the patient's ability to physical or mental activity.
Interactions
With simultaneous use with lisuride, there is a risk of impaired consciousness, so regular clinical supervision of patients is necessary.
Driptan should be used with caution with other anticholinergic agents due to the possibility of potentiation of the anticholinergic effect.
There have been isolated cases of interaction between anticholinergics and phenothiazines, amantidine, butyrophenones, levodopa, digitalis preparations, tricyclic antidepressants. Caution should be exercised in the case of the simultaneous use of oxybutynin with these preparations.
Due to decreased gastric motility, oxybutynin may impair the absorption of other medicinal products.
Overdose
Symptoms. Overdose symptoms of Driptan develop in order from an increase in the usual side effects from the central nervous system (from anxiety and agitation to psychotic behavior) to circulatory disorders (hot flashes, decreased blood pressure, circulatory failure, etc.), respiratory failure, paralysis and coma.
Treatment. In case of overdose, predominantly symptomatic treatment is used: immediate gastric lavage; with a pronounced anticholinergic syndrome that threatens life, neostigmine (or physostigmine) may be used; elimination of fever.
In case of severe anxiety or agitation, inject diazepam intravenously.
In case of tachycardia, administer propranolol intravenously.
With urinary retention, catheterization of the bladder is indicated.
In case of development of paralysis of the respiratory muscles, carry out mechanical ventilation.
Storage conditions
In a place inaccessible to children at a temperature not exceeding 30 ° C.
Conditions for dispensing from pharmacies: by prescription.