by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.loxapine inhaledMonitor Closely (3)oxybutynin transdermal decreases levels of loxapine inhaled by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin transdermal decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor. loxapine inhaled increases effects of oxybutynin transdermal by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.maprotilineMonitor Closely (1)oxybutynin transdermal and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.meclizineMonitor Closely (1)meclizine and oxybutynin transdermal both decrease cholinergic effects/transmission. Use Caution/Monitor.methscopolamineMonitor Closely (1)methscopolamine and oxybutynin transdermal both decrease cholinergic effects/transmission. Use Caution/Monitor.metoclopramideMonitor Closely (1)oxybutynin transdermal decreases effects of metoclopramide by pharmacodynamic antagonism. Use Caution/Monitor. May antagonize prokinetic effects.midazolam intranasalMonitor Closely (1)oxybutynin transdermal will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.neostigmineMonitor Closely (1)neostigmine increases and oxybutynin transdermal decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.nitrofurantoinMonitor Closely (1)oxybutynin transdermal increases levels of nitrofurantoin by unspecified interaction mechanism. Use Caution/Monitor.nortriptylineMonitor Closely (1)oxybutynin transdermal and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.olanzapineMonitor Closely (3)oxybutynin transdermal decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin transdermal decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor. olanzapine increases effects of oxybutynin transdermal by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.onabotulinumtoxinAMonitor Closely (1)onabotulinumtoxinA and oxybutynin transdermal both decrease cholinergic effects/transmission. Use Caution/Monitor.orphenadrineMonitor Closely (1)oxybutynin transdermal and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.oxybutyninMonitor Closely (1)oxybutynin and oxybutynin transdermal both decrease cholinergic effects/transmission. Use Caution/Monitor.paliperidoneMonitor Closely (3)oxybutynin transdermal decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin transdermal decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor. paliperidone increases effects of oxybutynin transdermal by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.pancuroniumMonitor Closely (1)oxybutynin transdermal and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.perphenazineMonitor Closely (3)oxybutynin transdermal decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin transdermal decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor. perphenazine increases effects of oxybutynin transdermal by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.Minor (1)oxybutynin transdermal increases toxicity of perphenazine by unspecified interaction mechanism. Minor/Significance Unknown.physostigmineMonitor Closely (1)physostigmine increases and oxybutynin transdermal decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.pilocarpineMonitor Closely (1)pilocarpine increases and oxybutynin transdermal decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.pimozideMonitor Closely (3)oxybutynin transdermal decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin transdermal decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor. pimozide increases effects of oxybutynin transdermal by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.pralidoximeMonitor Closely (1)oxybutynin transdermal and pralidoxime both decrease cholinergic effects/transmission. Use Caution/Monitor.pramlintideSerious - Use Alternative (1)pramlintide, oxybutynin transdermal. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.prochlorperazineMonitor Closely (3)oxybutynin transdermal decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin transdermal decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor. prochlorperazine increases effects of oxybutynin transdermal by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.Minor (1)oxybutynin transdermal increases toxicity of prochlorperazine by unspecified interaction mechanism. Minor/Significance Unknown.promazineMinor (1)oxybutynin transdermal increases toxicity of promazine by unspecified interaction mechanism. Minor/Significance Unknown.promethazineMonitor Closely (3)oxybutynin transdermal decreases levels of promethazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin transdermal decreases levels of promethazine by pharmacodynamic antagonism. Use Caution/Monitor. promethazine increases effects of oxybutynin transdermal by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.Minor (1)oxybutynin transdermal increases toxicity of promethazine by unspecified interaction mechanism. Minor/Significance Unknown.propanthelineMonitor Closely (1)oxybutynin transdermal and propantheline both decrease cholinergic effects/transmission. Use Caution/Monitor.protriptylineMonitor Closely (1)oxybutynin transdermal and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.pyridostigmineMonitor Closely (1)pyridostigmine increases and oxybutynin transdermal decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.quetiapineMonitor Closely (3)oxybutynin transdermal decreases levels of quetiapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin transdermal decreases levels of quetiapine by pharmacodynamic antagonism. Use Caution/Monitor. quetiapine increases effects of oxybutynin transdermal by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.rapacuroniumMonitor Closely (1)oxybutynin transdermal and rapacuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.ribociclibMonitor Closely (1)ribociclib will increase the level or effect of oxybutynin transdermal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.rimantadineMonitor Closely (1)oxybutynin transdermal, rimantadine. Mechanism: pharmacodynamic synergism. Use Caution/Monitor. Enhanced CNS side effects.Minor (1)rimantadine increases effects of oxybutynin transdermal by pharmacodynamic synergism. Minor/Significance Unknown.risperidoneMonitor Closely (3)oxybutynin transdermal decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin transdermal decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor. risperidone increases effects of oxybutynin transdermal by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.rivastigmineMonitor Closely (1)rivastigmine increases and oxybutynin transdermal decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.rocuroniumMonitor Closely (1)oxybutynin transdermal and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.ruxolitinibMinor (1)oxybutynin transdermal will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.ruxolitinib topicalMinor (1)oxybutynin transdermal will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.scopolamineMonitor Closely (1)oxybutynin transdermal and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.secretinSerious - Use Alternative (1)oxybutynin transdermal decreases effects of secretin by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Concomitant use of anticholinergic drugs may cause a hyporesponse to stimulation testing with secretin. Discontinue anticholinergic drugs at least 5 half-lives before administering secretin.solifenacinMonitor Closely (1)oxybutynin transdermal and solifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.succinylcholineMonitor Closely (1)succinylcholine increases and oxybutynin transdermal decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.tazemetostatMonitor Closely (1)oxybutynin transdermal will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.thioridazineMonitor Closely (3)oxybutynin transdermal decreases levels of thioridazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin transdermal decreases levels of thioridazine by pharmacodynamic antagonism. Use Caution/Monitor. thioridazine increases effects of oxybutynin transdermal by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.Minor (1)oxybutynin transdermal increases toxicity of thioridazine by unspecified interaction mechanism. Minor/Significance Unknown.thiothixeneMonitor Closely (3)oxybutynin transdermal decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin transdermal decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor. thiothixene increases effects of oxybutynin transdermal by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.tinidazoleMonitor Closely (1)oxybutynin transdermal will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tiotropiumMonitor Closely (1)oxybutynin transdermal and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.tolterodineMonitor Closely (1)oxybutynin transdermal and tolterodine both decrease cholinergic effects/transmission. Use Caution/Monitor.trazodoneMonitor Closely (1)oxybutynin transdermal and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.trifluoperazineMonitor Closely (3)oxybutynin transdermal decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin transdermal decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor. trifluoperazine increases effects of oxybutynin transdermal by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.Minor (1)oxybutynin transdermal increases toxicity of trifluoperazine by unspecified interaction mechanism. Minor/Significance Unknown.trihexyphenidylMonitor Closely (1)oxybutynin transdermal and trihexyphenidyl both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.trimipramineMonitor Closely (1)oxybutynin transdermal and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.trospium chlorideMonitor Closely (1)oxybutynin transdermal and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.vecuroniumMonitor Closely (1)oxybutynin transdermal and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.ziprasidoneMonitor Closely (3)oxybutynin transdermal decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin transdermal decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of oxybutynin transdermal by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.zotepineMonitor Closely (2)oxybutynin transdermal decreases levels of zotepine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin transdermal decreases levels of zotepine by pharmacodynamic antagonism. Use Caution/Monitor. NOTE: anticholinergic adverse effects are less with transdermal application compared with oral administration >10% Pruritus at application site (14-16.8%) 1-10% Xerostomia (4.1-9.6%) Erythema at application site (5.6-8.3%) Constipation (3.3%) Vesicles, macules, rash at application site (2.5-3.3%) Diarrhea (3.2%) Blurred vision (2.5%) Dysuria (2.4%) Postmarketing Reports Nervous system disorders: Memory impairment, dizziness, somnolence, confusion Psychiatric disorders: Delirium, hallucinations Contraindications Hypersensitivity Gastric retention Uncontrolled narrow-angle glaucoma Urinary retention Conditions that severely decrease GI motility Cautions Caution with clinically significant bladder outflow obstruction because of the risk of urinary retention Caution with gastrointestinal obstructive disorders or decreased intestinal motility because of the risk of gastric retention Caution with GERD and/or those taking drugs that can cause or exacerbate esophagitis (eg, bisphosphonates) Discontinue if skin hypersensitivity occurs Avoid use in patients with myasthenia gravis because of decreased cholinergic activity; if experiencing exacerbation of symptoms of myasthenia gravis, oxybutynin-containing product should be discontinued and appropriate therapy promptly provided Caution with other anticholinergics (antimuscarinics); may increase risk for xerostomia, constipation, headache, dizziness, somnolence, and blurred vision Angioedema requiring hospitalization and emergency medical treatment has occurred with the first or subsequent doses of oral oxybutynin; in the event of angioedema, oxybutynin containing products should be discontinued and appropriate therapy promptly provided Pregnancy There are no studies with topical or oral oxybutynin use in pregnant women to inform a drug associated risk for birth defects or miscarriage; no adverse developmental outcomes observed in animal reproduction studies when administered to pregnant rats and rabbits during organogenesis at approximately 50 and 1 times, respectively, the maximum human dose based on body surface area Lactation There is no information on presence of drug in human milk, effects on breastfed child, or on milk production; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for therapy and any potential adverse effects on breastfed child from therapy or from the underlying maternal conditionPregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Exerts antispasmodic and antimuscarinic effects on smooth muscle; decreases uninhibited contractions, and delays desire to void; increases bladder capacity Pharmacokinetics Peak Plasma Concentration: 3-6.6 ng/mL Metabolism: bypasses first-pass in liver by CYP3A4, AUC ratio of N-desethyloxybutynin (active metabolite) to parent compound is 1:1 BRAND FORM. UNIT PRICE PILL IMAGE Oxytrol transdermal- 3.9 mg/24 hr transdermal systemOxytrol transdermal- 3.9 mg/24 hr transdermal systemGelnique transdermal- 10 % (100 mg/gram) gelGelnique transdermal- 10 % (100 mg/gram) gelCopyright © 2010 First DataBank, Inc.Print Patient Educationoxybutynin transdermal OXYBUTYNIN - TRANSDERMAL (OX-i-BUE-ti-nin) COMMON BRAND NAME(S): Oxytrol USES: Oxybutynin is used to treat an overactive bladder. By relaxing the muscles in the bladder, oxybutynin improves symptoms such as the inability to control urination (incontinence), feeling that one has to urinate (urgency), and having to go to the bathroom often (frequency). This medication belongs to the class of drugs known as antispasmodics.This medication is not recommended for use in children younger than 5 years of age. Consult your doctor for more information.Unless otherwise directed by your doctor, the over-the-counter product should only be used by adult women who have symptoms of overactive bladder for at least 2 months.For over-the-counter products, carefully read the package instructions to make sure the product is right for you. Check the ingredients on the label even if you have used the product before. The manufacturer may have changed the ingredients. Also, products with similar names may contain different ingredients meant for different purposes. Taking the wrong product could harm you. HOW TO USE: If you are taking the over-the-counter product to self treat,