of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor. paliperidone increases effects of oxybutynin topical by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.pancuroniumMonitor Closely (1)oxybutynin topical and pancuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.perphenazineMonitor Closely (3)oxybutynin topical decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin topical decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor. perphenazine increases effects of oxybutynin topical by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.Minor (1)oxybutynin topical increases toxicity of perphenazine by unspecified interaction mechanism. Minor/Significance Unknown.physostigmineMonitor Closely (1)physostigmine increases and oxybutynin topical decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.pilocarpineMonitor Closely (1)pilocarpine increases and oxybutynin topical decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.pimozideMonitor Closely (3)oxybutynin topical decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin topical decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor. pimozide increases effects of oxybutynin topical by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.pralidoximeMonitor Closely (1)oxybutynin topical and pralidoxime both decrease cholinergic effects/transmission. Use Caution/Monitor.pramlintideSerious - Use Alternative (1)pramlintide, oxybutynin topical. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.prochlorperazineMonitor Closely (3)oxybutynin topical decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin topical decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor. prochlorperazine increases effects of oxybutynin topical by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.Minor (1)oxybutynin topical increases toxicity of prochlorperazine by unspecified interaction mechanism. Minor/Significance Unknown.promazineMinor (1)oxybutynin topical increases toxicity of promazine by unspecified interaction mechanism. Minor/Significance Unknown.promethazineMonitor Closely (3)oxybutynin topical decreases levels of promethazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin topical decreases levels of promethazine by pharmacodynamic antagonism. Use Caution/Monitor. promethazine increases effects of oxybutynin topical by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.Minor (1)oxybutynin topical increases toxicity of promethazine by unspecified interaction mechanism. Minor/Significance Unknown.propanthelineMonitor Closely (1)oxybutynin topical and propantheline both decrease cholinergic effects/transmission. Use Caution/Monitor.protriptylineMonitor Closely (1)oxybutynin topical and protriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.pyridostigmineMonitor Closely (1)pyridostigmine increases and oxybutynin topical decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.quetiapineMonitor Closely (3)oxybutynin topical decreases levels of quetiapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin topical decreases levels of quetiapine by pharmacodynamic antagonism. Use Caution/Monitor. quetiapine increases effects of oxybutynin topical by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.rapacuroniumMonitor Closely (1)oxybutynin topical and rapacuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.risperidoneMonitor Closely (3)oxybutynin topical decreases levels of risperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin topical decreases levels of risperidone by pharmacodynamic antagonism. Use Caution/Monitor. risperidone increases effects of oxybutynin topical by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.rocuroniumMonitor Closely (1)oxybutynin topical and rocuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.ruxolitinibMinor (1)oxybutynin topical will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.ruxolitinib topicalMinor (1)oxybutynin topical will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.scopolamineMonitor Closely (1)oxybutynin topical and scopolamine both decrease cholinergic effects/transmission. Use Caution/Monitor.secretinSerious - Use Alternative (1)oxybutynin topical 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 topical and solifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.succinylcholineMonitor Closely (1)succinylcholine increases and oxybutynin topical decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.thioridazineMonitor Closely (3)oxybutynin topical decreases levels of thioridazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin topical decreases levels of thioridazine by pharmacodynamic antagonism. Use Caution/Monitor. thioridazine increases effects of oxybutynin topical by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.Minor (1)oxybutynin topical increases toxicity of thioridazine by unspecified interaction mechanism. Minor/Significance Unknown.thiothixeneMonitor Closely (3)oxybutynin topical decreases levels of thiothixene by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin topical decreases levels of thiothixene by pharmacodynamic antagonism. Use Caution/Monitor. thiothixene increases effects of oxybutynin topical by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.tinidazoleMonitor Closely (1)oxybutynin topical will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.tiotropiumMonitor Closely (1)oxybutynin topical and tiotropium both decrease cholinergic effects/transmission. Use Caution/Monitor.tolterodineMonitor Closely (1)oxybutynin topical and tolterodine both decrease cholinergic effects/transmission. Use Caution/Monitor.trazodoneMonitor Closely (1)oxybutynin topical and trazodone both decrease cholinergic effects/transmission. Use Caution/Monitor.trifluoperazineMonitor Closely (3)oxybutynin topical decreases levels of trifluoperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin topical decreases levels of trifluoperazine by pharmacodynamic antagonism. Use Caution/Monitor. trifluoperazine increases effects of oxybutynin topical by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.Minor (1)oxybutynin topical increases toxicity of trifluoperazine by unspecified interaction mechanism. Minor/Significance Unknown.trihexyphenidylMonitor Closely (1)oxybutynin topical and trihexyphenidyl both decrease cholinergic effects/transmission. Use Caution/Monitor. Potential for additive anticholinergic effects.trimipramineMonitor Closely (1)oxybutynin topical and trimipramine both decrease cholinergic effects/transmission. Use Caution/Monitor.trospium chlorideMonitor Closely (1)oxybutynin topical and trospium chloride both decrease cholinergic effects/transmission. Use Caution/Monitor.vecuroniumMonitor Closely (1)oxybutynin topical and vecuronium both decrease cholinergic effects/transmission. Use Caution/Monitor.ziprasidoneMonitor Closely (3)oxybutynin topical decreases levels of ziprasidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin topical decreases levels of ziprasidone by pharmacodynamic antagonism. Use Caution/Monitor. ziprasidone increases effects of oxybutynin topical by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.zotepineMonitor Closely (2)oxybutynin topical decreases levels of zotepine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. oxybutynin topical decreases levels of zotepine by pharmacodynamic antagonism. Use Caution/Monitor. NOTE: anticholinergic adverse effects are less with topical application compared with oral administration 1-10% Xerostomia (7.5%) Urinary tract infection (6.9%) Application site reaction (5.4%) Dizziness (2.8%) Fatigue (2.1%) Constipation (1.3%) 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) Caution with myasthenia gravis because of decreased cholinergic activity Discontinue if skin hypersensitivity occurs 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 Somnolence reported with oxybutynin-containing products; use caution with activities requiring mental alertness Gelnique is flammable Pregnancy Category: B Lactation: Unknown whether distributed in breast milk, caution advisedPregnancy 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 urinary contractions, and delays desire to void; increases bladder capacity Pharmacokinetics Vd: 193 L (IV) Peak Plasma Concentration: 6.8-8.3 ng/mL (gel) Metabolism: bypasses first-pass in liver by CYP3A4, AUC ratio of N-desethyloxybutynin (active metabolite) to parent compound is 1:1 No images available for this drug. No images available for this drug.A Patient Handout is not currently available for this monograph.Print FormularyPatient DiscountsAdding plans allows you to compare formulary status to other drugs in the same class.To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.Create Your List of PlansAdding plans allows you to:View the formulary and any restrictions for each plan.Manage and view all your plans together – even plans in different states.Compare formulary status to other drugs in the same class.Access your plan list on any device – mobile or desktop. The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. View explanations for tiers and restrictions Tier Description 1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs. 2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs. 3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs. 4 This drug is available at a higher level co-pay. 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