Ditropan XL (Oxybutynin) - Oral

What Is Ditropan XL?

Ditropan XL (oxybutynin) is an orally prescribed extended-release (ER) medication that is primarily used to treat symptoms of overactive bladder, including urge incontinence (loss of bladder control), urgency, and frequency. Additionally, for children 6 and older, Ditropan XL is used to treat detrusor overactivity associated with a neurological condition, such as spina bifida.

The primary ingredient in Ditropan XL, oxybutynin, is classified as an antispasmodic and anticholinergic agent. Anticholinergics/antispasmodic agents are a category of drugs that are used to relieve cramps or spasms of the stomach, intestines, and bladder.

Specifically, anticholinergics are drugs that block the action of a neurotransmitter called acetylcholine. Acetylcholine transports signals between cells that can affect bodily functions. Anticholinergics block acetylcholine from causing involuntary muscle movements in the lungs, gastrointestinal (GI) tract, urinary tract, and other parts of the body.

In comparison, antispasmodics are medications that can help control some symptoms that arise from the gut (intestines). They work by attaching to muscle receptors, stopping the chemicals from "docking" to make the muscle contract.

As a result, oxybutynin works to control bladder function by relaxing the smooth muscles in the bladder. Once the smooth muscles of the bladder are relaxed, Ditropan XL can increase bladder capacity, reduce the frequency of unwanted contractions of the bladder, and slow the initial desire to urinate, thus decreasing the urgency and frequency of involuntary and voluntary urination.

It should be noted that oxybutynin as a generically-marketed product is available through a prescription.

This article will focus solely on Ditropan XL as an oral medication.

What Is Ditropan XL Used For?

Ditropan XL is Food and Drug Administration (FDA)-approved for the treatment of an overactive bladder that corresponds with symptoms of urge urinary incontinence, urgency, and frequency.

An overactive bladder is a condition where the bladder squeezes urine out at the wrong time. You may have an overactive bladder if you have two or more of these symptoms:

• You urinate eight or more times a day or two or more times at night.
• You have the sudden, strong need to urinate immediately.
• You leak urine after a sudden, strong urge to urinate.

In comparison, urinary incontinence is defined as a loss of bladder control. Incontinence is caused by either nerve problems, too much fluid, or too much caffeine. However, quite often, the cause is unknown.

An overactive bladder, in addition to a lack of bladder control, is a common ailment among older adults, present in both men and women. Notably, overactive bladder (OAB) syndrome, according to one study, can greatly impact a person's ability to conduct daily activities and has an estimated prevalence of 16.5% within the United States (U.S.). What's more, many people do not seek medical help.

Additionally, while Ditropan XL is mainly for adults, it can also be used to treat children 6 or older with bladder overactivity symptoms that are associated with neurological conditions, such as spina bifida (a birth defect where a developing baby's spinal cord fails to develop properly).

Children born with spina bifida are almost always found to have a neurogenic bladder. This is because the nerves in the spinal cord that control the bladder did not form properly. This means that the bladder will have trouble storing urine in the bladder, emptying the bladder, or both.

How to Take Ditropan XL

You should take this medication as directed by your healthcare provider. The XL tablet must be swallowed whole. Do not crush, break, or chew it; try to take this medicine at the same time each day, according to your healthcare provider's instructions.

The ER tablet is usually taken once a day with or without food.

When you start this medication, your healthcare provider may need to adjust your dose in 5-milligram increments to determine which dosage works best for you.

After taking this medicine, you may see a part of the tablet or tablet shell pass into your stools. If this happens, do not be alarmed, this is normal so you have nothing to worry about.

This medication may cause drowsiness or blurred vision, so you should avoid activities requiring mental alertness or coordination until you know how Ditropan XL will affect you. Additionally, drinking alcohol while consuming oxybutynin may enhance these effects.

Storage

Store this medicine in a closed container at room temperature, away from heat, moisture, and direct light. Do not store in a bathroom. Additionally, make sure to keep out of reach of children and pets.

Refilling and traveling with this medication carries no special instructions. Ask your healthcare provider to request a refill if you need more medication.

What Are the Side Effects of Ditropan XL?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

The most common side effects associated with Ditropan XL include:

• Urinary retention
• Constipation
• Diarrhea 
• Nausea
• Dry mouth
• Heartburn
• Stomach pain
• Dizziness
• Blurred vision
• Headache
• Fatigue
  

Severe Side Effects

Call 911 if your side effects feel life-threatening or if you think you’re having a medical emergency.

Serious side effects can include the following:

• Signs of an allergic reaction to Ditropan XL and/or any of its ingredients: Itching or urticaria (hives), swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Confusion
• Seizures
• Hallucinations
• Angioedema 
• Decreased sweating/heat prostration (overheating of the body when Ditropan XL is taken in hot environments)
  

Dosage: How Much Ditropan XL Should I Take?

Modifications

Users should be aware of the following before beginning Ditropan XL:

Allergic reactions: If you are allergic to oxybutynin, or any of the active ingredients in Ditropan XL, you should avoid use. Speak with your healthcare provider to find alternative methods to treat OBS or urinary incontinence.

Pregnancy: There are no adequate and well-controlled studies using Ditropan XL in pregnant people. Ditropan XL should be used during pregnancy only if the potential benefit outweighs the risk to the parent and fetus.

People who become pregnant during Ditropan XL treatment are encouraged to contact their healthcare provider to be advised on the next steps in treatment. 

Breastfeeding: It is not known whether oxybutynin is excreted in human milk. Because many drugs are excreted in human milk, caution should be used when Ditropan XL is administered to a nursing person. Consult with your healthcare provider to determine if it is safe to breastfeed while taking Ditropan XL.

Children: The safety and efficacy of Ditropan XL were studied in 60 children in a 24-week, open-label, non-randomized trial. In this study, people were 6 to 15 years old, all had symptoms of detrusor overactivity in combination with a neurological condition, and all were current users of oxybutynin.

Therefore, the safety and efficacy of Ditropan XL in children under 6 have not been studied enough to warrant FDA approval.

Older adults: The rate and severity of anticholinergic effects reported by people under 65 and those older than 65 were similar. Therefore, no standard dosing adjustments are typically needed based on age.

Missed Dose

If you miss your dose of Ditropan XL, take the dose as soon as you remember. If it is almost time for your next dose, wait until then and take the regular dose. Do not take extra medicine to make up for a missed dose.

Overdose: What Happens If I Take Too Much Ditropan XL?

Agitation, confusion, and hallucinations may develop with moderate poisoning from excessive Ditropan XL use.

Moreover, severe effects may include agitated delirium, psychosis, hallucinations, seizures, hyperthermia (heat-related illnesses), and coma.

If an overdose of Ditropan XL or similar anticholinergic medications is suspected, seek medical attention immediately. 

Precautions

What Are Reasons I Shouldn't Take Ditropan XL?

You should consult with your healthcare provider before taking Ditropan XL if you have any of the following conditions, as Ditropan XL may exasperate or make these conditions worse:

• Currently pregnant or breastfeeding while taking Ditropan XL
• Kidney disease
• Dementia
• Glaucoma
• Heart disease
• Cardiac arrhythmias
• Hypertension (high blood pressure)
  
• Myasthenia gravis
• Parkinson's disease
• Benign prostatic hyperplasia (BPH; enlarged prostate)
• Trouble urinating
• Stomach or bowel problems (including colitis, chronic constipation, a bowel blockage)
• Gastroesophageal reflux disease (GERD)

You should not take Ditropan XL if you have any of the following conditions:

• Known allergic reaction to oxybutynin chloride or to any component of the product
• Known or at risk for gastric retention or other severe decreased gastrointestinal motility conditions
• Known or at risk for uncontrolled narrow-angle glaucoma
• Known or at risk for urinary retention

What Other Medications May Interact With Ditropan XL?

Taking oxybutynin with other anticholinergic medications can increase your chances of developing dry mouth, constipation, drowsiness, or other severe anticholinergic-like side effects.

Please talk with your healthcare provider if you are taking any of the following medications because these medications can increase the concentration of oxybutynin in your body:

• Reglan (metoclopramide)
• Bisphosphonate medications
• Drugs that treat infection, such as Biaxin XL (clarithromycin), erythromycin, Sporanox (itraconazole), ketoconazole, and miconazole)

What Medications Are Similar?

Other anticholinergic medications that treat overactive bladder and urinary urgency symptoms include:

• Detrol (tolterodine)
• Darifenacin
• Vesicare (solifenacin)
• Trospium
• Toviaz (fesoterodine)

How Can I Stay Healthy While Taking Ditropan XL?

This medicine may make you dizzy or drowsy, or cause vision problems. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

This medicine may also make you sweat less. This can cause your body to become too hot. It is important to take precautions if you exercise strenuously or are outside in hot weather. Drink plenty of fluids to stay hydrated.

While taking this Ditropan XL, your healthcare provider will check your progress and the effects of this medicine at regular visits so be sure to keep all of your appointments.