Ditropan

Generic Name: Oxybutynin hydrochloride
Product Name: Ditropan

Indication

Ditropan is the brand name for a drug called oxybutynin chloride. This is a smooth muscle relaxant drug mainly used to relieve bladder muscle spasm where other conservative measures have already failed. Ditropan can be used to treat a number of bladder instability disorders associated with abnormal nerve impulses to the bladder. In these cases, Ditropan reduces bladder activity and relieves symptoms of urgency, frequency, dysuria and urinary incontinence. Ditropan may also be used to treat incontinence in children older than 5 years. Note that Ditropan helps control your symptoms but does not cure your condition. Thus you will need to take it every day for a specified period of time. Note that Ditropan may have been prescribed to you for a reason other than those listed above. If you have any queries regarding why Ditropan has been prescribed, discuss them with your doctor. Furthermore, not all patients with the above conditions should be treated with Ditropan. You should discuss with your doctor whether Ditropan is suited for you and your particular circumstances.

Action

The active component of Ditropan called oxybutynin chloride, relaxes smooth muscles in the body. It does this by a direct means and by inhibiting effects of a compound called acetylcholine. In particular, Ditropan relaxes bladder smooth muscle (detrusor muscle) in patients with involuntary contractions. This delays the initial desire and the urge to urinate.

Dose advice

Do not take Ditropan if you:

• Are allergic to Ditropan or any of the other inactive ingredients of the tablets.
• Have acute angle closure glaucoma or problems with the pressure in your eyes, bowel obstruction, intestinal problems (including colitis), myaesthenia gravis (a muscle disorder), urinary tract blockage or severe bleeding.
• Are pregnant or breastfeeding as Ditropan may have unwanted effects on your baby.

Before taking Ditropan you should tell your doctor:

1. If you are allergic to any medications, foods or dyes- Ditropan should not be used if you are allergic to this type of medication.
2. If you are pregnant or intend on becoming pregnant- Research into the use of Ditropan during pregnancy is currently limited and safety data is only based on a few animal studies. Your doctor will discuss the risks and benefits of using this medication during pregnancy.
3. If you have any other medical conditions- In particular tell your doctor if you have any liver, kidney or heart problems, high blood pressure, an enlarged prostate, eye problems, intestinal or bowel problems, myaesthenia gravis, urinary tract obstruction or hiatus hernia as Ditropan may aggravate some of these conditions.
4. Any other medications you are taking (including those bought from supermarkets or the chemist)- Ditropan can interact with some medications used to treat depression, psychotic disorders, Parkinson’s disease and heart arrhythmias which may affect how one or both drugs work. Your doctor will discuss which other medications are safe to use concurrently with Ditropan.

Dose administration:

Ditropan comes as round light blue tablets containing 5mg of the active component oxybutinin hydrochloride. They are supplied in bottles of 100 tablets. Ditropan tablets are intended to be swallowed whole with a glass of water. You should always take Ditropan as prescribed by your doctor. For adults, the usual dose is one tablet 2-3 times per day (up to a maximum of four times per day). Elderly patients may require a lower dose. Children older than five years usually have one tablet two times per day. During your treatment your doctor will monitor your response and development of any side effects. They may perform regular cystometry which is a series of tests measuring your bladder function. Whilst taking Ditropan you should be careful driving and operating machinery as Ditropan can cause dizziness, drowsiness and affect your vision. Alcohol and other sedative drugs may also worsen these side effects. In addition, be careful taking Ditropan in very hot environments as it can impair your ability to sweat and hence cause overheating.

Schedule

S4 (prescription required).

Common side effects

Ditropan helps most people with bladder problems but like all medications may have unwanted side effects in some people. The majority of these side effects are mild and do not require specific treatment; however some patients can have more serious side effects. In general the larger dose used, the more likely you are to experience side effects. If you experience any symptoms you may think are caused by taking Ditropan be sure to discuss them with your doctor. The most commonly reported side effects of Ditropan occurring in at least 5% of patients treated with the drug include:

• Abdominal pain.
• Headache.
• Dry mouth.
• Nausea
• Constipation
• Dyspepsia (a feeling of indigestion or discomfort in the upper part of the stomach).
• Diarrhoea
• Dizziness.
• Drowsiness.
• Blurred vision.
• Difficulty urinating.
• Burning or discomfort urinating which may be a sign of urinary tract infection.
• Facial flushing (especially in children).

Uncommon side effects

A small number of patients can experience more serious side effects that should be addressed more urgently by your doctor. The following side effects occur in less than approximately 2% of patients:

• Cardiovascular problems: if you notice a fast or irregular heartbeat tell your doctor immediately.
• Reduced sweating and overheating: this can be avoided by taking appropriate precautions such as avoiding hot weather and excessive exercise. However if you do notice a fever or heat stroke seek medical assistance urgently.
• Cognitive dysfunction: confusion, hallucinations, anxiety and paranoia (severe suspiciousness) may occur in some patients.
• Eye problems- including eye muscle dysfunction and increase intraocular pressure. These side effects may threaten your vision.
• Convulsions or fits.
• Difficulty sleeping, unusual tiredness and weakness.
• Reduced flow of breast milk during lactation.
• Impotence.
• Difficulty breathing: this usually only occurs in acute overdose of Ditropan.
• Overdosing usually leads to a combination of symptoms such as central nervous system excitation (restlessness, tremor, irritability etc), flushing, fever, dehydration, irregular heart beat, vomiting and urinary retention. In severe overdose this can lead to respiratory failure, paralysis and coma.

Do not be alarmed by these long lists of side effects as most patients will not experience any side effects at all. It is however important that you know the most common and serious side effects so that they can be identified and treated early. You may also experience side effects other than those listed as Ditropan can affect all patients differently. If you have any queries or concerns discuss them with your doctor.

References

1. Australian Medicines Handbook- 13.1.1- Oxybutynin, AMH Pty Ltd. 2006.
2. Ditropan- Consumer Medicine Information, Sanofi-Aventis Australia Pty Ltd 2006. Available from: [URL Link]
3. Ditropan- Product Information, Ortho-McNeil, 2003. Available from: [PDF File]
4. MIMS online- Prescribing Information, Ditropan, MIMS Australia Pty Ltd 2003.

For further information talk to your doctor.