Oxybutynin transdermal (patient information)

Why is this medication prescribed

Oxybutynin transdermal patches are used to treat an overactive bladder (a condition in which the bladder muscles contract uncontrollably and cause frequent urination, urgent need to urinate, and inability to control urination). Oxybutynin is in a class of medications called anticholinergics. It works by relaxing the bladder muscles to prevent urgent, frequent, or uncontrolled urination.

How should this medicine be used

Transdermal oxybutynin comes as a patch to apply to the skin. It is usually applied twice each week (every 3-4 days). You should apply transdermal oxybutynin on the same 2 days of the week every week. To help you remember to apply your patches on the right days, you should mark the calendar on the back of your package of medication. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use transdermal oxybutynin exactly as directed. Do not apply more or fewer patches or apply the patches more often than prescribed by your doctor.

You can apply oxybutynin patches anywhere on your stomach, hips, or buttocks except the area around your waistline. Choose an area where you think the patch will be comfortable for you, where it will not be rubbed by tight clothing, and where it will be protected from sunlight by clothing. After you apply a patch to a particular area, wait at least 1 week before applying another patch in that spot. Do not apply patches to skin that has wrinkles or folds; that you have recently treated with any lotion, oil, or powder; or that is oily, cut, scraped, or irritated. Before applying a patch, be sure the skin is clean and dry.

After you apply an oxybutynin patch, you should wear it all the time until you are ready to remove it and put on a fresh patch. If the patch loosens or falls off before it is time to replace it, try to press it back in place with your fingers. If the patch cannot be pressed back on, throw it away and apply a fresh patch to a different area. Replace the fresh patch on your next scheduled patch change day.

You may bathe, swim, shower, or exercise while you are wearing an oxybutynin patch. However, try not to rub on the patch during these activities, and do not soak in a hot tub for a long period of time while wearing a patch.

Transdermal oxybutynin controls the symptoms of overactive bladder but does not cure the condition. Continue to take transdermal oxybutynin even if you feel well. Do not stop taking transdermal oxybutynin without talking to your doctor.

To use the patches, follow these steps:

• Open the protective pouch and remove the patch.
• Peel the first piece of liner off the sticky side of the patch. A second strip of liner should remain stuck to the patch.
• Press the patch firmly onto your skin with the sticky side down. Be careful not to touch the sticky side with your fingers.
• Bend the patch in half and use your fingertips to roll the remaining part of the patch onto your skin. The second liner strip should fall off of the patch when you do this.
• Press firmly on the surface of the patch to attach it tightly to your skin.
• When you are ready to remove a patch, peel it off slowly and gently. Fold the patch in half with the sticky sides together and throw it away in a trash can that is out of reach of children and pets. Children and pets can be harmed if they chew on, play with, or wear used patches.
• Wash the area that was under the patch with mild soap and warm water to remove any residue. If necessary, you can use baby oil or a medical adhesive removal pad to remove residue that will not come off with soap and water. Do not use alcohol, nail polish remover, or other solvents.
• Apply a new patch to a different area immediately by following steps 1-5.

Other uses for this medicine

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow

Before using transdermal oxybutynin

• tell your doctor and pharmacist if you are allergic to oxybutynin (Ditropan, Ditropan XL, Oxytrol), any other medications, medical tape products, or other skin patches.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements and herbal products you are taking. Be sure to mention any of the following: antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), and miconazole (Micatin, Monistat); antihistamines; aspirin and other nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); chlorpromazine (Thorazine); cimetidine (Tagamet); clarithromycin (Biaxin); cyclosporine (Neoral, Sandimmune); danazol (Danocrine); delavirdine (Rescriptor); diltiazem (Cardizem, Dilacor, Tiazac); doxycycline (Doryx, Vibramycin); erythromycin (E.E.S., E-Mycin, Erythrocin); fluoxetine (Prozac, Sarafem); fluvoxamine (Luvox); HIV protease inhibitors such as indinavir (Crixivan) and ritonavir (Norvir); ipatropium (Atrovent); isoniazid (INH, Nydrazid); iron supplements; medications for osteoporosis or bone disease such as alendronate (Fosamax), etidronate (Didronel), ibandronate (Boniva), and risedronate (Actonel); medications for irritable bowel disease, motion sickness, Parkinson's disease, ulcers, or urinary problems; metronidazole (Flagyl); morphine (MSIR, Oramorph, others); nefazodone (Serzone); oral contraceptives (birth control pills); paroxetine (Paxil); potassium supplements (Slow-K, Klor-Con, others); qunidine (Quinaglute); tetracycline (Sumycin); troleandomycin (TAO); verapamil (Calan, Covera, Isoptin, Verelan); and zafirlukast (Accolate). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you or any of your family members have or have ever had glaucoma (an eye disease that can cause vision loss) and if you have or have ever had any type of blockage in the bladder or digestive system; gastroesophageal reflux disease (GERD, a condition in which the contents of the stomach back up into the esophagus and cause pain and heartburn); myasthenia gravis (a disorder of the nervous system that causes muscle weakeness); ulcerative colitis (sores in the intestine that cause stomach pain and diarrhea); benign prostatic hypertrophy (BPH, enlargement of the prostate, a male reproductive organ); or liver or kidney disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using transdermal oxybutynin, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are using transdermal oxybutynin.
• you should know that transdermal oxybutynin may make you drowsy and may blur your vision. Do not drive a car or operate machinery until you know how this medication affects you.
• remember that alcohol can add to the drowsiness caused by this medication.
• you should know that transdermal oxybutynin may make it harder for your body to cool down when it gets very hot. Avoid exposure to extreme heat, and call your doctor or get emergency medical treatment if you have fever or other signs of heat stroke such as dizziness, upset stomach, headache, confusion, and fast pulse after you are exposed to heat.

What special dietary instructions should I follow

Talk to your doctor about drinking grapefruit juice while taking this medicine.

What should I do if I forget a dose

Remove the old patch and apply a new patch to a different spot as soon as you remember it. Replace the new patch on your next scheduled patch change day. Do not apply two patches to make up for a missed dose and never wear more than one patch at a time.

Side effects

Mild side effects

Transdermal oxybutynin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• redness, burning, or itching in the place where you applied a patch
• dry mouth
• constipation
• stomach pain
• gas
• upset stomach
• extreme tiredness
• drowsiness
• headache
• blurred vision
• flushing
• back pain

Severe side effects

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, call your doctor immediately:

• blisters, rash, or spots in the place where you applied a patch
• rash anywhere on the body
• painful urination

Transdermal oxybutynin may cause other side effects. Call your doctor if you have any unusual problems while using this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

What storage conditions are needed for this medicine

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store the patches in their protective pouches and do not open a pouch until you are ready to apply the patch. Store this medication at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

• flushing
• fever
• constipation
• dry skin
• sunken eyes
• extreme tiredness
• irregular heartbeat
• vomiting
• inability to urinate
• memory loss
• semi-awake state
• confusion
• wide pupils

What other information should I know

Keep all appointments with your doctor

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Brand names

• Ditropan®
• Ditropan® Syrup
• Ditropan® XL