<p>Insights into the Management of Overactive Bladder with Transdermal Oxybutynin: A Practical Review</p>

Abstract

Overactive bladder (OAB), clinically defined as urinary urgency, with or without incontinence, generally accompanied by an increase in urinary frequency and nocturia, after any local disease or metabolic disorder that would explain these symptoms have been ruled out, is a highly prevalent condition that affects millions of men and women worldwide. Not only can the symptoms of OAB be very bothersome, but OAB can have significant detrimental effects on many aspects of individuals' lives, representing a particularly impactful health burden to quality of life and productivity. Besides a wide range of conservative treatments, the clinical efficacy of which remains an open issue, antimuscarinics are the mainstay of pharmacotherapy for this condition but anticholinergic troublesome side effects like dry mouth, and the patient's perception of lack of efficacy and poor adherence, are common reasons of abandonment of treatment. An alternative to oral administration treatment, with a lower incidence of dry mouth and other anticholinergic adverse effects, might be attractive to patients and a real treatment option for physicians. Delivery of oxybutynin directly through the skin with oxybutynin transdermal (OXY-TDS) avoids the first-pass hepatic metabolism that occurs with orally administered oxybutynin and prevents the appearance of anticholinergic adverse events. OXY-TDS being equally effective than oral treatment improves adherence, persistence, and patient satisfaction. The aim of this review is to focus on evidence available of the use of OXY-TDS in the management of patients with OAB, and to help clinicians in the challenges involved in the treatment options for patients with this condition.

Cognitive effects of individual anticholinergic drugs: a systematic review and meta-analysis

“…Regarding the route of administration, transdermal scopolamine was not associated with significant cognitive effects in three out of five included studies. Despite the efficacy in reducing symptoms, multiple observational studies could not find a meaningful association between transdermal oxybutynin use and risk of cognitive impairment as well [46][47][48][49] . There are limited studies on the assessment of cognitive effects of mydriatic eye solutions, which mostly include ACs.…”

Injectable, Adhesive, and Self-Healing Composite Hydrogels Loaded With Oxybutynin Hydrochloride for the Treatment of Overactive Bladder in Rats

“…OAB with urgent urinary incontinence has an important impact on the economic burden of patients and the medical care system, and on public health and clinical management ( Wang et al, 2019 ; Staskin et al, 2020 ; Dmochowski et al, 2021 ). Many oxybutynin preparations have been developed, including various oral preparations and solutions ( Ramsay et al, 2020 ; Vozmediano-Chicharro et al, 2020 ; Suzuki et al, 2021 ). The first developed immediate-release oral preparation has high side effects.…”

Repositioning Oxybutynin Hydrochloride: State of the Art in Synthesis, Mode of Action, Metabolism, and Formulations

“…However, that first metabolite also exhibits high affinity for the M3 muscarinic receptors and especially for those located in the parotid gland. N-desethyloxybutynin is thought to be the main agent responsible for the dry mouth side-effect associated with the oral administration of oxybutynin [42,51,52]. It is important to note that oxybutynin also exerts spasmolytic and local anesthetic effects on the bladder smooth muscle.…”

“…Advantages, efficacy, and safety of the transdermal administration of oxybutynin were the subject of several clinical trials discussed in the works of Cohn [65] and Vozmediano-Chicharro [52]. The original pharmacokinetic parameters for different oral and transdermal formulations can be found in the study of Kennelly [51].…”