Transdermal Oxybutynin: What Role in the Management of Overactive Bladder?

Overactive bladder (OAB), a bothersome condition that is frequently associated with incontinence, commonly affects middleaged and elderly people. OAB not only has a negative effect on physical and mental well-being but also accounts for billions of dollars in health care costs and lost productivity. Although OAB can be treated effectively with muscarinic acetylcholine receptor antagonists, these agents often cause anticholinergic adverse effects, such as dry mouth and constipation, which are believed to be a major reason for low treatment persistence. Oxybutynin is an established OAB treatment that is available in oral and transdermal formulations. Oxybutynin chloride topical gel (OTG) (Gelnique (R), Watson Pharmaceuticals, Corona, CA, USA.) is a new formulation that was approved by the US Food and Drug Administration in January 2009. Results of a 12-week, placebo-controlled US phase 3 study demonstrated that OTG is efficacious in patients with OAB and rarely causes anticholinergic adverse events. Only dry mouth occurred significantly more often with OTG than placebo (6.9% vs. 2.8% of patients). Furthermore, OTG showed very little propensity to cause application site skin reactions. In conclusion, the efficacy and good tolerability of OTG make it a valuable treatment option for patients with OAB.