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Improved efficacy of extended release oxybutynin in children with persistent daytime urinary incontinence converted
Kyle J Van Arendonk1, Matthew J Knudson, J Christopher Austin
1Division of Pediatric Urology, Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Insights
Switching children with persistent daytime urinary incontinence from regular oxybutynin (Ditropan) to extended-release oxybutynin (Ditropan XL) improved bladder capacity and reduced wetting frequency. Many patients experienced significant improvement after the medication change.
Area of Science:
- Pediatric Urology
- Pharmacology
- Clinical Medicine
Background:
- Persistent daytime urinary incontinence affects children's quality of life.
- Oxybutynin is a common anticholinergic medication used to treat overactive bladder.
- Transitioning between formulations may impact treatment efficacy and patient experience.
Purpose of the Study:
- To evaluate the effectiveness of switching from regular oxybutynin (Ditropan) to extended-release oxybutynin (Ditropan XL) in pediatric patients with persistent daytime urinary incontinence.
Main Methods:
- Retrospective review of 27 children with daytime wetting who switched from Ditropan to Ditropan XL.
- Analysis included patient demographics, reasons for change, uroflowmetry, side effects, and medication dosage.
- Paired t-test was used for statistical analysis (P <0.05).
Main Results:
- 13 out of 27 patients showed improvement or resolution of incontinence by the first visit after switching to Ditropan XL.
- Significant increases in mean voided volume (38% to 53%) and total bladder capacity (55% to 70%) were observed.
- While some side effects resolved, new ones emerged in 7 patients; however, overall bladder function improved.
Conclusions:
- Switching to extended-release oxybutynin (Ditropan XL) can decrease wetting frequency in children with persistent incontinence.
- The transition to Ditropan XL led to increased voided volume and bladder capacity.
- Ditropan XL represents a viable alternative for managing persistent daytime urinary incontinence in pediatric patients.
Objectives:
To examine the response to conversion from regular oxybutynin (Ditropan) to an extended-release form (Ditropan XL) in children with persistent daytime urinary incontinence.
Methods:
A retrospective review of patients with daytime wetting who switched from Ditropan to Ditropan XL included patient age, sex, reason for the change in medication, uroflowmetry findings before and after the change, side effects, and duration and dosage of the medication. The data were analyzed using a paired, two-tailed t test, with P <0.05 considered significant.
Results:
Twenty-seven patients were followed up for an average of 35.8 months. A lack of improvement (n = 11), convenience (n = 6), side effects (n = 2), and a dislike of the taste (n = 2) were identified as reasons for changing to the extended release form. The mean dosage of Ditropan and Ditropan XL did not differ significantly (0.40 and 0.38 mg/kg/day, respectively). After the change to Ditropan XL, 6 patients had a resolution of side effects and 7 developed new side effects. Of the 27 patients, 13 became dry or had significant improvement by the first visit after the change to Ditropan XL. Significant increases in voided volume (38% versus 53%; P <0.01) and total bladder capacity (55% versus 70%; P = 0.03), normalized for age-expected bladder capacity, occurred by the first clinic visit after beginning Ditropan XL. No significant changes in the postvoid residual urine volume occurred.
Conclusions:
The frequency of wetting decreased and the voided volume and bladder capacity increased after a change to Ditropan XL in children with persistent wetting when taking Ditropan.
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