Indications: Overactive bladder Common symptoms include urgency, urinary incontinence, and increased urinary frequency Side Effects: dry mouth constipation QT prolongation urinary tract infection worsening of myasthenia gravis aggravation of decreased GI motility in patients with autonomic neuropathy WARNINGS: angioedema of the face, lips tongue and/or larynx has been reported CNS Effects: agitation, confusion, hallucinations, abnormal behavior & memory impairment in patients taking 5 mg oxybutynin for more than 3 years compared to no use (Thomas & Walters, 2021): increased risk of dementia (adjusted hazard ratio 1.54) increased risk for Alzheimers disease (adjusted HR 1.63) Pharmacokinetics: taken orally by tablet, 5 or 10 mg once daily metabolized by CYP3A4 half life 13 hrs Notes: the estimated Walmart cost for generic oxybutynin is ~$9 for a supply of 30 generic tablets (GoodRx.com
The invisible degradation problem The frustrating reality is that early-stage degradation produces no visible changes
Drugs that have a long half-life stay longer in the body and so have a longer duration of action
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Laboratory findings help explain why scientists remain interested, but they cannot establish clinical benefit by themselves
Some patients stay on a GLP-1 long term, sometimes at a lower maintenance dose
