Can you stop taking oxybutynin abruptly? (+3 disadvantages)
By
Ivan Kahwa
Author bio
Mr Ivan Kahwa is a chemist and phytopharmaceutical scientist with expertise in chemistry, pharmacology, phytochemistry, and Nanobiotechnology. He writes and reviews content on these topics.
Mr Ivan Kahwa’s Highlights:
Guest Researcher at the University of Leipzig, Senior Research Fellow/Scientist, and Lecturer at the Department of Pharmacy, Faculty of Medicine, Mbarara University of Science and Technology.
Professional Experience:
Mr Ivan joined PHARMBIOTRAC as a research fellow/scientist during his master of science tenure. He contributed to the development of most of the phytopharmaceutical products in the project. Furthermore, he participated in carrying out the pharmacological activities of the developed products in laboratory animals such as mice and rats in order to develop proper doses hence leading to pre-clinical studies.
With the above relevant research experience, Ivan started to work with the University of Leipzig on collaborative projects with Mbarara University to develop the chemistry of Ugandan Medicinal plants and their pharmacological activities. This was coupled with several consultative positions by different German NGOs. Mr. Kahwa is also a supporting in the teaching and learning at the Departments of Pharmacy and Pharmaceutical Sciences, Faculty of Medicine, Mbarara University of Science and Technology.
With the increase in antimicrobial resistance globally, Ivan retooled his thinking towards developing new naturally derived antibiotic regimens from Ugandan propolis with the assistance of nanotechnology to improve their delivery to microbial cells. Kahwa has also published over 28 articles in peer-reviewed journals and he is currently reviewing for many journals.
Education:
2023-2027: PhD in Pharmaceutical Sciences (ongoing) with a focus on Pharmaceutical Microbiology and Nanobiology at Mbarara University of Science and Technology.
2022: 2Msc. in Pharmacognosy and Natural Medicine Science at Mbarara University of Science and Technology.
2018: Bachelor of Science (Chemistry) at Mbarara University of Science and Technology.
Publications:
▪ Iqbal, S., Jabeen, F., Kahwa, I., & Omara, T. 2023. Suberosin Alleviates Thiazolidinedione-Induced Cardiomyopathy in Diabetic Rats by Inhibiting Ferroptosis via Modulation of ACSL4-LPCAT3 and PI3K-AKT Signaling Pathways. Cardiovascular Toxicology. https://doi.org/10.1007/s12012-023-09804-7
▪ Gupta, A. K., Yadav, R., Sharma, S., Sawale, J., & Kahwa, I. 2023. Anti-ageing Activity and Antioxidant Activity of Methanol Extracts of Leaves and Flowers of Salvia officinalis and Rosmarinus officinalis. Journal of Young Pharmacists, 15(3), 448–455. https://doi.org/10.5530/jyp.2023.15.60
▪ Tolo, C.U., Kahwa, I., Nuwagira, U., Weisheit, A. and Ikiriza, H., 2023. Medicinal plants used in treatment of various diseases in the Rwenzori Region, Western Uganda. Ethnobotany Research and Applications, 25, pp.1-16.
https://ethnobotanyjournal.org/index.php/era/article/view/4683
▪ Kahwa, I., Ajayi, C.O., Yadav, R., Chauhan, N.S., Shah, K., Abdelgadir, A.A., Shegena, E.A., Daniel, S., Omara, T., Asiimwe, J.B. and Ikiriza, H., 2023. Pharmacognostic and phytochemical studies as an invaluable approach for correct identification of medicinal plants: The case of Artemisia vulgaris L. substituted for Artemisia annua L. in Western Uganda. TMR Integr Med, 7, p.e23004.
https://doi.org/10.53388/TMRIM202307004
▪ Nalimu, F., Oloro, J., Kahwa, I. and Ogwang, P.E., 2021. Review on the phytochemistry and toxicological profiles of Aloe vera and Aloe ferox. Future Journal of Pharmaceutical Sciences, 7, pp.1-21.
https://doi.org/10.1186/s43094-021-00296-2
▪ Elamin, O.H.S., Ali, M.A., Elgezuli, I.A.A., Bashir, M.A. and Kahwa, I., 2021. Diagnosis of pre-and post-treatment of echinococcus granulosus with counter current immune electrophoresis and bacterial co-agglutination. Journal of Microbiology and Infectious Diseases, 11(02), pp.88-94.
https://doi.org/10.5799/jmid.951600
Published book Chapter
▪ Kahwa, I., Ayesiga, I., Nakalema, S., Alinaiswe, R., Mbabazi, R. and Iqbal, S., 2023. Natural products in the management of onchocerciasis. In Natural Products in Vector-Borne Disease Management (pp. 63-80). Academic Press. Book Chapter.
https://doi.org/10.1016/B978-0-323-91942-5.00012-4
Submitted manuscripts Under Review:
▪ Comparison of the Wound Healing Activity of the Leaf and Leaf Ash Extracts of Vernonia amygdalina in Rats. Journal name: Clinical Phytoscience
▪ Ethnobotanical Survey of Medicinal plants used in the management of cancer in Uganda. Journal name: Journal of Herbal Medicine
▪ Ethnobotanical survey and phytochemical screening of medicinal plants used in treatment of epilepsy by PROMETRA-Uganda Traditional Health Practitioners in Mpigi District, Uganda. Journal name: Journal of Ethnopharmacology
Submitted book chapters under review
1.Book title: Algae as a Natural Solution for Water-Food-Energy Nexus, Section 4: Microalgae and cyanobacteria for food applications, Chapter 4.6: Safety, toxicological and allergenic aspects of using algae for food. Authors: Christine Kyarimpa, Tom Omute, Caroline K. Nakiguli, Alice V. Khanakwa4, Christopher Angiro, Ivan Kahwa, Fortunate Ahumuza, Timothy Omara*. Publisher: Springer Nature Singapore Pte Ltd. 152 Beach Road, #21-01/04 Gateway East, Singapore 189721, Singapore.
2.Book title: Nutraceuticals Inspiring the Contemporary Therapy for Lifestyle Diseases. Chapter: Nutraceutical applications of Seaweeds and their Phytocompounds in Nutrition and Treatment of Diseases. Authors: Ivan Kahwa, Timothy Omara , Innocent Ayesiga , Gael Noel Neh Neba Ambe , Zehbanaz Javidbhai Panwala , Rachel Mbabazi , Shabnoor Iqbal , Christine Kyarimpa , Christine Betty Nagawa , Kamal Shah ,Nagendra Singh Chauhan* Publisher: CRC Press
You can view my works on the following professional sites:
Research Gate: https://www.researchgate.net/profile/Ivan-Kahwa
Google Scholar: https://scholar.google.com/citations?user=tOwrvqoAAAAJ&hl=en
ORCID: https://orcid.org/0000-0002-6440-3437
Linkedin: https://de.linkedin.com/in/ivan-kahwa-865450159
In this article, we will discuss whether you may discontinue oxybutynin abruptly. We will also discuss the adverse effects associated with the abrupt discontinuation and deprescribing process of oxybutynin.
Can you stop taking oxybutynin abruptly?
No, you should not stop taking oxybutynin suddenly. Discontinuing oxybutynin suddenly may cause adverse effects. The symptoms of an overreactive bladder and muscle spasm of the bladder may also return or worsen.
Most of the patients abruptly discontinue oxybutynin due to its associated side effects, especially constipation and dry mouth. Oxybutynin inhibits the muscarinic effect of acetylcholine on the smooth muscles, causing bladder relaxation.
Abruptly stopping oxybutynin might lead to anticholinergic discontinuation syndrome. These withdrawal symptoms are usually moderate but may last up to six to eight weeks.
You should always consult your doctor before discontinuing the treatment of oxybutynin. The doctor will taper off the medication or give you another medication for your underlying disease.
What happens if you stop taking oxybutynin abruptly?
The minor withdrawal symptoms associated with oxybutynin’s abrupt discontinuation involve hand tremors, nausea and sweating (1). The patient also experiences urinary frequency and urgency.
In some cases, the patient might develop anticholinergic discontinuation syndrome. These adverse effects are much more severe and might include:
- Tachycardia,
- Anxiety,
- Mood fluctuations,
- Inconsistent urinary flow,
- Urinary retention,
- Orthostatic hypotension, and
- Insomnia.
What does research suggest?
Apart from its therapeutic use, anticholinergic drugs like oxybutynin are also reported to decrease depressive symptoms, induce relaxation, improve mood and cause a sense of euphoria.
In one such case report, a young girl taking oxybutynin (40 mg/month) reported tremors, sweating, social phobia, and anxiety when she discontinued the drug abruptly (1).
In another case, the abrupt discontinuation of oxybutynin caused anorexia, insomnia and discomfort in a 22-year-old male. The patient also had trouble focusing but he exhibited normal perception and speech (2).
How is oxybutynin cleared from the body?
Oxybutynin is metabolised in the liver and intestinal wall by the cytochrome P3A4 enzymatic system. Due to extensive metabolism, oxybutynin is converted to its active metabolite known as N-desethyloxybutynin.
Simultaneously, hepatic biotransformation leads to the formation of inactive metabolites known as 2-cyclohexyl-2-phenylglycolic acid. Only 0.1% of oxybutynin remains unchanged and is excreted through the urine.
The plasma elimination half-life of oxybutynin is 2 hours, however, it is prolonged (up to 5 hours) in elderly patients. For this reason, elderly patients might experience more adverse effects than adults during abrupt drug discontinuation.
The elder patients also take multiple drugs, often termed polypharmacy. This increases the chances of developing adverse effects especially if one of the drugs is discontinued abruptly.
How to taper off oxybutynin?
It is important to taper off some medications, especially antidepressants like Citalopram, when there are high risk of getting adverse effects after abrupt drug discontinuation.
If the patient feels that oxybutynin-associated side effects outweigh its therapeutic efficacy, then he may request the doctor to deprescribe the medication. The doctor will examine the side effects and the severity of the disease.
In the first phase, the doctor with reduce the dosing frequency of oxybutynin. Oxybutynin, 5 mg, is usually given thrice a day. The doctor might advise the patient to take 5 mg oxybutynin twice daily for 2 weeks.
In the next phase, the doctor will examine the patient for 2 weeks for urinary inconsistency and other possible withdrawal effects. If the patient experiences minimal side effects, the drug may be tapered off completely.
As a qualified pharmacist, I always advise patients to understand the importance of the recommended dosage regimen. Dose and dosing frequencies are established after strenuous clinical trials.
You should always complete your course of medication. If you feel your side effects are affecting your quality of life, consult the doctor to take suitable interventions and recommend alternate therapies.
Was this helpful?
References
1.-
Kınık MF, Dönder F, Duymaz MK, Karakaya I. Addiction of oxybutynin: an adolescent case report. J Addict Res The. 2015;6(228):2. https://www.researchgate.net/profile/Fatih-Kinik/publication/280080123_Addiction_of_Oxybutynin_An_Adolescent_Case_Report/links/55a6c2d008ae92aac77f49f4/Addiction-of-Oxybutynin-An-Adolescent-Case-Report.pdf
2.-
Sonkurt HO, Altınöz AE. Oxybutynin addiction: two case reports. Journal of Substance Use. 2021 Sep 3;26(5):455-7. https://www.tandfonline.com/doi/abs/10.1080/14659891.2020.1851404
