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long-acting oral agents preferred of the non-selective agents detrol la tolterodine la 2 to 4 mg daily similar efficacy compared to oxybutinin xr tolterodine causes less dry mouth diokno 2003 mayo clin proc 78 687-95 pubmed ditropan xl or oxytrol xr oxybutynin xr 5 to 10 to 30 mg daily ditropan xl is now generic reduces urge incontinence 28 dry mouth is more common least likely to cause constipation cns effects such as dizziness and sedation are more common sanctura xr trospium xr no drug interactions with cyp3a4 metabolized agents renal clearance less cns effects does not cross bbb dry mouth is less common toviaz xr fesoterodine xr risk of high drug levels in decreased metabolism of cytochrome p450 2d6 transdermal agents tolterodine transdermal patch oxybutynin transdermal patch oxytrol apply 2x week as effective as oral agent less anticholinergic side effects frequently causes skin reaction dmochowski 2003 urology 62 237-42 pubmed oxytrol for women otc, oxybutynin patch indicated for women over age 18 years with at least 3 months of urinary urgency with frequency or urinary incontinence cost is 30 per month otc out-of-pocket cost versus 270 for prescription contraindicated in men due to overflow incontinence risk due to bph related urinary obstruction 2013 presc lett 20 9 51 short acting oral agents avoid now that ditropan xl is now generic increased anticholinergic side effects dry mouth, constipation tolterodine detrol 1 to 2 mg po bid oxybutynin ditropan 2.
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