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A warning re. Oybutynin I spotted in today's press...

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    A warning re. Oybutynin I spotted in today's press...

    Bladder drug taken by thousands is linked to dementia: Doctors warn pills should no longer be used because they raise the risk by 54%

    • Use of bladder drug oxybutynin has risen 31 per cent in the five years
    • But evidence now suggests the drug's side effects include dementia
    • Doctors warned last night it should no longer be used because of the risks



    Read more: http://www.dailymail.co.uk/health/ar...#ixzz4cWbDcMPK
    Follow us: @MailOnline on Twitter | DailyMail on Facebook

    #2
    This isn't really new news since the initial warnings go back about a year. I have two comments and one question...
    First, it increases the chance of differentia 54% but from what original chance? Does it go from 1 in 100 to 1.54 in 100?
    Second, I've avoided Botox injections because most clinical trials include Botox in their list of disqualifiers. I'm not in a trial but also don't want to inadvertently exclude myself. Finally, what other comparable drugs are available for bladder spasticity with larger molecules to prevent penetrating the brain blood barrier?
    T3 complete since Sept 2015.

    Comment


      #3
      The concern is with any anticholinergic. Trospium can be used as it does not cross the blood brain barrier.
      Mirgabetron is also not included because it is not an anticholinergic.
      Even if you had Botox to bladder, it is not permanent but is the most effective in most people.
      However, if you really don't find it interferes with your lifestyle then not taking drugs/injections is good.
      CWO
      The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

      Comment


        #4
        Yeah, I wish. I have enough bladder spasticity that I leak at any volume without an anti spasmodic, but urodynamics puts my pressures safe to 800 mL with oxybutynin. Guess it's time to ask the uro to try alternatives.
        T3 complete since Sept 2015.

        Comment


          #5
          Myrbetriq is non-anticholinergic, no?

          Comment


            #6
            I guess I'll stick with it. None of the other drugs suppress AD for me.
            Tom

            "Blessed are the pessimists, for they hath made backups." Exasperated 20:12

            Comment


              #7
              I have been using this drug for 26 years. How long do you have to use it for the chances to go up? Since I have used it for such a long time can I really benefit by stopping at this point? It does a great job of course dementia is not something anyone wants as a trade off for anything. Of the ones that you mention CWO how do they compare to effectiveness of Oxybutynin?

              Comment


                #8
                trospium (Sanctura) is the safer alternative.

                As with everything, you balance your risks. And you keep the absolute risk in perspective.

                Comment


                  #9
                  I have used it for 33 years. Never knew it caused dementia.

                  Comment


                    #10
                    Originally posted by Scott C4/5 View Post
                    Myrbetriq is non-anticholinergic, no?
                    Yes, it is the mirabegron referred to by SCI nurse. It is an alpha 3 agonist or something like that. Really a novel class of drug as no one has targeted that receptor before.

                    Comment


                      #11
                      Ohhhhhh Goddddd, help me! I am so sick of this shit!!!! What now???? Ditropan XL is THE only drug that works for my son!
                      5 mg once per day. He's 33 yrs old and has been on this for 13 years! I'm not even going to tell him this! Anyone have any success with another drug? Thanks!

                      Comment


                        #12
                        Originally posted by Mombo View Post
                        Ohhhhhh Goddddd, help me! I am so sick of this shit!!!! What now???? Ditropan XL is THE only drug that works for my son!
                        5 mg once per day. He's 33 yrs old and has been on this for 13 years! I'm not even going to tell him this! Anyone have any success with another drug? Thanks!
                        I used to take Ditropan XL but it quit working so I take Myrbetriq now. It's been 6 months since I've had major leaking (knock on wood).

                        Comment


                          #13
                          The smaller the dose the less chance. And 5 mg a day is a very low dose.
                          Also, there is an increased chance per the research. NOT everyone is going to get it and personally I haven't seen any more dementia in this population. But if anyone has memory problems or starts to have concern, we switch them right away.
                          A hamburger theoretically increases your chance of dementia caused by vascular issues!
                          Not to make this unimportant but if you don't need it, don't take it or if one of the other meds will then try it. But if it keeping your bladder volume at 800 mls- which to me- you could probably take a lower dose but just my thought.
                          And more research needs to be done!
                          CWO
                          CWO
                          The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                          Comment


                            #14
                            The National Spinal Injuries Centre
                            Bucks Healthcare NHS Trust
                            Statement on the use of Oxybutynin and potential increased risk of dementia - March 2017
                            Concern...s have been raised to staff within the National Spinal Injuries Unit by patients and their representatives following a publication in the Daily Mail on 27 Mar 2017.
                            The article from the Daily Mail draws on information and discussions held at the 2017 European Association of Urology conference and a research article published in January 2015. (1-3)
                            The advice from the National Spinal Injuries Centre is as follows:
                            The National Spinal Injuries Centre does not recommend that spinal cord injured patients stop taking oxybutynin. If you are concerned about this issue, we advise to NOT stop taking your medication without speaking to a medical practitioner to decide which medicine would suit you best, considering how effective it is at managing symptoms, and whether there is a risk of unwanted side effects for you personally. This advice is also endorsed by Professor Marcus Drake, the urologist at University of Bristol who was quoted in the Daily Mail. (8)
                            Stopping oxybutynin suddenly may lead to significant health problems including (6):
                            - Silent kidney damage as a result of high bladder pressures
                            - Autonomic dysreflexia (a life-threatening condition which can lead to sudden increase in blood pressure and other symptoms) in susceptible individuals
                            - Urinary incontinence
                            - Risk of catheter blockages
                            - Urinary tract infections
                            - Bladder irritation
                            - Skin damage due to wetness
                            The use of oxybutynin in spinal cord injured patients is specifically for the treatment of overactive neurogenic bladder, which is a specialised medical condition.
                            Additional information:
                            The research article quoted in the Daily Mail and published in 2015 (see reference 3) focused on the use of different medicines with “antimuscarinic/ anticholinergic” effects, including hayfever tablets and oxybutynin. Oxybutynin forms a small number of the prescriptions analysed in the paper. It suggested a possible link between patients who take high doses or long term antimuscarinic medicines and dementia, with oxybutynin listed as an example. However, that does not mean that oxybutynin will definitely cause dementia and there is lack of consensus about this evidence. (4)
                            It is also worth noting that only adults of age > 65 years old participated in the study. The European Association of Urology conference paper in March 2017 (see reference 2) was focused on the increased number of prescriptions being written for oxybutynin within the USA rather than presenting any new data on any potential increased risk of dementia. (2) The majority of prescriptions for oxybutynin within the UK are prescribed for the treatment of overactive bladder within the general population and is recommended by the National Institute for Health and Care Excellence (NICE). (5)

                            Comment


                              #15
                              Out Urologists say Oxybutynin is better for SCI- and pretty inexpensive for the short acting. Trospium is a safer alternative. Mirgabetron is even better as it is not an anticholinergic but cost/? Get samples!
                              CWO
                              The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                              Comment

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