![]() Patients who prefer a transdermal preparation may be candidates for transdermal oxybutynin, assuming they do not experience cutaneous side effects. Cost is not an important factor prices for all of these agents are similar ( Table 4). Until further research in primary care settings is performed, there is little evidence to guide family physicians in the choice of anticholinergic medications for urge incontinence. Furthermore, an independent analysis 17 of transdermal oxybutynin concluded that this agent probably is less effective than oral medications for controlling incontinence. It is not clear how this study applies to primary care patients with a new diagnosis of urge incontinence, because the study enrolled subjects with both urge and mixed incontinence who had been on long-term treatment with anticholinergic drugs. Cutaneous side effects, however, were frequent: 20 percent of patients reported moderate to severe reactions. This 12-week study, sponsored by the manufacturer of transdermal oxybutynin, found that the transdermal agent was as effective as oral tolterodine and caused fewer anticholinergic side effects, presumably because of the “smoother” release of the drug from a transdermal patch. ![]() 15 The one published study 16 comparing transdermal oxybutynin with oral anticholinergics used oral, long-acting tolterodine as the comparison drug. It is more effective than placebo in reducing episodes of urge incontinence. Transdermal oxybutynin is the newest anticholinergic agent available for treating urge incontinence.
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