Safer bladder treatment for the elderly
How do I treat my elderly patients with irritable bladder who are using timoptic for glaucoma or who have borderline elevated eye pressure? Is ditropan safe? D.L. Ducheck, MD, Selkirk, MB
Irritable bladder/detrusor instability is a common cause of urinary incontinence in the elderly. Ditropan (oxybutynin) is strongly anticholinergic and therefore more likely to cause adverse effects including elevating intraocular pressure as well as mental confusion in the frail/cognitively impaired elderly. Other anti-muscarinics have less anticholinergic effect, e.g. Detrol (tolterodine) or Enablex (darifenacin). In the case of your patient, I’d probably check with his/her ophthalmologist before proceeding further.