Product Details

Oxytrol

Oxybutynin Chloride
36 mg/Patch (3.9 mg/Day)
Transdermal Patch


DIN/PIN/NPN

02254735

Manufacturer

Allergan Inc.

Formulary Listing Date

0000-00-00  

Unit Price

Amount MOH Pays

Coverage Status

Exceptional Access Program Product

ODB Formulary Therapeutic Classification

Therapeutic Note

NO

ATC Code

G04BD04

Interchangeable Products

NO  

LU Clinical Criteria

NO  

EAP Criteria

Therapeutic Class Reimbursement Criteria
Urinary Antispasmodics

Oxybutynin Transdermal System

  • Brand(s): Oxytrol
  • Dosage Form/Strength: 36 mg transdermal patch (3.9 mg/day system)

The treatment of urinary frequency, urgency or urge incontinence in patients who are unable to take oral treatments (e.g., inability to swallow or who are unable to absorb (e.g., short gut syndrome).

Adverse effects to oral therapy (e.g., dizziness) are not acceptable. 

Duration of Approval: 5 Years

EAP Drug Request Form:

Standard Form for EAP Drug Requests

Product Monograph

View Monograph