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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 7 - Obstetrics, Gynaecology, and urinary-tract disorders 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing

07.04.02 Drugs for urinary frequency, enuresis, and incontinence
07.04.02 Urinary incontinence

Oxybutynin Hydrochloride tablets
(2.5mg & 5mg immediate release)

First Choice

NOTE - immediate release (ordinary) tablets can be dispersed/crushed in 10ml water and administered orally or via NG/PEG tubes.

Do not offer oxybutynin (immediate release) to older women who may be at higher risk of a sudden deterioration in their physical or mental health.

One of the first line options for urinary incontinence

Entry reviewed: September 2024

Solifenacin tablets

First Choice

10mg and 5mg 

 

One of the first line choices for urinary incontinence

 

Entry reviewed: September 2023

Tolterodine tablets

First Choice

Immediate release tablets 

 One of the first line choices for urinary incontinence

Entry reviewed: September 2023

Tolterodine XL Capsules

Second Choice

Tolthen XL is preferred brand in Primary Care

 

Entry reviewed: September 2023

Darifenacin (Emselex®)

Second Choice

Entry reviewed: September 2023

Trospium 20mg
(Tablets)

Second Choice

Entry reviewed: September 2023

Fesoterodine Modified Release tablet

Second Choice

4mg & 8mg Modified-Release Tablets

Entry reviewed: September 2023

Vibegron (Obgemsa®)
(75 mg film-coated tablets)

Third Choice

Must only be used in line with NICE TA999 for treating symptoms of overactive bladder

 

Entry reviewed: January 2025

Oxybutynin Hydrochloride (Kentera®)
(Transdermal Patch)

Formulary

Do not offer oxybutynin (immediate release) to older women who may be at higher risk of a sudden deterioration in their physical or mental health.

Restricted Item For use in patients with swallowing difficulties only.

 

Entry reviewed: September 2023

Oxybutynin Hydrochloride 5mg/5mL elixir

Restricted Drug Restricted

5mg in 5ml - Unlicensed - Low Risk


Restricted - for use in overactive bladder in children and elderly with frail skin (patches may damage).

Use patches for those unable to swallow tablets.

N.B. £240 per 150mL bottle.


NOTE - immediate release (ordinary) tablets can be dispersed/crushed in 10ml water and administered orally or via NG/PEG tubes.


In primary care this is a pharmaceutical special.

Non formulary items

Oxybutynin Hydrochloride Modified Release (5mg, 10mg Tablets)

 
Non Formulary

Not approved for treatment of nocturnal enuresis in children following september 2025 review

07.04.02 Nocturnal enuresis
Classifications
May be initiated in any care setting
Specialist to advise therapy and provide first 28 days supply, continuation in Primary Care
Specialist to initiate and stabilise medicine prior to continuation in Primary Care
To be prescribed as per Shared Care Guidance. If no SCG in place status reverts to red.
Red medicines are designated as specialist only medicines which should only be prescribed by a specialist, usually within secondary care (either due to the requirement for specialist knowledge, long-term monitoring requirements, or restrictions that mean medicine supplies are only available to hospitals).
A decision has been made either locally and/or nationally not to routinely commission this preparation. Do not prescribe.
To be purchased over the counter. May be prescribed for chronic, long term conditions or on admission to hospital if essential.