Oxybutynin and Blood Pressure Effects

Medication Safety and Efficacy

The American Geriatrics Society suggests that alpha-1 blockers, such as doxazosin, prazosin, and terazosin, are strongly associated with orthostatic hypotension, especially in older adults 2
Central alpha-2 agonists, including clonidine and methyldopa, are likely to produce adverse effects, such as orthostatic hypotension, in older adults 5
Peripheral vasodilators increase the risk of orthostatic hypotension and are rarely effective long-term 6
Diuretics can cause volume depletion, leading to orthostatic hypotension, particularly in elderly patients 4
The American College of Physicians may consider oxybutynin as a high-risk medication in older adults due to its broad muscarinic receptor blockade, affecting vision, urination, constipation, and cognition, but not blood pressure 1

The anticholinergic burden from medications like oxybutynin is associated with a decline in cognition, functional status, and activities of daily living scores, leading to injurious falls, confusion, delirium, emergency department visits, and hospitalizations 1