Flavoxate: Drug information

For additional information see "Flavoxate: Patient drug information"

For abbreviations, symbols, and age group definitions show table

Brand Names: Canada

Urispas [DSC]

Pharmacologic Category

Antispasmodic Agent, Urinary

Dosing: Adult

Urinary spasms and incontinence, smooth muscle relaxant

Urinary spasms and incontinence, smooth muscle relaxant (eg, bladder): Oral: 100 to 200 mg 3 or 4 times daily; reduce the dose when symptoms improve.

Dosing: Kidney Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Liver Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric

Children >12 years: Refer to adult dosing.

Dosing: Kidney Impairment: Pediatric

There are no dosage adjustments provided in manufacturer's labeling.

Dosing: Liver Impairment: Pediatric

There are no dosage adjustments provided in manufacturer's labeling.

Adverse Reactions

The following adverse drug reactions are derived from product labeling unless otherwise specified.

Frequency not defined:

Cardiovascular: Palpitations, tachycardia

Dermatologic: Skin rash, urticaria

Gastrointestinal: Nausea, vomiting, xerostomia

Genitourinary: Dysuria

Hematologic & oncologic: Eosinophilia, leukopenia

Nervous system: Confusion (especially in older adults), drowsiness, headache, nervousness, vertigo

Ophthalmic: Accommodation disturbance, blurred vision, increased intraocular pressure

Miscellaneous: Hyperpyrexia

Postmarketing:

Hepatic: Jaundice (Sevenoaks 1999)

Ophthalmic: Acute angle-closure glaucoma (Mohammed 2008)

Contraindications

Pyloric or duodenal obstruction; gastrointestinal hemorrhage; obstructive intestinal lesions; ileus; achalasia; obstructive uropathies of lower urinary tract.

Warnings/Precautions

Concerns related to adverse effects:

• CNS effects: May cause CNS drowsiness and blurred vision, which may impair physical or mental abilities; patients must be cautioned about performing tasks which require mental alertness (eg, operating machinery or driving).

Disease-related concerns:

• Glaucoma: Use with caution in patients with suspected glaucoma.

Concurrent drug therapy issues:

• Sedatives: CNS effects may be potentiated when used with other sedative drugs or ethanol.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral, as hydrochloride:

Generic: 100 mg

Generic Equivalent Available: US

Yes

Pricing: US

Tablets (flavoxATE HCl Oral)

100 mg (per each): $1.15 - $2.16

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Tablet, Oral:

Urispas: 200 mg [DSC]

Administration: Pediatric

Oral: Take without regard to meals

Use: Labeled Indications

Urinary spasms and incontinence, smooth muscle relaxant (eg, bladder): For symptomatic relief of dysuria, nocturia, suprapubic pain, urgency, frequency and incontinence, which may occur in patients with cystitis, urethritis, urethrocystitis, urethrotrigonitis, and prostatitis.

Medication Safety Issues

Sound-alike/look-alike issues:

FlavoxATE may be confused with fluvoxaMINE

Older Adult: High-Risk Medication:

Beers Criteria: Flavoxate is identified in the Beers Criteria as a potentially inappropriate medication in patients 65 years and older due to its strong anticholinergic properties (Beers Criteria [AGS 2023]).

Metabolism/Transport Effects

None known.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.

Acetylcholinesterase Inhibitors: May decrease therapeutic effects of Agents with Clinically Relevant Anticholinergic Effects. Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Acetylcholinesterase Inhibitors. Risk C: Monitor

Aclidinium: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid

Acrivastine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Amantadine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Benperidol: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Benperidol. Risk C: Monitor

Benztropine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Benztropine. Risk C: Monitor

Biperiden: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Biperiden. Risk C: Monitor

Bornaprine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Bornaprine. Risk C: Monitor

Botulinum Toxin-Containing Products: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Bromperidol: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Bromperidol. Risk C: Monitor

Buclizine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Buclizine. Risk C: Monitor

Cannabinoid-Containing Products: Agents with Clinically Relevant Anticholinergic Effects may increase tachycardic effects of Cannabinoid-Containing Products. Risk C: Monitor

Chlorprothixene: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Chlorprothixene. Risk C: Monitor

Cimetropium: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Cimetropium. Risk X: Avoid

CloZAPine: Agents with Clinically Relevant Anticholinergic Effects may increase constipating effects of CloZAPine. Management: Consider alternatives to this combination whenever possible. If combined, monitor closely for signs and symptoms of gastrointestinal hypomotility and consider prophylactic laxative treatment. Risk D: Consider Therapy Modification

Cyclizine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Darifenacin: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Darifenacin. Risk C: Monitor

Dicyclomine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Dicyclomine. Risk C: Monitor

Dimethindene (Systemic): Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Dimethindene (Systemic). Risk C: Monitor

DroNABinol: Agents with Clinically Relevant Anticholinergic Effects may increase tachycardic effects of DroNABinol. Risk X: Avoid

Eluxadoline: Agents with Clinically Relevant Anticholinergic Effects may increase constipating effects of Eluxadoline. Risk X: Avoid

Fesoterodine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Fesoterodine. Risk C: Monitor

FluPHENAZine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Gastrointestinal Agents (Prokinetic): Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Gastrointestinal Agents (Prokinetic). Risk C: Monitor

Gepotidacin: May decrease anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Glucagon: Agents with Clinically Relevant Anticholinergic Effects may increase adverse/toxic effects of Glucagon. Specifically, the risk of gastrointestinal adverse effects may be increased. Risk C: Monitor

Glycopyrrolate (Oral Inhalation): Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Glycopyrrolate (Oral Inhalation). Risk X: Avoid

Glycopyrrolate (Systemic): Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Glycopyrrolate (Systemic). Risk C: Monitor

Glycopyrronium (Topical): May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid

Ipratropium (Nasal): May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Ipratropium (Oral Inhalation): May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid

Itopride: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Itopride. Risk C: Monitor

Levosulpiride: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Levosulpiride. Risk X: Avoid

Maprotiline: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Maprotiline. Risk C: Monitor

Melperone: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Methotrimeprazine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Methotrimeprazine. Risk C: Monitor

Methscopolamine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Methscopolamine. Risk C: Monitor

Mirabegron: Agents with Clinically Relevant Anticholinergic Effects may increase adverse/toxic effects of Mirabegron. Risk C: Monitor

Nitroglycerin: Agents with Clinically Relevant Anticholinergic Effects may decrease absorption of Nitroglycerin. Specifically, anticholinergic agents may decrease the dissolution of sublingual nitroglycerin tablets, possibly impairing or slowing nitroglycerin absorption. Risk C: Monitor

OLANZapine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of OLANZapine. Risk C: Monitor

Opioid Agonists: Agents with Clinically Relevant Anticholinergic Effects may increase adverse/toxic effects of Opioid Agonists. Specifically, the risk for constipation and urinary retention may be increased with this combination. Risk C: Monitor

Opipramol: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Oxatomide: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid

OxyBUTYnin: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of OxyBUTYnin. Risk C: Monitor

Perazine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Perphenazine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Perphenazine. Risk C: Monitor

Potassium Chloride: Agents with Clinically Relevant Anticholinergic Effects may increase ulcerogenic effects of Potassium Chloride. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride. Risk X: Avoid

Potassium Citrate: Agents with Clinically Relevant Anticholinergic Effects may increase ulcerogenic effects of Potassium Citrate. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium citrate. Risk X: Avoid

Pramlintide: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. These effects are specific to the GI tract. Risk X: Avoid

Promethazine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Promethazine. Risk C: Monitor

Propantheline: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Propantheline. Risk C: Monitor

Propiverine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

QuiNIDine: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk C: Monitor

Ramosetron: Agents with Clinically Relevant Anticholinergic Effects may increase constipating effects of Ramosetron. Risk C: Monitor

Revefenacin: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Revefenacin. Risk X: Avoid

Rivastigmine: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Rivastigmine. Rivastigmine may decrease therapeutic effects of Agents with Clinically Relevant Anticholinergic Effects. Management: Use of rivastigmine with an anticholinergic agent is not recommended unless clinically necessary. If the combination is necessary, monitor for reduced anticholinergic effects. Risk D: Consider Therapy Modification

Scopolamine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Scopolamine. Risk C: Monitor

Secretin: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Secretin. Management: Avoid concomitant use of anticholinergic agents and secretin. Discontinue anticholinergic agents at least 5 half-lives prior to administration of secretin. Risk D: Consider Therapy Modification

Sofpironium: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Sofpironium. Risk X: Avoid

Thiazide and Thiazide-Like Diuretics: Agents with Clinically Relevant Anticholinergic Effects may increase serum concentration of Thiazide and Thiazide-Like Diuretics. Risk C: Monitor

Thiothixene: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Thiothixene. Risk C: Monitor

Tiapride: Agents with Clinically Relevant Anticholinergic Effects may decrease therapeutic effects of Tiapride. Risk C: Monitor

Tiotropium: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Tiotropium. Risk X: Avoid

Tolterodine: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Tolterodine. Risk C: Monitor

Topiramate: Agents with Clinically Relevant Anticholinergic Effects may increase adverse/toxic effects of Topiramate. Risk C: Monitor

Tricyclic Antidepressants: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Tricyclic Antidepressants. Risk C: Monitor

Trimethobenzamide: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Trimethobenzamide. Risk C: Monitor

Trospium: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Trospium. Risk C: Monitor

Umeclidinium: May increase anticholinergic effects of Agents with Clinically Relevant Anticholinergic Effects. Risk X: Avoid

Zuclopenthixol: Agents with Clinically Relevant Anticholinergic Effects may increase anticholinergic effects of Zuclopenthixol. Risk C: Monitor

Pregnancy Considerations

Adverse events have not been observed in animal reproduction studies.

Breastfeeding Considerations

It is not known if flavoxate is excreted in breast milk. The manufacturer recommends that caution be exercised when administering flavoxate to nursing women.

Monitoring Parameters

Monitor urinary frequency and urgency, anticholinergic signs and symptoms.

Mechanism of Action

Synthetic antispasmotic with similar actions to that of propantheline; it exerts a direct relaxant effect on smooth muscles via phosphodiesterase inhibition, providing relief to a variety of smooth muscle spasms; it is especially useful for the treatment of bladder spasticity, whereby it produces an increase in urinary capacity

Pharmacokinetics (Adult Data Unless Noted)

Onset of action: 55 minutes

Excretion: Urine (57%) within 24 hours

Brand Names: International

International Brand Names by Country

For country code abbreviations (show table)

(AE) United Arab Emirates: Flavospas | Urispas;
(BD) Bangladesh: Avox | Flavox | Urilax | Uripay;
(CH) Switzerland: Urispas;
(CL) Chile: Urodial;
(CN) China: An jin | Du luo jie | Flavoxate | Luo wo ke | You bi da | Youbida;
(CO) Colombia: Bladuril | Genurin;
(CZ) Czech Republic: Urispas;
(DE) Germany: Spasuret;
(DO) Dominican Republic: Flutiflo;
(EC) Ecuador: Relaxate | Urex | Urodial;
(EG) Egypt: Nephroflam;
(ES) Spain: Uronid;
(FR) France: Urispas;
(GB) United Kingdom: Urispas;
(HK) Hong Kong: Foxate | Fucotin;
(ID) Indonesia: Urispas | Uroxal;
(IE) Ireland: Urispas;
(IN) India: Antaspa | Belvox | Elflav | Evaflav | Flavate | Flavidoz | Flavocip | Flavodac | Flavogem | Flavomark | Flavoride | Flavorin | Flavoscan | Flavospas | Flavovib | Flavoxate | Flavozest | Flavtab | Flavxo | Herflav | Konflav | Speroxate | Urely | Uridax | Urigive | Urikind | Urinet | Uripil | Urisol | Urispas | Urizox | Uroza | Urozet | Uticept | Verin uti | Voxate;
(JO) Jordan: Urispas;
(JP) Japan: Apolakeat | Bladaxan | Bladderon | Bolaboran | Demiel | Flabosefu | Flacalvon | Flavonate | Flavoron iwaki | Flavoron teisan | Flavosert | Flaxate | Flouraet | Flouraet choseido | Gistelink | Harbahn | Harnin | Jinfurikku | Lady guard | Latobolel | Latobolel tatumi | Lollarm | Lollarm amel | Lollarm mita | Menantal | Nadesmin | Patricin kaken | Patricin taiyo | Progut | Purimeral | Ruadan | Ruadan kaken | Ruadan merck hoei | Sawadaron | Uriflart | Urinaron | Urinaron aventis | Urinaron takeshima | Urolodan | Urolodan takata | Urostate | Urotailon | Visdecan;
(KE) Kenya: Uraxil forte;
(KR) Korea, Republic of: Flavogen | Flavoxate | Flix | Genurin | Lavoxen | Spagerine | Uclean | Uropeace;
(KW) Kuwait: Urispas;
(LB) Lebanon: Urispas;
(LV) Latvia: Spasuret;
(MY) Malaysia: Uripax | Urispas | Uroxate;
(NO) Norway: Urispadol;
(PE) Peru: Bladuril | Detrucalm | Flavoxil | Uripax;
(PK) Pakistan: Flavox | Flexot | Floxate | Genurin | Uricon | Urivox;
(PL) Poland: Urispas;
(PR) Puerto Rico: Flavoxate | Flavoxate HCL | Urispas;
(PT) Portugal: Flavoxato;
(QA) Qatar: Urispas;
(SG) Singapore: Cleanxate | Genurin;
(SR) Suriname: Urispas;
(TH) Thailand: Flavoxas | U-spa | Urixate | Uroxate | Voxate;
(TR) Turkey: Urispas;
(TW) Taiwan: Bladaton | Bladderon | Flavon | Foxate | Fucotin | Fuercon | Genurin | Genxate | Gistelink | Harbahn | Patricin | Pedercon | Psole | Ruadan | Sheuan | Tonlin | Uridron | Urimeton | Urinaron | Urinol | Urinsu | Urol | Urolodan | Uroxate | Yungken;
(VE) Venezuela, Bolivarian Republic of: Flavoxato | Flavoxuni | Urobiol | Urodutan;
(VN) Viet Nam: Camoas | Manduka | Meyerflavo | Yspuripax

2023 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052-2081. doi:10.1111/jgs.18372 [PubMed 37139824]
Flavoxate hydrochloride [prescribing information]. Minneapolis, MN: Perrigo; October 2016.
Mohammed ZS, Simi ZU, Tariq SM, Ali KR. Bilateral acute angle closure glaucoma in a 50 year old female after oral administration of flavoxate. Br J Clin Pharmacol. 2008;66(5):726-727. doi:10.1111/j.1365-2125.2008.03254.x [PubMed 18754848]
Sevenoaks M, Gorard DA. Jaundice associated with flavoxate. J R Soc Med. 1999;92(11):589. doi:10.1177/014107689909201116 [PubMed 10703502]

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Flavoxate: Drug information