title: Risk of serious falls associated with oxybutynin and tolterodine: a population based study.
abstract: OBJECTIVE
  We compared the short-term risk of falls among recipients of oxybutynin or tolterodine to treat urinary incontinence.
  
  
  METHODS
  We conducted a population based, retrospective cohort study with propensity score matching among patients 66 years old or older who commenced treatment with oxybutynin or tolterodine in Ontario, Canada. The primary outcome was a hospital visit for a fall within 90 days of drug initiation. Secondary outcomes included hospital visits for fractures, delirium or all cause mortality.
  
  
  RESULTS
  We found no difference in the risk of falls among users of oxybutynin vs tolterodine (adjusted hazard ratio 1.04, 95% CI 0.95 to 1.14). Secondary analyses revealed no differential risk of fractures (aHR 0.96, 95% CI 0.82 to 1.13) or delirium (aHR 0.90, 95% CI 0.66 to 1.23) associated with oxybutynin. However, statistically significant increases in the risk of all cause hospitalization (aHR 1.12, 95% CI 1.07 to 1.17) and death (aHR 1.20, 95% CI 1.07 to 1.35) were seen with oxybutynin.
  
  
  CONCLUSIONS
  Oxybutynin was not associated with a short-term increased risk of hospital visit for falls, fractures or delirium compared to tolterodine. Further research is needed to confirm whether oxybutynin is associated with an increased risk of hospitalization or death.
authors.affiliation: Institute for Clinical Evaluative Sciences, University of Toronto, Toronto, Ontario, Canada. tara.gomes@ices.on.ca
authors.forename: Tara
authors.initials: T
authors.lastname: Gomes
authors.forename: David N
authors.initials: DN
authors.lastname: Juurlink
authors.forename: Joanne M-W
authors.initials: JM
authors.lastname: Ho
authors.forename: Sebastian
authors.initials: S
authors.lastname: Schneeweiss
authors.forename: Muhammad M
authors.initials: MM
authors.lastname: Mamdani
mesh_terms: D000058:Accidental Falls; D000368:Aged; D001559:Benzhydryl Compounds / Q000009:adverse effects* / Q000627:therapeutic use; D003408:Cresols / Q000009:adverse effects* / Q000627:therapeutic use; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008333:Mandelic Acids / Q000009:adverse effects* / Q000627:therapeutic use; D018727:Muscarinic Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D010665:Phenylpropanolamine / Q000009:adverse effects* / Q000627:therapeutic use; D012307:Risk Factors; D000068737:Tolterodine Tartrate; D053202:Urinary Incontinence, Urge / Q000188:drug therapy*
chemical_list: D001559:Benzhydryl Compounds; D003408:Cresols; D008333:Mandelic Acids; D018727:Muscarinic Antagonists; D010665:Phenylpropanolamine; D000068737:Tolterodine Tartrate; C005419:oxybutynin