Abstract

To assess the efficacy of salivary stimulant pastilles in improving tolerance of and compliance with oxybutynin chloride for detrusor instability. Thirty women with detrusor instability were treated with oxybutynin in either a fixed or variable dose. After 3 weeks, patients were given salivary stimulant pastilles (Salivix, Thames Laboratories, Clwyd, UK) to chew as often as required. Symptom diaries were used to record episodes of dry mouth (xerostomia) together with a 100 mm visual analogue scale (VAS) score of the severity of xerostomia. The frequency of xerostomia was unchanged but there was a significant decrease in median severity from 71 to 39 on the VAS (P < 0.05, Mann-Whitney U-test). Nine patients on the variable-dose regimen tolerated a higher dose of oxybutynin when taking the pastilles (P < 0.01, Wilcoxon's matched-pairs test). Salivary stimulant pastilles appear to be a useful adjuvant therapy for patients receiving oxybutynin chloride for detrusor instability, allowing higher doses of oxybutynin to be tolerated.

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