Oxybutynin: a new addition to drugs effective for hot flash suppression

Research announced at the 2018 San Antonio Breast Cancer Symposium has demonstrated that oxybutynin is more effective in suppressing hot flashes than the current drugs of choice, venlafaxine or citalopram.
"We have to be cautious, as these are cross-trial comparisons, but oxybutynin shows a more significant decrease in hot flash score [than anything else so far], so with the results of this particular study, we will be more keen on using oxybutynin now," he said. (source)
In more detail, researchers tested both doses of oxybutynin, 2.5 mg and 5 mg, and found:
measures related to sleep, leisure activities, work, and relationships, were significantly better in comparison with women who received placebo.

However, neither dosage of oxybutynin offset the effect that hot flushes had on patients' ability to concentrate or on their sexuality. At the lower dosage, oxybutynin did not improve mood or enjoyment of life; at the higher dosage, improvements were seen for these measures. (source)
But as we all know, there is no such thing as a free lunch.
Side effects were as expected with any anticholinergic and included dry mouth, abdominal pain, and difficulty urinating with both dosages.

At the higher dosage, oxybutynin also increased the risk of developing dry eyes, as well as risk for episodes of confusion, diarrhea, and headaches. (source)
Here are the FDA product information files for the 5 mg dose strength. The product is also available in extended release and syrup forms with a total FDA listing here.

As this is posted, drug coupon source GoodRx lists a retail cost of $42.09 for 60 5 mg tablets, but offers coupons to bring that cost down $20-25. Insurance coverage will depend upon individual companies' policies and agreements with pharmacies and manufacturers.

In addition to women with hormone-receptor-positive cancers, especially those taking tamoxifen which contraindicates the use of many SSRIs, this product may be helpful for other women, such as endo sufferers, who are looking for non-hormonal control of their symptoms.