Solifenacin
Solifenacin
Vesicare
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Summary
Common uses
Overactive bladder (urgency, frequency, urge incontinence)0, Neurogenic detrusor overactivity0
Pharmacy
Starting dose
5 mg PO once daily; titrate to 10 mg after 2 weeks if needed
Preparations
5, 10 mg tablets
US FDA Max
10 mg/d (5 mg if severe renal or moderate hepatic impairment, or strong CYP3A4 inhibitors)
Pharmacology
Routes
Oral
Onset
Symptom improvement within 1-2 weeks
Duration
24 hours
Half-life
~45-68 hours[1]
Bioavailability
~90% (oral)[1]
Pregnancy
Limited data.[citation needed]
Legal status
Rx-only in US
Purported mechanism
Solifenacin is a competitive muscarinic receptor antagonist with substantially higher selectivity for M3 (bladder detrusor) over M2 (cardiac) and M1 (CNS) than oxybutynin; the relative subtype selectivity reduces (but does not eliminate) the systemic anticholinergic burden.0 CYP3A4 substrate; QT-interval prolongation has been reported at higher doses. Like other antimuscarinics, contributes to cumulative anticholinergic burden in older adults[1].
References
- ↑ 1.0 1.1 1.2 FDA Prescribing Information, Vesicare (solifenacin succinate), Astellas, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/021518s019lbl.pdf