• Overactive bladder with symptoms (urge incontinence, urgency, frequency) (tablets only).
• Neurogenic detrusor overactivity (suspension only)

Contraindicated in:

• Hypersensitivity
• Urinary retention
• Gastric retention
• Uncontrolled angle-closure glaucoma
• Severe hepatic impairment
• History of QT interval prolongation or concurrent use of QT interval prolonging medications.

Use Cautiously in:

• Moderate hepatic impairment (lower dose recommended)
• Renal impairment
• Bladder outflow obstruction
• GI obstructive disorders, severe constipation, or ulcerative colitis
• Myasthenia gravis
• Angle-closure glaucoma
• OB: Safety not established in pregnancy
• Lactation: Safety not established in breastfeeding
• Pedi: Children <2 yr (safety and effectiveness not established).

CV: palpitations, QT interval prolongation, tachycardia.

EENT: blurred vision.

GI: constipation, dry mouth, abdominal pain, dyspepsia, nausea.

GU: urinary tract infection.

MS: muscle weakness.

Neuro: confusion, drowsiness, hallucinations, headache.
Misc: (INCLUDING ANAPHYLAXIS AND ANGIOEDEMA)HYPERSENSITIVITY REACTIONS .

Drug-Drug:

• Strong CYP3A4 inhibitors, including ketoconazole, may significantly ↑ levels and risk of toxicity.
• QT interval prolonging medications may ↑ risk of QT interval prolongation; avoid concurrent use.

(Generic available)

• Tablets (Vesicare): 5 mg; 10 mg;
• Oral suspension (orange flavor) (Vesicare LS): 1 mg/mL;

Overactive Bladder

• PO (Adults): Tablets: 5 mg once daily, may ↑ to 10 mg once daily; Concurrent use of strong CYP3A4 inhibitors: Tablets: Not to exceed 5 mg once daily.

Neurogenic Detrusor Overactivity

• PO (Children 2 yr and >60 kg): Suspension: 5 mg once daily, may ↑ to 10 mg once daily; Concurrent use of strong CYP3A4 inhibitors: Suspension: Not to exceed 5 mg once daily.
• PO (Children 2 yr and 46–60 kg): Suspension: 4 mg once daily, may ↑ to 8 mg once daily; Concurrent use of strong CYP3A4 inhibitors: Suspension: Not to exceed 4 mg once daily.
• PO (Children 2 yr and 31–45 kg): Suspension: 3 mg once daily, may ↑ to 6 mg once daily; Concurrent use of strong CYP3A4 inhibitors: Suspension: Not to exceed 3 mg once daily.
• PO (Children 2 yr and 16–30 kg): Suspension: 3 mg once daily, may ↑ to 5 mg once daily; Concurrent use of strong CYP3A4 inhibitors: Suspension: Not to exceed 3 mg once daily.
• PO (Children 2 yr and 9–15 kg): Suspension: 2 mg once daily, may ↑ to 4 mg once daily; Concurrent use of strong CYP3A4 inhibitors: Suspension: Not to exceed 2 mg once daily.

VESIcare, VESIcare LS

• Acts as a muscarinic (cholinergic) receptor antagonist; antagonizes bladder smooth muscle contraction.

• Decreased symptoms of overactive bladder.
• Improved maximum cystometric capacity in neurogenic detrusor overactivity.

Therapeutic Classification: urinary tract antispasmodics

Pharmacologic Classification: anticholinergics

Absorption: 90% absorbed following oral administration.

Distribution: Extensively distributed to tissues.

Protein Binding: 98%.

Metabolism/Excretion: Extensively metabolized by liver via the CYP3A4 isoenzyme. 69% excreted in urine as metabolites, 22% in feces.

Half-life: Tablets: 45–68 hr; Suspension: 26 hr.

(plasma concentrations)

• Instruct patient to take solifenacin as directed. Advise patient to read the Patient Information before starting therapy and with each prescription refill. Overactive bladder: if a dose is missed, skip dose and take next day; do not take 2 doses in same day. Neurogenic Detrusor Overactivity: take missed doses as soon as remembered if within 12 hr; if >12 hr since missed dose, omit dose and take next dose at usual time.
• Do not share solifenacin with others; may be dangerous.
• May cause dizziness and blurred vision. Caution patient to avoid driving and other activities that require alertness until response to medication is known.
• Advise patient to notify health care professional immediately if hives; rash; swelling or lips, face, tongue, or throat; or trouble breathing occurs.
• Inform patient of potential anticholinergic side effects (constipation, urinary retention, blurred vision, heat prostration in a hot environment).
• Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications.
• Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

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