solifenacin


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Related to solifenacin: Solifenacin succinate

solifenacin

(so-li-fen-a-sin) ,

VESIcare

(trade name)

Classification

Therapeutic: urinary tract antispasmodics
Pharmacologic: anticholinergics
Pregnancy Category: C

Indications

Overactive bladder with symptoms (urge incontinence, urgency, frequency).

Action

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

Therapeutic effects

Decreased symptoms of overactive bladder.

Pharmacokinetics

Absorption: Well absorbed (90%).
Distribution: Unknown.
Protein Binding: 98%.
Metabolism and Excretion: Extensively metabolized by the CYP3A4 enzyme system. 69% excreted in urine as metabolites, 22% in feces.
Half-life: 45–68 hr.

Time/action profile

ROUTEONSETPEAKDURATION
Oralunknown3–8 hr24 hr

Contraindications/Precautions

Contraindicated in: Hypersensitivity;Urinary retention;Gastric retention;Uncontrolled angle-closure glaucoma;Severe hepatic impairment; Lactation: Lactation.
Use Cautiously in: Concurrent use of CYP3A4 inhibitors (use lower dose/clinical monitoring may be necessary);Moderate hepatic impairment (lower dose recommended);Renal impairment (dose should not exceed 5 mg/day if CCr <30 mL/min);Bladder outflow obstruction;GI obstructive disorders, severe constipation, or ulcerative colitis;Myasthenia gravis;Angle-closure glaucoma; Obstetric: Use only if maternal benefit outweighs fetal risk; Pediatric: Safety not established.

Adverse Reactions/Side Effects

Central nervous system

  • confusion
  • drowsiness
  • hallucinations
  • headache

Cardiovascular

  • palpitations
  • tachycardia

Ear, Eye, Nose, Throat

  • blurred vision

Gastrointestinal

  • constipation (most frequent)
  • dry mouth (most frequent)
  • dyspepsia
  • nausea

Musculoskeletal

  • muscle weakness

Miscellaneous

  • angioedema (life-threatening)

Interactions

Drug-Drug interaction

Drugs that induce or inhibit the CYP3A4 enzyme system may significantly alter levels; ketoconazole ↑ levels and risk of toxicity (do not exceed 5 mg/day).

Route/Dosage

Oral (Adults) 5 mg once daily, may be ↑ to 10 mg once daily; Concurrent use of ketoconazole or other potent CYP3A4 inhibitors—Dose should not exceed 5 mg/day.

Renal Impairment

(Adults) CCr <30 mL/min—Dose should not exceed 5 mg/day.

Hepatic Impairment

(Adults) Moderate hepatic impairment—Dose should not exceed 5 mg/day.

Availability

Tablets: 5 mg, 10 mg Cost: All strengths $703.66 / 90

Nursing implications

Nursing assessment

  • Monitor voiding pattern and assess symptoms of overactive bladder (urinary urgency, urinary incontinence, urinary frequency) to and periodically during therapy.

Potential Nursing Diagnoses

Impaired urinary elimination (Indications)

Implementation

  • Do not confuse Vesicare (solifenacin) with Vesanoid (oral tretinoin).
  • Oral: Administer once daily without regard to food. Tablets must be swallowed whole; do not break, crush, or chew.

Patient/Family Teaching

  • Instruct patient to take solifenacin as directed. Advise patient to read the Patient Information before starting therapy and with each prescription refill. If a dose is missed, skip dose and take next day; do not take 2 doses in same day.
  • 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; 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.

Evaluation/Desired Outcomes

  • Decrease in symptoms of overactive bladder (urge urinary incontinence, urgency, frequency).

solifenacin

an anticholinergic.
indication This drug is used to treat overactive bladder.
contraindications Uncontrolled narrow-angle glaucoma, urinary retention, gastric retention, and known hypersensitivity to this drug prohibit its use.
adverse effects Adverse effects of this drug include anxiety, paresthesia, fatigue, headache, chest pain, hypertension, abdominal pain, dry mouth, dyspepsia, dysuria, urinary retention and frequency, urinary tract infection, rash, pruritus, bronchitis, cough, pharyngitis, and upper respiratory tract infection. Common side effects include dizziness, vision abnormalities, xerophthalmia, nausea, vomiting, anorexia, and constipation.
References in periodicals archive ?
Solifenacin was the most widely prescribed antimuscarinic, perhaps reflecting the fact that prescribing for the private population in Canada is unconstrained by provincial policy regarding the first-line use of oxybutynin IR.
80 episodes in OAB patients given solifenacin 5 mg with mirabegron 50 mg (dosage was increased from 25 mg after 4 weeks) as an add-on therapy compared to a reduction of 1.
Efficacy of combination therapy with tamsulosin OCAS and solifenacin in NEPTUNE: Results from a randomized Phase III trial in men with LUTS.
Urinary tract drugs: Darifenacin, Fesoterodine, Solifenacin, Silodosin, Tamsulosin
Lastly, in 2004, three newer agents--darifenacin, solifenacin, and trospium--challenged older compounds by having a less frequent dosing schedule and a more favorable side effect profile.
Anticholinergic agents such as oxybutynin, oxytrol, tolterodine, and solifenacin succinate are often used to inhibit detrusor muscle contraction.
Solifenacin and tolterodine for UI and dutasteride and tamsulosin for BPH dominated the market in 2010 and generated $0.
7%, with the next closest being solifenacin at 22% at 1 year.
May 5, 2015 /PRNewswire/ -- Astellas announced that two abstracts detailing clinical data from studies of enzalutamide and one abstract detailing clinical data from a study of mirabegron as an add-on treatment to solifenacin will be presented during a late breaking plenary session at the 2015 annual meeting of the American Urological Association (AUA) on May 17 in New Orleans, Louisiana.
Tenders are invited for Supply of Solifenacin succinate 10 mg tab
A global Phase 3 programme is now underway evaluating the safety and efficacy of the concomitant use of solifenacin (known commercially as VESICARE(TM)) and mirabegron (known commercially as BETMIGA(TM)), for the treatment of overactive bladder.