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 ?
Prospective open label study of solifenacin for overactive bladder in children.
Sixty-two patients in the control group were treated with tamsulosin, while sixty-two patients in the observation group were treated with tamsulosin in combination with solifenacin.
Long-term safety and efficacy of single-tablet combinations of solifenacin and tamsulosin oral controlled absorption system in men with storage and voiding lower urinary tract symptoms: Results from the NEPTUNE study and NEPTUNE II open-label extension.
To do that, the researchers turned to solifenacin, the antimuscarinic drug for overactive bladder; the bladder muscle contains several muscarinic receptors.
We were excited about this because solifenacin is an approved ding that's already on the market," said Sim.
Anticholinergic drugs, such as oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), darifenacin (Enablex), trospium (Sanctura) or solifenacin (Vesicare)
Available agents include darifenacin, fesoterodine, oxybutynin, solifenacin, tolterodine, and trospium.
Antimuscarinics include darifenacin, fesoterodine, oxybutynin, solifenacin, tolterodine, and trospium, which all have similar efficacy, In general, patients with more severe symptoms have a greater degree of response to medications, regardless of which medication is chosen.
Affected drugs range from anticancer drugs like Nilotinib, sold under the brand name Tasigna, to the bladder medication Solifenacin, also known as Vesicare.
Antimuscarinics, such as oxybutynin, tolterodine, darifenacin, solifenacin, fesoterodin, and trospium chloride are the only oral drug class to demonstrate a positive benefit-to-risk ratio.
Anticholinergics/ Oxybutynin * (b) Block Antimuscarinics Tolterodine * parasympathetic Solifenacin * transmission Scopolamine [right arrow] Atropine decreased Tricyclic contraction of antidepressants detrusor.