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Pharmacologic class: Anticholinergic
Therapeutic class: Renal and genitourinary agent
Pregnancy risk category C
Antagonizes muscarinic receptors, reducing urinary bladder smooth-muscle contractions
Tablets: 5 mg, 10 mg
Indications and dosages
➣ Overactive bladder with symptoms of urge urinary incontinence, urgency, and urinary frequency
Adults: 5 mg P.O. daily initially; may increase to 10 mg P.O. daily if well tolerated
• Moderate hepatic impairment
• Severe renal impairment
• Concurrent use of potent CYP3A4 inhibitors (such as ketoconazole)
• Hypersensitivity to drug or its components
• Urinary retention
• Gastric retention
• Uncontrolled angle-closure glaucoma
Use cautiously in:
• hepatic or renal impairment, bladder outflow obstruction, decreased GI motility, GI obstructive disorder, controlled angle-closure glaucoma, congenital or acquired QT interval prolongation
• increased risk of urinary retention or heat prostration
• pregnant or breastfeeding patients
• children (safety and efficacy not established).
• Give with liquids, with or without food. Make sure patient swallows tablet whole.
CNS: dizziness, depression, fatigue, asthenia
EENT: dry eyes, blurred vision, dry throat, pharyngitis
GI: nausea, vomiting, constipation, upper abdominal pain, dyspepsia, dry mouth
GU: urinary tract infection, urinary retention
Skin: dry skin, rash, pruritus
Other: influenza, leg or foot edema
Drug-drug. Anticholinergics: increased frequency or severity of adverse reactions
CYP3A4 inhibitors (such as ketoconazole): increased solifenacin blood level
• Monitor GI, renal, and hepatic function frequently.
• Monitor patient for ophthalmic disorders, especially angle-closure glaucoma. If present, stop drug until condition stabilizes.
• Instruct patient to take drug with liquids, with or without food, and to swallow tablet whole.
• Advise patient to contact prescriber if severe abdominal pain or constipation lasting 3 or more days occurs.
• Caution patient to avoid driving and other hazardous activities until drug effects are known.
• Advise patient of risk for heat prostration; describe symptoms.
• Instruct patient to consult prescriber before taking over-the-counter products such as antihistamines because these may increase risk of side effects.
• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs mentioned above.
ClassificationTherapeutic: urinary tract antispasmodics
|Oral||unknown||3–8 hr||24 hr|
Adverse Reactions/Side Effects
Central nervous system
Ear, Eye, Nose, Throat
- blurred vision
- constipation (most frequent)
- dry mouth (most frequent)
- muscle weakness
- angioedema (life-threatening)
Drug-Drug interactionDrugs that induce or inhibit the CYP3A4 enzyme system may significantly alter levels; ketoconazole ↑ levels and risk of toxicity (do 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.
- Monitor voiding pattern and assess symptoms of overactive bladder (urinary urgency, urinary incontinence, urinary frequency) to and periodically during therapy.
Potential Nursing DiagnosesImpaired urinary elimination (Indications)
- 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.
- 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.
- Decrease in symptoms of overactive bladder (urge urinary incontinence, urgency, frequency).