Home Drug Guide Solifenacin Succinate

Drug Guide

Generic Name

Solifenacin Succinate

Brand Names Vesicare, Vesicare Ls

Classification

Therapeutic: Urinary antispasmodic, Anticholinergic

Pharmacological: Antimuscarinic agent

FDA Approved Indications

Overactive bladder with symptoms of urge incontinence, urgency, and frequency

Mechanism of Action

Solifenacin is a selective antagonist of the M3 muscarinic receptor, reducing bladder muscle contractions and thereby decreasing urgency and frequency.

Dosage and Administration

Adult: Typically initiated at 5 mg once daily. Dose may be increased to 10 mg once daily based on response and tolerability.

Pediatric: Not approved for pediatric use.

Geriatric: Start at lower end of dosing spectrum, monitor for anticholinergic side effects.

Renal Impairment: Reduce dose in moderate to severe impairment.

Hepatic Impairment: Use with caution; no specific dosage adjustments established.

Pharmacokinetics

Absorption: Well absorbed after oral administration.

Distribution: Widely distributed; protein binding approximately 98%.

Metabolism: Metabolized in the liver mainly via CYP3A4.

Excretion: Primarily excreted in feces; about 20-30% excreted in urine.

Half Life: Approximately 45-68 hours.

Contraindications

Urinary retention, gastric retention, uncontrolled glaucoma, severe hepatic impairment,

Precautions

Use with caution in patients with gastrointestinal or urinary retention, or decreased hepatic function. Monitor for signs of urinary retention, dry mouth, or blurred vision.

Adverse Reactions - Common

Dry mouth (Very common)
Constipation (Common)
Blurred vision (Uncommon)
Urinary retention (Uncommon)

Adverse Reactions - Serious

Urinary retention exacerbation (Rare)
Angioedema (Rare)
QT prolongation (Rare)

Drug-Drug Interactions

Other drugs with anticholinergic activity, such as antihistamines, tricyclic antidepressants, other antimuscarinics.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Assess for urinary retention, gastrointestinal motility, and current medications. Monitor for dry mouth and other anticholinergic side effects.

Diagnoses:

Risk for urinary retention
Impaired oral mucous membrane

Implementation: Administer once daily at the same time. Provide water for dry mouth. Educate patients on avoiding activities requiring alertness until response is known.

Evaluation: Monitor symptom relief of overactive bladder, side effects, and signs of adverse reactions.

Patient/Family Teaching

Take medication exactly as prescribed.
Report any difficulty urinating, vision changes, or severe dry mouth.
Avoid activities requiring alertness until adverse effects are known.
Stay well hydrated.
Use caution if experiencing blurred vision.

Special Considerations

Black Box Warnings:

None currently

Genetic Factors: Genetic variation in CYP3A4 may affect metabolism.

Lab Test Interference: No significant interference reported.

Overdose Management

Signs/Symptoms: Severe anticholinergic symptoms: dry mouth, blurred vision, urinary retention, tachycardia, hallucinations.

Treatment: Supportive care, activated charcoal if ingestion was recent, and symptomatic treatment. Consider administration of physostigmine in severe cases under medical supervision.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).

Stability: Stable for the shelf life when stored properly.