Solifenacin

Solifenacin is a prescription drug used to treat overactive bladder in adults. It is a relatively new drug and compares favorably to older drugs used to treat this condition. When formulated as the succinate salt, it is marketed as Vesicare by Yamanouchi (now Astellas) Pharmaceuticals.

Other Names

Generic or common names: Solifenacin

Uses

Solifenacin is a prescription medicine used in adults to treat the following symptoms due to a condition called overactive bladder:

• Having to go to the bathroom too often, also called urinary frequency
• Having a strong need to go to the bathroom right away, also called urgency
• Leaking or wetting accidents, also called urinary incontinence.

Solifenacin has not been studied in children.

How is Solifenacin Taken

• Solifenacin is prescribed medicine and should be taken as directed. A doctor may prescribe the lowest dose if certain medical conditions such as liver or kidney problems exist.
• Take one solifenacin tablet once a day.
• Take solifenacin with liquid and swallow the tablet whole.
• Solifenacin can be taken with or without food.

How Solifenacin Works

Urinary bladder and adjacent structures, showing the detrusor muscle. Source:NCI.

Solifenacin works by relaxing the detrusor muscle in the wall of the bladder.

Side Effects

The most common side effects with solifenacin are related to alterations in other muscles that are structurally similar to the detrusor muscle in the bladder in the eyes, gut, and blood vessels. These include:

• Blurred vision, which may impair driving.
• Dry mouth
• Constipation lasting more than 3 days, which may require dosage adjustment.
• Heat prostration due to decreased sweating can occur in hot environments.

Benefits

Solifenacin helps patients by relieving overactive bladder symptoms. Overactive bladder can cause frequent urination and can also lead to urinary incontinence (the inability to control when urine is released).

Risks

Solifenacin may worsen constipation or delay the diagnosis of diseases that affect the flow of urine, so a thorough history and physical exam are needed before starting therapy. Solifenacin may worsen narrow angle glaucoma, an eye problem; it may also worsen liver problems, kidney problems, or a woman's ability to become pregnant. It may cross the placenta and enter into breast milk and so should not be used by women who are pregnant, trying to become pregnant, or are breastfeeding.

Alternatives

Tolterodine (Detrol) and oxybutynin (Oxytrol) are well established drugs for treatment of overactive bladder, but they cause unpleasant side effects and many patients stop therapy for this reason. Trospium (Sanctura) is water-soluble and therefore less likely to cross from the blood into the central nervous system; this reduces some of the side effects compared to oxybutynin. Darifenacin (Enablex) is more selective for the bladder than older agents and may reduce side effects for this reason.^[1]

References

1. ↑ Epstein BJ, Gums JG, Molina E. Newer agents for the management of overactive bladder. Am Fam Physician. 2006 Dec 15;74(12):2061-8. Abstract | Full Text | PDF