Antimuscarinic (M3-selective)
Darifenacin
Brand names: Emselex
Adult dose
Dose: 7.5mg OD; increase to 15mg OD after 2 weeks if needed
Route: Oral
Frequency: OD
Clinical pearls
- NICE NG123 OAB: antimuscarinic option for overactive bladder; M3 selectivity may reduce CNS effects
- BAUS / EAU OAB guidance
- Minimise anticholinergic burden in elderly (STOPP/START)
Contraindications
- Urinary retention
- Gastric retention
- Closed-angle glaucoma
- Severe hepatic impairment
- Myasthenia gravis
- Hypersensitivity
Side effects
- Dry mouth
- Constipation
- Blurred vision
- Urinary retention
- Confusion (elderly)
- QT prolongation
Interactions
- Strong CYP2D6/CYP3A4 inhibitors
- Other anticholinergics
- QT-prolonging drugs
Monitoring
- Symptom response
- Anticholinergic burden
Reference: BNF; NICE NG123; BAUS / EAU; https://bnf.nice.org.uk/drugs/darifenacin/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.