Antimuscarinic (M3-selective)
Solifenacin succinate
Brand names: Vesicare
Adult dose
Dose: 5mg PO OD; may increase to 10mg OD
Route: PO
Frequency: OD
Dose adjustments
Renal
Max 5mg if eGFR <30
Clinical pearls
- Overactive bladder
- Mirabegron preferred in older adults to reduce cognitive risk
Contraindications
- Urinary retention
- GI obstruction
- Glaucoma
- Myasthenia gravis
- Severe ulcerative colitis
- Toxic megacolon
- Severe hepatic impairment
Side effects
- Dry mouth
- Constipation
- Blurred vision
- QT prolongation
- Anticholinergic burden
Interactions
- Strong CYP3A4 inhibitors (max 5mg)
- QT-prolonging drugs
- Other antimuscarinics
Monitoring
- Symptoms
- Anticholinergic burden
Reference: BNF; NICE NG123; https://bnf.nice.org.uk/drugs/solifenacin-succinate/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.