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Selective M3 muscarinic receptor antagonist

Solifenacin

Brand names: Vesicare

Solifenacin is an antimuscarinic used for the symptoms of overactive bladder (urgency, frequency and urge incontinence).

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

• 5 mg tablet taken orally once daily, and if well tolerated may be increased to 10 mg once daily ( 2.1 ). • Do not exceed the 5 mg dose of solifenacin succinate tablets in patients with: • Severe renal impairment creatinine clearance <30 mL/min/1.73 m 2 ( 2.2 , 8.6 ). • Moderate hepatic impairment (Child-Pugh B). Solifenacin succinate tablets are not recommended in patients with severe hepatic impairment (Child- Pugh C) ( 2.3 , 8.7 ). • Concomitant use of strong CYP3A4 inhibitors ( 2.4 , 7.1 ). 2.1 Dosing Information The recommended oral dose of solifenacin succinate tablets is 5 mg once daily. If the 5 mg dose is well tolerated, the dose may be increased to 10 mg once daily. Solifenacin …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2026-01-28. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It blocks muscarinic (mainly M3) receptors in the bladder, reducing detrusor overactivity.

Prescribing in practice

  • Antimuscarinic effects (dry mouth, constipation, blurred vision, and — importantly in older people — confusion and falls) limit it; weigh the overall anticholinergic burden.
  • Avoid in narrow-angle glaucoma, significant urinary retention or gastrointestinal obstruction.
  • It can prolong the QT interval.

Monitoring

Review symptom benefit and anticholinergic adverse effects, particularly cognition in older patients.

Counselling the patient

  • Dry mouth and constipation are common.
  • Report difficulty passing urine or new confusion.
  • It may take a few weeks for full benefit.

Evidence & guidelines

An antimuscarinic option for overactive bladder (NICE NG123), mindful of anticholinergic burden in older people.

Reference: NICE NG123; EAU Incontinence Guidelines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.