Antimuscarinic
Pregnancy: C
Solifenacin 5 mg
Brand names: Vesicare
Adult dose
Dose: 5 mg once daily; may increase to 10 mg once daily
Route: oral
Frequency: once daily
Max: 10 mg/day
Do not exceed 5 mg/day with CYP3A4 inhibitors, hepatic/renal impairment; greater bladder selectivity than oxybutynin
Paediatric dose
Route:
Not licensed in children under 18 years
Dose adjustments
Renal
Max 5 mg/day if eGFR <30 ml/min
Hepatic
Max 5 mg/day in moderate hepatic impairment; avoid in severe
Clinical pearls
- M3-receptor selectivity: higher urothelial selectivity than oxybutynin — better tolerability
- Long half-life (45–68h) allows once-daily dosing and forgiveness for missed doses
- Head-to-head STAR trial: superior to tolterodine MR for dry OAB
Contraindications
- Urinary retention
- Narrow-angle glaucoma
- Myasthenia gravis
- Severe hepatic impairment
Side effects
- Dry mouth (most common)
- Constipation
- Blurred vision
- UTI
- Nausea
- Dyspepsia
Interactions
- CYP3A4 inhibitors (max 5 mg/day)
- Other antimuscarinics
Monitoring
- OAB symptom scores
- Residual urine (post-void)
Reference: BNFc; BNF 86; NICE NG123; STAR trial. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs