α-blocker + antimuscarinic Pregnancy: Not indicated for use in women, so pregnancy and lactation do not apply. Fertility: the effect on fertility has not been established; animal studies with solifenacin or tamsulosin do not indicate harmful effects on fertility and early embryonic development. Ejaculation disorders, retrograde ejaculation and ejaculation failure have been reported with tamsulosin.

Tamsulosin with solifenacin

Brand names: Vesomni

This fixed-dose combination joins the alpha-blocker tamsulosin with the antimuscarinic solifenacin for men with both voiding and storage lower urinary tract symptoms associated with benign prostatic hyperplasia.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: One tablet (solifenacin succinate 6 mg / tamsulosin hydrochloride 0.4 mg) once daily

Route: Oral — modified-release tablet; must be swallowed whole and intact without biting or chewing, do not crush; may be taken with or without food

Frequency: Once daily

Max: One tablet (6 mg / 0.4 mg) daily — stated as the maximum daily dose

Indicated for adult males, including older people. Renal impairment: can be used in mild to moderate impairment (creatinine clearance >30 mL/min); patients with severe renal impairment (creatinine clearance ≤30 mL/min) should be treated with caution and the maximum daily dose remains one tablet. Hepatic impairment: can be used in mild impairment (Child-Pugh score ≤7); moderate impairment (Child-Pugh score 7–9) should be treated with caution with a maximum daily dose of one tablet; severe impairment (Child-Pugh score >9) is contraindicated. Moderate and strong CYP3A4 inhibitors (e.g. verapamil, ketoconazole, ritonavir, nelfinavir, itraconazole): the maximum daily dose should be limited to one tablet and the combination used with caution. Paediatric population: there is no relevant indication for use in children and adolescents. §4.4: initiation is not recommended in patients scheduled for cataract or glaucoma surgery because of Intraoperative Floppy Iris Syndrome. Source: UK SPC for Solifenacin succinate/Tamsulosin hydrochloride 6 mg/0.4 mg Modified-release tablet (Milpharm, eMC product 100465); §4.4 and §4.8 were truncated at the source-fetch limit and no separate §4.5 interactions section was retrieved in this bundle.

Dose adjustments

Renal

Can be used in patients with mild to moderate renal impairment (creatinine clearance >30 mL/min). Patients with severe renal impairment (creatinine clearance ≤30 mL/min) should be treated with caution, with a maximum daily dose of one tablet (6 mg/0.4 mg). Contraindicated in patients undergoing haemodialysis, and in severe renal impairment when combined with a strong CYP3A4 inhibitor.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to the active substances or to any of the excipients
Patients undergoing haemodialysis
Severe hepatic impairment
Severe renal impairment in patients also treated with a strong CYP3A4 inhibitor (e.g. ketoconazole)
Moderate hepatic impairment in patients also treated with a strong CYP3A4 inhibitor (e.g. ketoconazole)
Severe gastrointestinal conditions (including toxic megacolon), myasthenia gravis or narrow-angle glaucoma, and patients at risk for these conditions
A history of orthostatic hypotension

Side effects

Dry mouth (9.5%)
Constipation (3.2%)
Dyspepsia including abdominal pain (2.4%)
Ejaculation disorder including retrograde ejaculation (1.5%); dizziness including vertigo (1.4%)
Vision blurred (1.2%) and fatigue (1.2%); acute urinary retention (0.3%, uncommon) is the most serious adverse drug reaction observed in clinical studies

Interactions

Moderate and strong CYP3A4 inhibitors (e.g. verapamil, ketoconazole, ritonavir, nelfinavir, itraconazole) — limit the maximum daily dose to one tablet and use with caution (§4.2); combination with a strong CYP3A4 inhibitor is contraindicated in severe renal or moderate hepatic impairment (§4.3)
Drugs and conditions predisposing to QT prolongation (e.g. pre-existing long QT syndrome, hypokalaemia) — QT prolongation and Torsade de Pointes have been observed with solifenacin succinate (§4.4)
Bisphosphonates and other medicinal products that can cause or exacerbate oesophagitis — use with caution in patients with hiatus hernia/gastro-oesophageal reflux (§4.4)
NOTE: §4.5 of this SPC was not retrieved in the source bundle — the list above is drawn from §4.2/§4.3/§4.4 and is not a complete interactions section

Clinical monograph

How it works

Tamsulosin relaxes prostatic and bladder-neck smooth muscle through selective alpha-1A adrenoceptor blockade to ease voiding, while solifenacin blocks detrusor M3 muscarinic receptors to reduce urgency and frequency.

Prescribing in practice

The antimuscarinic component risks acute urinary retention, so it should be avoided where there is a significant post-void residual or high obstruction risk, and patients warned to report inability to void.
Combined effects include postural hypotension from tamsulosin and antimuscarinic effects (dry mouth, constipation, confusion), with caution in narrow-angle glaucoma and the elderly.
Tell cataract surgeons about tamsulosin use because of the risk of intra-operative floppy iris syndrome.

Monitoring

Review voiding efficiency and post-void residual alongside storage-symptom response and antimuscarinic tolerability.

Counselling the patient

Report any difficulty or inability to pass urine promptly.
Expect possible dry mouth and dizziness on standing; mention this medicine before eye surgery.

Evidence & guidelines

Trials of combined alpha-blocker and antimuscarinic therapy show improved storage symptoms over alpha-blocker alone in selected men with low retention risk.

Reference: NICE NG106; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways