Mechanism of effect
Inhibits muscarinic receptors resulting in decreased urinary bladder contraction, increased residual urine volume, and decreased detrusor muscle pressure.
Pharmacodynamic
Solifenacin is a competitive muscarinic receptor antagonist.
Pharmacokinetics
Metabolism:Extensively hepatic; Excretion:Urine (69%; <15% as unchanged drug); feces (23%) Time to Peak:Plasma: 3-8 hours Half-Life Elimination:45-68 hours following chronic dosing Protein Binding:~98% bound primarily to alpha1-acid glycoprotein
Dosage
Dosing: Adult Overactive bladder: Oral: 5 mg once daily; if tolerated, may increase to 10 mg once daily Dosage adjustment with concomitant CYP3A4 inhibitors: Maximum solifenacin dose: 5 mg/day
Interactions
Acetylcholine , Pyridostigmine , Pimozide , Galantamine , Aprepitant , Ipratropium bromide , Itraconazole , Bosentan , Topiramate , Tiotropium bromid , Hydrochlorothiazide , Clozapine , Enzalutamide , Aclidinium , Fucidic acid , revefenacin , Rifabutin , potassium citrate , Dolasetron , vandetanib , sparfloxacin , Mefloquine , Dofetilide , Anagrelide , pilocarpine oral , Pramlintide , Secretin , Halofantrine , Grepafloxacin , Mibefradil , cobicistat , Delavirdine , Huperzine A , Troleandomycin , glycopyrrolate topical , Bepridil , bedaquiline , BlonanserinAlerts
1-patients must be cautioned about performing tasks which require mental alertness (eg, operating machinery or driving).
2-use caution in hot weather and/or exercise.
3-Cases of angioedema involving the face, lips, tongue, and/or larynx have been reported during treatment; some cases have occurred after the first dose. May be life-threatening. Immediately discontinue and institute supportive care if tongue, hypopharynx, or larynx is involved.
Points of recommendation
Swallow tablet whole; administer with liquids; may be administered without regard to meals.
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