Formulary
Darifenacin: Indications, Dosing, Side Effects and Interactions
Darifenacin clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Darifenacin: Indications, Dosing, Side Effects and Interactions
Darifenacin clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Urinary frequency,Urinary urgency,Incontinence**
- **Adult** (By Mouth): Initially 7.5 mg once daily, increased if necessary to 15 mg after 2 weeks.
Cautions
For all antimuscarinics (systemic) Acute myocardial infarction; arrhythmias (may be worsened); autonomic neuropathy; cardiac insufficiency (due to association with tachycardia); cardiac surgery (due to association with tachycardia); conditions characterised by tachycardia; congestive heart failure (may be worsened); coronary artery disease (may be worsened); diarrhoea; elderly (especially if frail); gastro-oesophageal reflux disease; hiatus hernia with reflux oesophagitis; hypertension; hyperthyroidism (due to association with tachycardia); individuals susceptible to angle-closure glaucoma; prostatic hyperplasia; pyrexia; ulcerative colitis Cautions, further information Elderly Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria to aid medication reviews (see Prescribing in the elderly for information). Potentially inappropriate: if treating extrapyramidal side-effects of antipsychotic medications (risk of antimuscarinic toxicity) with delirium or dementia (risk of exacerbation of cognitive impairment), angle-closure glaucoma (contra-indicated; risk of acute exacerbation of glaucoma), or chronic prostatism (risk of urinary retention) if two or more antimuscarinic drugs prescribed concomitantly (risk of increased antimuscarinic toxicity)
Contraindications
For all antimuscarinics (systemic) Angle-closure glaucoma; gastro-intestinal obstruction; intestinal atony; myasthenia gravis (but some antimuscarinics may be used to decrease muscarinic side-effects of anticholinesterases); paralytic ileus; pyloric stenosis; severe ulcerative colitis; significant bladder outflow obstruction; toxic megacolon; urinary retention
Side effects
For all antimuscarinics (systemic) Common or very common Constipation; dizziness; drowsiness; dry mouth; dyspepsia; flushing; headache; nausea; palpitations; skin reactions; tachycardia; urinary disorders; vision disorders; vomiting Rare or very rare Angioedema; confusion (more common in elderly) Side-effects For darifenacin Common or very common Abdominal pain; dry eye; nasal dryness Uncommon Asthenia; bladder pain; cough; diarrhoea; dyspnoea; erectile dysfunction; flatulence; hyperhidrosis; hypertension; increased risk of infection; injury; insomnia; oedema; oral ulceration; taste altered; thinking abnormal; urinary tract disorder
Interactions
**Other interactions (26):**
- Effects of other medicinal products on darifenacin Darifenacin metabolism is primarily mediated by the cytochrome P450 enzymes CYP2D6 and CYP3A4.
- Therefore, inhibitors of these enzymes may increase darifenacin exposure.
- CYP2D6 inhibitors In patients receiving substances that are potent CYP2D6 inhibitors (e.g.
- Concomitant treatment with potent CYP2D6 inhibitors results in an increase in exposure (e.g.
- CYP3A4 inhibitors Darifenacin should not be used together with potent CYP3A4 inhibitors (see section 4.3) such as protease inhibitors (e.g.
- Potent P-glycoprotein inhibitors such as ciclosporin and verapamil should also be avoided.
Pregnancy
Manufacturer advises avoid-toxicity in animal studies.
Breast feeding
Present in milk in animal studies-manufacturer advises caution.
Hepatic impairment
Manufacturer advises caution in moderate impairment; avoid in severe impairment (risk of increased exposure). Dose adjustments Manufacturer advises maximum 7.5 mg daily in moderate impairment.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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