Formulary
Solifenacin succinate: Indications, Dosing, Side Effects and Interactions
Solifenacin succinate clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 4 min read
Solifenacin succinate: Indications, Dosing, Side Effects and Interactions
Solifenacin succinate clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Urinary frequency,Urinary urgency,Urinary incontinence**
- **Adult** (By Mouth): 5 mg once daily, increased if necessary to 10 mg once daily.
**Neurogenic detrusor overactivity for solifenacin succinate**
- **Child 2-17 years (body-weight 9-15 kg)** (By mouth): Initially 2 mg once daily, increased if necessary up to 4 mg once daily.
- **Child 2-17 years (body-weight 16-30 kg)** (By mouth): Initially 3 mg once daily, increased if necessary up to 5 mg once daily.
- **Child 2-17 years (body-weight 31-45 kg)** (By mouth): Initially 3 mg once daily, increased if necessary up to 6 mg once daily.
- **Child 2-17 years (body-weight 46-60 kg)** (By mouth): Initially 4 mg once daily, increased if necessary up to 8 mg once daily.
- **Child 2-17 years (body-weight 61 kg and above)** (By mouth): Initially 5 mg once daily, increased if necessary up to 10 mg once daily.
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) Cautions For solifenacin succinate Susceptibility to QT-interval prolongation
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 solifenacin succinate Common or very common Gastrointestinal discomfort Uncommon Cystitis; dry eye; dry throat; fatigue; gastrointestinal disorders; nasal dryness; peripheral oedema; taste altered; urinary tract infection Rare or very rare Hallucination Frequency not known Anaphylactic reaction; appetite decreased; arrhythmias; delirium; dysphonia; glaucoma; hyperkalaemia; liver disorder; muscle weakness; QT interval prolongation; renal impairment
Interactions
**Other interactions (7):**
- Solifenacin can reduce the effect of medicinal products that stimulate the motility of the gastrointestinal tract, such as metoclopramide and cisapride.
- Effect of other medicinal products on the pharmacokinetics of solifenacin Solifenacin is metabolised by CYP3A4.
- Simultaneous administration of ketoconazole (200 mg/day), a potent CYP3A4 inhibitor, resulted in a twofold increase of the AUC of solifenacin, while ketoconazole at a dose of 400 mg/day resulted in...
- Therefore, the maximum dose of solifenacin should be restricted to 5mg, when used simultaneously with ketoconazole or therapeutic doses of other potent CYP3A4 inhibitors (e.g.
- Since solifenacin is metabolised by CYP3A4, pharmacokinetic interactions are possible with other CYP3A4 substrates with higher affinity (e.g.
- Warfarin Intake of solifenacin did not alter the pharmacokinetics of R-warfarin or S-warfarin or their effect on prothrombin time.
Pregnancy
Manufacturer advises caution-no information available.
Breast feeding
Manufacturer advises avoid-present in milk in animal studies.
Hepatic impairment
Manufacturer advises caution in moderate impairment (risk of increased half-life); avoid in severe impairment (no information available). Dose adjustments Manufacturer advises maximum 5 mg once daily in moderate impairment.
Renal impairment
Manufacturer advises caution in severe impairment. Dose adjustments See Prescribing in renal impairment . Manufacturer advises maximum 5 mg once daily if creatinine clearance 30 mL/minute or less.
Medicinal forms
Solution,Tablet,Suspension,Solution
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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