Section 17 · Monograph
Solifenacin
Reviewed Nov 2026FDA label
VesicareAntimuscarinic
- Forms
- Tab: 5, 10mg | Susp: 1mg/mL (Vesicare LS)
- Dose
- 5mg once daily, may increase to 10mg; pediatric neurogenic detrusor overactivity is weight-based
- MOA
- M3-selective muscarinic blockade
Indications
- Overactive bladder with urge urinary incontinence, urgency and frequency in adultsFDA-labeled
- Neurogenic detrusor overactivity in pediatric patients 2 years and older (oral suspension)FDA-labeled
Mechanism of Action
- Muscarinic receptor antagonist with relative M3 selectivity that reduces detrusor contractions
Full Dosing
Adult / usual
- Adults: 5mg once daily; may increase to 10mg once daily
Renal
- Maximum 5mg/day with strong CYP3A4 inhibitors, severe renal impairment or moderate hepatic impairment
Pediatric
- Pediatric neurogenic detrusor overactivity: weight-based oral suspension (1mg/mL) per label
Contraindications
- Urinary retention
- Gastric retention
- Uncontrolled narrow-angle glaucoma
- Known hypersensitivity
Drug Interactions
- Strong CYP3A4 inhibitors raise levels
- Other anticholinergics: additive effects
- Cholinesterase inhibitors are antagonized
Adverse Effects
- Dry mouth, constipation, blurred vision
- QT prolongation at supratherapeutic doses
- Angioedema
Monitoring Parameters
- Post-void residual in neurogenic bladder
- QT risk factors
- Cognition in older adults
Pregnancy & Lactation
- Limited data; use only if benefit justifies risk
- Excreted in milk in animals