Solifenacin

Key facts

• Solifenacin (sold as Vesicare and generics) is an antimuscarinic, also called anticholinergic, that relaxes the bladder muscle to treat overactive bladder.
• You take it once daily, with or without food, and it can take several weeks to reach its full effect.
• Do not use it if you have urinary retention, severe gastrointestinal conditions such as toxic megacolon, or uncontrolled narrow-angle glaucoma, because it can make all three dangerously worse.
• Seek urgent care for a severe allergic reaction, inability to pass urine, or a fast or irregular heartbeat.

What solifenacin treats

Solifenacin treats overactive bladder, a condition marked by urinary urgency, frequent urination, and urge incontinence (leaking after a sudden need to go). It does not treat urinary tract infections or bladder pain caused by infection, and a doctor should rule out infection or other causes of urinary symptoms before you start treatment.

How solifenacin works

The bladder muscle contracts when a chemical messenger, acetylcholine, binds to muscarinic receptors in its wall. Solifenacin blocks those receptors, so the bladder contracts less often and holds more urine before you feel the urge to go. This reduces both the frequency of urination and episodes of leakage.

Before you take it

• Do not take solifenacin if you have urinary retention, severe gastrointestinal motility problems, or uncontrolled narrow-angle glaucoma.
• Tell your prescriber about myasthenia gravis, liver or kidney impairment, and any heart rhythm problems, since dose adjustment may be needed.
• Other medicines with anticholinergic effects, such as some antihistamines, antidepressants, and other bladder medicines, add to dry mouth, constipation, and confusion risk, particularly in older adults.
• Anticholinergics reduce sweating; take care in hot weather or during exercise, since this raises the risk of overheating.

Side effects

Common effects include dry mouth, constipation, blurred vision, and dry eyes.

Stop and seek urgent medical care for:

• A severe allergic reaction: facial swelling, hives, or difficulty breathing.
• Inability to pass urine or a swollen, painful bladder.
• A fast or irregular heartbeat.
• New confusion or severe drowsiness, especially in older adults.

Safety essentials

• Avoid solifenacin if you have urinary retention, uncontrolled narrow-angle glaucoma, or severe bowel conditions such as toxic megacolon; these are the drug's main contraindications.
• Older adults are more sensitive to its effects on the brain and bladder; report new confusion or difficulty urinating promptly.
• Doses above 5 mg daily are lowered in significant kidney or liver impairment.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.