SolifenacinSolifenacin Succinate

About Solifenacin

Solifenacin is an antimuscarinic that relaxes the bladder muscle. It is labeled for adults with overactive bladder with urge incontinence, urgency and frequent urination. Treatment starts at 5 mg once a day, and the prescriber may raise it to 10 mg if the lower dose is well tolerated. The dose stays at 5 mg with severe kidney impairment, moderate liver impairment or strong CYP3A4 inhibitors such as ketoconazole, and it is not used with severe liver impairment.

It must not be taken with urinary retention, gastric retention or uncontrolled narrow-angle glaucoma, or after an allergic reaction to it. Serious allergic reactions, including swelling (angioedema), have occurred, sometimes after the first dose, and need emergency care. Dry mouth and constipation are the most common side effects and are more frequent at 10 mg; blurred vision and urinary tract infections also occur, and constipation lasting three days or more should be reported. It is not recommended with significant bladder outlet obstruction, conditions that slow the gut or a high risk of QT prolongation, and treated narrow-angle glaucoma needs caution. Headache, confusion, hallucinations and sleepiness have been reported, so driving waits until its effects are known.

Because it reduces sweating, it can lead to heat exhaustion in hot surroundings. FDA records list both VESIcare tablet strengths as discontinued, and MedlinePlus notes the brand is no longer on the market. VESIcare LS, an orange-flavored suspension approved in 2020 for neurogenic detrusor overactivity in children 2 and older, is also listed as discontinued, and DailyMed lists no generic suspension. The generic tablets are labeled only for adults, so treatment for a child is a question for the prescriber.

Taking Solifenacin

How to take it

Once a day with water, with or without food, at about the same time each day. Swallow the tablet whole; do not split, chew or crush it.

If you miss a dose

Skip the missed dose and take the next one at the usual time the next day. Never take two doses in one day.

Storage

At room temperature in the original, tightly closed bottle, away from heat and moisture, out of reach of children.

Interactions to know about

Ketoconazole and other strong CYP3A4 inhibitors raise its levels, so the dose stays at 5 mg, and CYP3A4 inducers can lower them. It is not recommended for people at high risk of QT prolongation, including those with a history of it or who take medicines that prolong the QT interval; ask the prescriber about eating grapefruit or drinking grapefruit juice. Because it reduces sweating, avoid extreme heat, and do not drive until you know how it affects you.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Solifenacin differs from pharmacy to pharmacy

With the brand gone, every quote is for a generic, and many companies make the tablets; quotes can differ with the pharmacy’s dispensing fee, the maker it buys from and whether it keeps solifenacin on a flat-price generic list.

The 5 mg and 10 mg tablets are separate items, so a quote for one strength does not apply to the other, and the way the prescription is written matters.

Ways to pay less for Solifenacin without insurance

• Compare quotes from more than one pharmacy, and ask whether solifenacin is on a flat-price generic list.
• Once the dose is settled, ask for a ninety-day supply.
• If your dose is 10 mg, make sure the prescription is written for one 10 mg tablet rather than two 5 mg tablets.
• If cost is a barrier, ask the prescriber whether another bladder medicine, such as generic oxybutynin or tolterodine, would suit you.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Solifenacin

1. 1.Will my dose be raised to 10 mg, and how will I know whether it is working?
2. 2.Is it safe with my glaucoma, prostate, bowel or heart rhythm problems?
3. 3.Does it interact with my antifungal, antibiotic or other medicines?
4. 4.What can I do about dry mouth and constipation?

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