Solifenacin (solifenacin succinate)
Also sold as: Solifair, Vesicare, Soflinol
Pregnancy
Cat C
Lactation
Unknown
Schedule
H
Forms
tablet 5mg +1
Indications
- Overactive bladder (OAB) — urgency, frequency, urge urinary incontinence
- Nocturia associated with OAB
Adult Dosing
Overactive bladder (OAB)
5 mg once daily; may increase to 10 mg once daily if 5 mg is tolerated but insufficient
Take at the same time each day with or without food; long-term therapy
At least 4–6 weeks to assess response. Use lowest effective dose especially in elderly.
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| CrCl 30–80 mL/min | 5 mg once daily — do not exceed this dose |
| CrCl <30 mL/min (severe renal impairment) | 5 mg once daily — use with caution; avoid 10 mg dose |
Hepatic Adjustment
Child-Pugh A: no dose adjustment required. Child-Pugh B (moderate): maximum 5 mg once daily. Child-Pugh C (severe): avoid use.
Pregnancy & Lactation
Pregnancy: Category C
No adequate human data. Animal studies show some adverse effects at high doses. Use only if benefit clearly outweighs risk.
Lactation: Unknown
Excretion in breast milk unknown. Avoid in breastfeeding due to potential anticholinergic effects in infant.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Strong CYP3A4 inhibitors (ketoconazole, itraconazole, ritonavir) | Doubles solifenacin exposure (AUC) — maximum dose of 5 mg when co-prescribed with potent CYP3A4 inhibitors | Major |
| Rifampicin (strong CYP3A4 inducer) | Significantly reduces solifenacin plasma levels — may reduce efficacy | Moderate |
| Other anticholinergic drugs (oxybutynin, tolterodine, tricyclics, antihistamines) | Additive anticholinergic effects — dry mouth, constipation, cognitive impairment, urinary retention | Moderate |
| Digoxin | Slight increase in digoxin exposure — monitor digoxin levels | Minor |
DoctorScribe — AI Medical Scribe
Stop looking up Solifenacin — just speak the prescription
"Solifenacin as per dose, BD for 5 days." DoctorScribe writes the full prescription with brand, strength, frequency, and route — auto-applies pediatric weight-based dosing and renal adjustments. Try the live demo.
Side Effects
Common
- Dry mouth (most common)
- Constipation
- Blurred vision (accommodation disorder)
- Dry eyes
- Dyspepsia
- Urinary tract infection
- Fatigue
Serious / Discontinue If
- Urinary retention (paradoxical — use with caution in patients with outflow obstruction)
- Acute angle-closure glaucoma (ophthalmic emergency)
- QT prolongation (rare — caution with other QT-prolonging drugs)
- Cognitive impairment / delirium (especially in elderly — anticholinergic burden)
- Torsades de pointes (rare)
Contraindications
- Urinary retention
- Gastric retention / severe GI dysmotility
- Uncontrolled narrow-angle glaucoma
- Myasthenia gravis
- Severe hepatic impairment (Child-Pugh C)
- Severe ulcerative colitis / toxic megacolon
- Hypersensitivity to solifenacin
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Vesicare 5mg | Astellas Pharma | ₹285/10 tab |
| Solifair 5mg | Cipla | ₹198/10 tab |
| Soflinol 5mg | Sun Pharma | ₹215/10 tab |
Monitoring Required
- Bladder diary — frequency, urgency, and incontinence episodes
- Post-void residual urine (PVR) — especially if bladder outflow obstruction suspected
- Renal function (eGFR/CrCl) at baseline and periodically
- Intraocular pressure if glaucoma risk
- Cognitive function in elderly patients (anticholinergic burden scoring)
Patient Counseling Points
- Take the tablet whole — do not crush or chew
- Drink adequate fluids but avoid drinking large amounts before bedtime
- Dry mouth is common — sip water frequently, use sugar-free gum or candy
- Constipation — increase dietary fibre and fluid intake
- Avoid driving or operating machinery if vision is blurred
- Seek immediate help if you cannot pass urine at all
- Tell your doctor immediately if you develop sudden eye pain or redness with blurred vision
- This medicine takes 4–6 weeks for full effect — do not stop abruptly without consulting your doctor
- Avoid anticholinergic medicines (certain allergy tablets, stomach medications) without checking with your doctor
Stop Googling drug references mid-consultation
EasyClinic auto-flags Solifenacin interactions, renal cutoffs, and pregnancy warnings the moment you write the prescription. Built-in safety net for every Indian doctor.
Clinically reviewed by: Dr. Sanjay Kulkarni, MS, MCh (Urology), Fellowship in Female Urology & Neurourology
Last reviewed: 2026-04-01
References
- Solifenacin SmPC — Astellas Pharma / Cipla India
- EAU Guidelines on Non-neurogenic Female LUTS 2024
- ICS/IUGA Joint Report on Overactive Bladder 2023
- Drugs.com Solifenacin Interactions Database 2026