Therapeutic: urinary tract antispasmodics
Overactive bladder with symptoms (urge incontinence, urgency, frequency).
Acts as a muscarinic (cholinergic) receptor antagonist; antagonizes bladder smooth muscle contraction. Therapeutic Effects: Decreased symptoms of overactive bladder.
Adverse Reactions/Side Effects
EENT: blurred vision. GI: constipation, dry mouth, dyspepsia, nausea.
PHYSICAL THERAPY IMPLICATIONS
Examination and Evaluation
Advise patient to increase fluid intake and dietary fiber to avoid constipation. Laxatives may also be helpful in patients susceptible to fecal impaction.
Instruct patient and family/caregivers to report other troublesome side effects such as severe or prolonged blurred vision or GI problems (nausea, dry mouth, indigestion).
Absorption: Well absorbed (90%).
Metabolism and Excretion: Extensively metabolized by the CYP3A4 enzyme system. 69% excreted in urine as metabolites, 22% in feces.
Contraindicated in: Hypersensitivity; Urinary retention; Gastric retention; Uncontrolled angle-closure glaucoma; Severe hepatic impairment; Lactation.
Use Cautiously in: Concurrent use of CYP3A4 inhibitors (use lower dose/clinical monitoring may be necessary); Moderate hepatic impairment (lower dose recommended); Renal impairment (dose should not exceed 5 mg/day if CCr < 30 mL/min); Bladder outflow obstruction; GI obstructive disorders, severe constipation or ulcerative colitis; Myasthenia gravis; Angle-closure glaucoma; Children (safety not established); Pregnancy (use only if maternal benefit outweighs fetal risk).
Drug-Drug: Drugs that induce or inhibit the CYP3A4 enzyme system may significantly alter blood levels of solifenacin; ketoconazole ↑ blood levels and risk of toxicity (do not exceed 5 mg/day).
PO (Adults): 5 mg once daily, may be ↑ to 10 mg once daily; hepatic impairment/severe renal impairment, concurrent use of ketoconazole or other inhibitors of CYP3A4—dose should not exceed 5 mg/day.