Vesicare

Vesicare is the brand name for solifenacin succinate, a prescription medication used to treat symptoms of overactive bladder, including urinary urgency, frequency, and urge incontinence.

Solifenacin is an antimuscarinic agent that acts as a selective antagonist of muscarinic receptors, with higher affinity for M3 receptors in the detrusor muscle. By blocking these receptors, it reduces involuntary bladder contractions and can increase bladder capacity.

Typical dosing involves 5 mg taken once daily, with the possibility of increasing to 10 mg daily if the response is inadequate and the drug is well tolerated. Dosing may be adjusted for hepatic impairment, and elderly patients may require closer monitoring due to heightened sensitivity to antimuscarinic effects.

Contraindications include urinary retention, uncontrolled narrow-angle glaucoma, severe hepatic impairment, and hypersensitivity to solifenacin. The drug should be used with caution in patients with gastroesophageal reflux, gastric retention, significant bladder outlet obstruction, or severe renal impairment.

Common adverse effects are dry mouth, constipation, blurred vision, and urinary retention. Other possible effects include dizziness, headache, flushing, and tachycardia. Antimuscarinic therapy can contribute to cognitive effects, particularly in older adults, and patients should be monitored for confusion or delirium.

Drug interactions are primarily related to solifenacin metabolism via the CYP3A4 pathway. Strong inhibitors of CYP3A4, such as certain azole antifungals or macrolide antibiotics, can increase solifenacin levels and the risk of side effects. Concomitant use with other anticholinergic medicines can raise the overall anticholinergic burden. Vesicare is marketed by Astellas.