Solifenacin succinate 10mg tablets are film-coated oral tablets. Firstly, each tablet contains solifenacin succinate 10mg.
Also, the Vesicare 10mg brand tablet is pink, round, and film-coated.
However, generic versions may vary in colour and marking. All contain the same active ingredient at the same dose.
Furthermore, several generic manufacturers supply solifenacin succinate 10mg tablets in the UK alongside the original Vesicare brand from Astellas.
Why M3 selectivity matters
Muscarinic receptors have five subtypes (M1 to M5). Firstly, they are distributed differently throughout the body.
Also, M3 receptors predominate on the bladder detrusor muscle. Blocking them reduces unwanted detrusor contractions.
However, M1 receptors are found in the brain (cognition), M2 in the heart (rate control), and M3 in salivary glands, gut, and eye.
Furthermore, solifenacin’s functional M3 selectivity means bladder effects at doses that have relatively less impact elsewhere. This reduces (but does not eliminate) dry mouth, constipation, blurred vision, and cognitive effects.
The role of 10mg as the titrated-up dose
The standard adult starting dose is 5mg once daily. Firstly, most patients begin here.
Also, if 5mg is not sufficient after several weeks and side effects are tolerated, the prescriber may increase to 10mg once daily.
However, the 10mg dose has proportionally more side effects than the 5mg dose. Dry mouth is more common (30% vs 11%); constipation and blurred vision are also more frequent.
Furthermore, not all patients benefit from moving up to 10mg. Some tolerate the higher dose but see no additional symptom improvement.
A once-daily prescription-only medicine
Solifenacin succinate 10mg is a prescription-only medicine (POM). Firstly, a UK-registered prescriber must issue a prescription.
Also, at Courier Pharmacy, our independent prescriber can review your case, confirm 5mg has been tried, and issue a 10mg prescription if appropriate.
However, we may need to see recent kidney and liver function tests, and review your other medicines, before prescribing 10mg.
Key features and specifications
Active ingredient: solifenacin succinate 10mg per film-coated tablet
Form: film-coated oral tablets. Vesicare 10mg is pink, round; generic versions may vary in appearance
Pack: usually 30 tablets (one month’s supply at once-daily dosing)
Marketing Authorisation Holders: Astellas (Vesicare brand) and various generic manufacturers
The titrated-up dose of an M3-selective antimuscarinic for overactive bladder
Solifenacin succinate 10mg is a prescription-only medicine (POM) for overactive bladder syndrome in adults. It is the titrated-up dose, used when the 5mg starting dose is not enough.
Firstly, solifenacin is a competitive muscarinic receptor antagonist with functional selectivity for the M3 subtype. M3 receptors mediate bladder detrusor contractions.
Also, this M3 selectivity is thought to give solifenacin a better tolerability profile than non-selective antimuscarinics like oxybutynin. Fewer receptors elsewhere in the body are affected.
However, solifenacin 10mg is not the starting dose. Most adults start on 5mg once daily. The 10mg dose is used only when 5mg is insufficient and side effects are tolerated.
Furthermore, several patient groups must stay on the 5mg dose and must not be titrated up to 10mg. Firstly, severe renal impairment (creatinine clearance below 30 mL/min).
However, patients on potent CYP3A4 inhibitors (ketoconazole, itraconazole, ritonavir, clarithromycin) must also stay on 5mg. Firstly, these medicines raise solifenacin blood levels significantly.
Furthermore, the 10mg dose has more side effects than the 5mg dose. Dry mouth, constipation, and blurred vision are all more common at the higher dose.
Above all, do not swallow with a bitten or broken tablet. Firstly, solifenacin powder has a strong bitter taste. Always swallow the tablet whole.
Also, solifenacin was first approved in the UK in 2004 by Astellas as Vesicare. Generic versions are now widely available at both 5mg and 10mg strengths.
At Courier Pharmacy, we can supply solifenacin succinate 10mg tablets through our independent prescriber service, subject to appropriate assessment.
When to seek medical advice while on solifenacin 10mg
Solifenacin is generally well tolerated when prescribed appropriately. However, some symptoms need urgent medical attention.
Sudden swelling of the face, lips, tongue, or throat, or difficulty breathing. Call 999 (possible severe allergic reaction or angioedema)
Widespread rash, blistering, or peeling skin. Stop the tablets and seek urgent help
Sudden inability to pass urine, or a significantly reduced urine output. Contact your GP or A&E (possible urinary retention)
Severe abdominal pain, no bowel movement for several days, or vomiting (possible severe constipation or bowel obstruction)
Palpitations, chest pain, or fainting (possible QT prolongation, especially with other QT-prolonging medicines)
Sudden confusion, hallucinations, or unusual drowsiness, particularly in older adults
Eye pain, sudden visual changes, or seeing haloes around lights (possible acute closed-angle glaucoma)
Signs of dehydration or overheating in hot weather (reduced sweating and dry mouth reduce the usual thirst signal)
If side effects on 10mg are intolerable (severe dry mouth, constipation, or blurred vision), discuss reducing to 5mg or switching medicine
If overactive bladder symptoms don’t improve after 2-3 months on 10mg, or worsen, review with your prescriber
If you are pregnant, breastfeeding, or planning pregnancy, discuss with your GP or prescriber before continuing
Five key takeaways
Solifenacin succinate 10mg is the titrated-up dose of an M3-selective muscarinic antagonist for adult overactive bladder syndrome. It is used only when the 5mg starting dose is insufficient.
Dose: 1 tablet (10mg) once daily. Swallow whole with water. Take with or without food. Re-evaluate response at 2-3 months.
Must NOT be used in severe renal impairment (CrCl below 30 mL/min), moderate hepatic impairment (Child-Pugh 7-9), or with potent CYP3A4 inhibitors. These patients must stay on 5mg only.
Contraindicated in urinary retention, severe GI conditions (toxic megacolon), myasthenia gravis, uncontrolled narrow-angle glaucoma, severe hepatic impairment, and haemodialysis.
Prescription-only medicine (POM). Available from Courier Pharmacy through our online prescriber service, subject to appropriate assessment and confirmation that 5mg has been tried.
What are Solifenacin Succinate 10mg Tablets: overview
Where solifenacin 10mg fits in overactive bladder treatment
Overactive bladder (OAB) affects around 11-16% of adults. It includes urinary urgency, frequency, and (sometimes) urge incontinence.
Firstly, first-line treatment is behavioural: bladder training, fluid management, reducing caffeine and alcohol.
Also, when medication is needed, NICE NG123 recommends offering the antimuscarinic with the lowest acquisition cost. Solifenacin 5mg is often chosen for its once-daily dosing and M3 selectivity.
However, if 5mg is insufficient after several weeks, solifenacin 10mg is a natural next step. Options include switching to a different antimuscarinic or to mirabegron (beta-3 agonist).
Solifenacin 10mg vs Solifenacin 5mg
Both tablets contain the same active ingredient at different strengths. Firstly, 5mg is the standard adult starting dose.
Also, 10mg is the titrated-up maintenance dose for patients whose symptoms are not adequately controlled by 5mg.
However, 10mg has more side effects. In clinical trials, dry mouth was around 11% at 5mg and 28% at 10mg. Constipation, blurred vision, and other antimuscarinic effects also increase.
Furthermore, some patients only need 5mg. Others benefit from 10mg. The trade-off between efficacy and tolerability is individual.
Solifenacin vs Tolterodine
Both are prescription antimuscarinics for OAB. However, they differ in receptor selectivity and dosing.
Firstly, solifenacin is M3-selective. Tolterodine is non-selective but shows in vivo bladder selectivity.
Also, solifenacin is once daily; tolterodine IR is twice daily (or once daily as XL 4mg).
However, individual response varies. Switching between them is a reasonable strategy if one is not tolerated.
Solifenacin vs Trospium
Both are prescription antimuscarinics. However, trospium is non-selective with a quaternary ammonium structure.
Firstly, trospium’s structure prevents most brain penetration, giving it a better cognitive profile than solifenacin.
Also, trospium must be taken on an empty stomach; solifenacin can be taken with or without food.
However, trospium is twice daily (or once daily as Regurin XL); solifenacin is once daily.
Solifenacin vs Fesoterodine (Toviaz)
Fesoterodine is a prodrug converted to 5-HMT by plasma esterases. Firstly, this active molecule is also produced from tolterodine but not from solifenacin.
Also, fesoterodine bypasses CYP2D6 variability (a factor for tolterodine but not for solifenacin).
However, both solifenacin and fesoterodine are once daily. Both are titratable (solifenacin 5mg/10mg; fesoterodine 4mg/8mg).
Solifenacin vs Mirabegron
Mirabegron is a beta-3 adrenergic agonist. It works through a different mechanism than antimuscarinics.
Firstly, mirabegron doesn’t cause typical antimuscarinic side effects (less dry mouth, less constipation, no cognitive impact).
However, mirabegron can raise blood pressure, requiring BP monitoring. Solifenacin does not have this concern.
Also, when solifenacin alone is not enough, adding mirabegron (combination therapy) is an evidence-based option.
Solifenacin vs Oxybutynin
Oxybutynin is the oldest and cheapest OAB antimuscarinic. However, it is non-selective, crosses the blood-brain barrier readily, and needs multiple daily doses.
Firstly, solifenacin’s M3 selectivity and once-daily dosing give it a better tolerability profile.
Also, solifenacin has less cognitive impact than oxybutynin, an advantage in older adults.
Long-term treatment
Overactive bladder is usually a chronic condition. Firstly, most patients need long-term treatment.
Also, solifenacin efficacy is maintained with continued use.
However, periodic review with your prescriber is important. This checks that the medicine is still needed, still effective, and still tolerated.
Prescriber support at Courier Pharmacy
Because solifenacin 10mg is prescription-only, buying at Courier Pharmacy involves prescriber assessment. Firstly, this ensures the medicine is suitable and safe for you at the 10mg dose.
Also, our independent prescriber will confirm you have tried 5mg, check for contraindications (renal, hepatic, interactions), and issue a prescription online if appropriate.
However, if you are elderly or have cognitive concerns, we may recommend an alternative with a better CNS profile (trospium, mirabegron).
Why choose Courier Pharmacy for your Solifenacin 10mg Tablets
Registered, independent, and patient-led
Courier Pharmacy is a UK-registered independent pharmacy with independent prescribers. The General Pharmaceutical Council regulates us.
Firstly, prescription-only medicines require prescriber involvement. Our online service makes this convenient.
Also, we treat every prescription request as a chance to review your care fully. This is not a simple retail transaction.
As a result, buying solifenacin 10mg from us comes with the reassurance of UK-qualified prescriber oversight, including confirmation that titrating up from 5mg is clinically appropriate.
Dr Ada Jex-Cori, our brand pharmacist
Our brand pharmacist is Dr Ada Jex-Cori. She represents the spirit of what we do. Named for Ada Lovelace, Sophia Jex-Blake, and Gerty Cori, she stands for evidence-led, unafraid-of-questions medicine. Her message is straightforward. You’re not broken. The system is. We’re here to change that.
Care that keeps showing up
Prescription medicines need ongoing review, not one-off dispensing. Firstly, we are here to answer follow-up questions if the medicine is not working as expected or if side effects appear.
Also, if 10mg side effects become intolerable, contact us. We can discuss reducing back to 5mg or switching to a different medicine.
However, we will not dispense repeated 10mg prescriptions to someone whose condition has not been reviewed. Overactive bladder benefits from periodic reassessment.
Buy Solifenacin Succinate 10mg Tablets from Courier Pharmacy
Solifenacin succinate 10mg is a prescription-only medicine. You can request supply through courierpharmacy.co.uk with our online prescriber service.
Complete our online consultation for overactive bladder or add solifenacin 10mg to your basket if you have an existing prescription
Our independent prescriber reviews your case, confirms 5mg has been tried, and may issue a 10mg prescription if suitable
Your prescription is dispensed and dispatched promptly
Follow the pack directions carefully. Contact us for follow-up questions or dose reviews
If solifenacin 10mg is not right for your situation, we will explain why. Options include solifenacin 5mg (lower dose if you have not yet tried it), another antimuscarinic (tolterodine XL, fesoterodine, trospium XL), mirabegron (beta-3 agonist, different mechanism), combination therapy (solifenacin plus mirabegron), or referral back to your GP or urology for further assessment.
Above all, we will not issue a prescription that is not clinically appropriate.
Summary
A prescription-only M3-selective muscarinic antagonist for adult overactive bladder syndrome, titrated up from 5mg after inadequate response.
Dose: 10mg once daily. Take with or without food. Swallow whole (bitter powder inside).
Reduces urinary urgency, frequency, and urge incontinence. Effect stabilises over 4-12 weeks. Re-evaluate at 2-3 months.
Must NOT be titrated up to 10mg in severe renal impairment, moderate hepatic impairment, or with potent CYP3A4 inhibitors (stay on 5mg).
Contraindicated in urinary retention, severe GI conditions, myasthenia gravis, uncontrolled narrow-angle glaucoma, severe hepatic impairment, and haemodialysis.
Active ingredient in Solifenacin Succinate 10mg Tablets
Solifenacin succinate 10mg per tablet
Solifenacin succinate is a synthetic competitive muscarinic receptor antagonist with functional selectivity for the M3 subtype. It was first approved in the UK in 2004 by Astellas as Vesicare.
Firstly, the 10mg dose contains solifenacin succinate 10mg. This is the titrated-up maintenance dose after the 5mg starting dose.
Also, solifenacin is well absorbed. Peak plasma levels are reached within 3-8 hours after dosing.
However, the elimination half-life is 45-68 hours. This is why once-daily dosing is effective and steady-state levels take about 10 days to establish.
Furthermore, solifenacin is metabolised primarily by liver CYP3A4. This affects drug interactions with CYP3A4 inhibitors and inducers.
M3-selective muscarinic blockade
Solifenacin shows functional selectivity for the M3 muscarinic receptor subtype. Firstly, M3 receptors dominate on the bladder detrusor muscle.
Also, blocking M3 receptors on the detrusor reduces the unwanted contractions that cause OAB symptoms.
However, M3 receptors are also present in salivary glands (dry mouth), gut (constipation), and eye (blurred vision). Solifenacin's effect at these sites causes the typical antimuscarinic side effects.
Furthermore, solifenacin has less M1 and M2 affinity than some other antimuscarinics. This gives less cognitive impact (M1) and less heart rate effect (M2).
CYP3A4 metabolism and long half-life
Solifenacin is metabolised by liver CYP3A4. Firstly, this affects interactions with CYP3A4 inhibitors (which raise levels) and inducers (which lower levels).
Also, potent CYP3A4 inhibitors (ketoconazole, itraconazole, ritonavir, clarithromycin) raise solifenacin levels significantly. This is why 10mg is contraindicated with these medicines.
However, the long elimination half-life (45-68 hours) supports once-daily dosing. Steady-state levels take about 10 days to establish.
What are Solifenacin Succinate 10mg Tablets for?
Overactive bladder syndrome (OAB)
Solifenacin is licensed for the symptomatic treatment of urge incontinence and/or increased urinary frequency and urgency as may occur in adults with overactive bladder syndrome.
Firstly, OAB is defined by urinary urgency, with or without urge incontinence, usually with increased frequency and nocturia.
Also, OAB affects around 11-16% of adults and has significant impact on quality of life.
However, OAB is often underreported. Many patients live with the symptoms without seeking treatment.
Urinary urgency
Urgency is the sudden, strong need to urinate that is difficult to defer. Firstly, this is often the most bothersome symptom of OAB.
Also, solifenacin reduces the frequency and intensity of urgency episodes by blocking bladder contractions.
Urinary frequency
Frequency means passing urine more often than expected. Firstly, solifenacin can reduce daytime frequency by allowing better bladder capacity.
Urge incontinence
Urge incontinence is involuntary leakage of urine preceded by urgency. Firstly, this is often the most distressing symptom.
Also, clinical trials show significant reduction in incontinence episodes with solifenacin over 12 weeks.
However, complete resolution is not guaranteed. Some patients need additional strategies (bladder training, pelvic floor exercises).
What solifenacin isn't for
Solifenacin is not for stress incontinence (leakage on coughing, sneezing, or exertion). Stress incontinence responds to pelvic floor exercises, physiotherapy, or (sometimes) surgery.
Also, it is not for urinary retention or bladder outflow obstruction. Solifenacin can worsen these conditions.
However, it is not licensed for children (Vesicare LS liquid formulation exists in some countries for paediatric neurogenic detrusor overactivity, but not the standard 10mg tablet).
How do Solifenacin Succinate 10mg Tablets work?
Muscarinic receptor blockade in the bladder
The bladder muscle (detrusor) is controlled by parasympathetic cholinergic nerves. Firstly, these release acetylcholine, which binds to muscarinic receptors on the detrusor.
Also, acetylcholine binding causes the detrusor to contract. This normally happens during voluntary voiding.
However, in overactive bladder, the detrusor contracts unexpectedly. This creates the urgent need to urinate.
M3 muscarinic receptors dominate on the bladder detrusor. Firstly, solifenacin's functional M3 selectivity means it targets the bladder effectively.
Also, this reduces (but does not eliminate) effects at M1 (brain), M2 (heart), M4 and M5 receptors.
However, M3 receptors are also present at other sites. This is why dry mouth (salivary M3), constipation (gut M3), and blurred vision (eye M3) still occur.
Why 10mg has more effect and more side effects than 5mg
Solifenacin dose-response is relatively linear at 5mg and 10mg. Firstly, doubling the dose approximately doubles the blood level.
Also, this can improve symptom control in patients where 5mg is not enough.
However, side effect frequency also rises. Dry mouth was 11% at 5mg and 28% at 10mg in trials. Constipation, blurred vision, and other effects also increase.
Furthermore, the trade-off between symptom control and tolerability is individual. Some patients need 10mg; others do best on 5mg.
How to take Solifenacin Succinate 10mg Tablets
Standard adult dose
Take 1 tablet (10mg) once daily. Firstly, this is the titrated-up dose after starting on 5mg.
Also, take at approximately the same time each day. Consistency helps you remember and maintains steady blood levels.
However, do not increase further than 10mg once daily. This is the maximum recommended dose.
Swallow whole (bitter taste warning)
Above all, swallow the tablet whole with a full glass of water. Firstly, the solifenacin powder inside has a strong bitter taste.
Also, do not crush, chew, or break the tablet. This exposes the bitter powder and can also damage the film coating.
However, if you cannot swallow tablets whole, discuss options with your prescriber. In some countries a liquid formulation exists for specific indications.
With or without food
Solifenacin 10mg tablets can be taken with or without food. Firstly, food does not significantly affect absorption.
However, taking with food may reduce mild stomach upset if this occurs.
How to know when 10mg is right for you
Solifenacin 10mg is not the starting dose. Firstly, you should have tried 5mg first for several weeks.
Also, the 10mg dose is used when 5mg has not adequately controlled overactive bladder symptoms and side effects on 5mg were tolerable.
However, some patients on 10mg see improved symptom control at the cost of more side effects. The trade-off is individual.
How quickly it works
Some patients notice symptom improvement within the first week or two. Firstly, full effect stabilises over 4-12 weeks.
However, re-evaluation is recommended at 2-3 months. If 10mg is not working after this time, discuss options with your prescriber.
Missed doses
If you miss a dose, take it as soon as you remember on the same day. However, if it is nearly time for your next dose, skip the missed one.
Also, do not take a double dose to make up for a forgotten one.
Stopping treatment
Solifenacin can be stopped without a taper. Firstly, there is no withdrawal syndrome.
However, symptoms of overactive bladder are likely to return once the drug clears. Discuss with your prescriber before stopping.
Also, if side effects on 10mg are intolerable, your prescriber may reduce back to 5mg or switch to a different medicine.
Do not take with other antimuscarinic medicines
Above all, do not take other antimuscarinic (anticholinergic) medicines alongside solifenacin without prescriber advice. Firstly, this multiplies side effects.
Also, examples include other bladder antimuscarinics (oxybutynin, tolterodine, trospium, fesoterodine, darifenacin), some antihistamines (chlorphenamine, hydroxyzine), tricyclic antidepressants (amitriptyline, nortriptyline), and some Parkinson's medicines.
However, mirabegron (a beta-3 agonist, different mechanism) can sometimes be combined with solifenacin under prescriber supervision.
Warnings and precautions for Solifenacin Succinate 10mg Tablets
Severe renal impairment (10mg contraindicated, stay on 5mg)
Above all, patients with severe renal impairment (creatinine clearance below 30 mL/min) must NOT be titrated up to 10mg. Firstly, they must stay on 5mg only.
Also, reduced kidney function reduces solifenacin clearance and raises blood levels. The 5mg dose is enough.
Moderate hepatic impairment (10mg contraindicated, stay on 5mg)
Above all, patients with moderate hepatic impairment (Child-Pugh score 7-9) must NOT be titrated up to 10mg. Firstly, they must stay on 5mg only.
Also, reduced liver function affects solifenacin metabolism and raises blood levels.
Potent CYP3A4 inhibitors (10mg contraindicated with these medicines)
Above all, patients on potent CYP3A4 inhibitors must NOT take 10mg. Firstly, they must stay on 5mg only.
Also, examples of potent CYP3A4 inhibitors include ketoconazole, itraconazole, ritonavir, atazanavir, clarithromycin, and telithromycin.
However, these medicines block solifenacin metabolism and raise blood levels significantly. Combining a potent CYP3A4 inhibitor with 10mg risks toxicity.
Severe hepatic impairment (contraindicated)
Solifenacin at any dose is contraindicated in severe hepatic impairment (Child-Pugh score above 9).
Haemodialysis (contraindicated)
Solifenacin at any dose is contraindicated in patients undergoing haemodialysis.
Urinary retention (contraindicated)
Solifenacin is contraindicated in urinary retention. Firstly, blocking muscarinic receptors can further reduce the bladder's ability to empty.
However, if you cannot pass urine while on solifenacin, stop and seek medical help. Urinary retention is a medical emergency.
Severe gastrointestinal conditions (contraindicated)
Contraindicated in severe gastrointestinal conditions (including toxic megacolon). Firstly, antimuscarinics reduce gut motility.
Also, this can worsen or precipitate severe GI complications.
Myasthenia gravis (contraindicated)
Solifenacin is contraindicated in myasthenia gravis. Firstly, antimuscarinics can worsen the muscle weakness of this condition.
Contraindicated in uncontrolled narrow-angle glaucoma. Firstly, muscarinic blockade can dilate the pupil, which can precipitate an acute glaucoma attack.
However, if you have any type of glaucoma, discuss with your prescriber and ophthalmologist before starting.
QT prolongation (caution)
Solifenacin has been associated with QT interval prolongation. Firstly, this is more likely at the 10mg dose than the 5mg dose.
Also, caution is required in patients with known QT prolongation history, congenital long QT syndrome, or taking other QT-prolonging medicines.
Furthermore, discuss with your prescriber if you have any history of heart rhythm problems.
Elderly patients (caution)
Older adults may be more sensitive to antimuscarinic effects. Firstly, this includes higher risk of confusion, cognitive slowing, and falls.
Also, cumulative anticholinergic burden across multiple medicines can be significant in older patients.
However, solifenacin's M3 selectivity gives it a better cognitive profile than oxybutynin. But if cognitive effects appear on 10mg, reduction to 5mg or switching to trospium or mirabegron should be considered.
Angioedema
Angioedema (swelling of face, lips, tongue, or larynx) has been reported with solifenacin. Firstly, it can occur after the first dose.
However, if you develop these symptoms, stop the tablets immediately and seek urgent medical help. Call 999 for severe symptoms.
Pregnancy (not recommended)
Solifenacin is not recommended during pregnancy. Firstly, there is limited human safety data.
However, if you become pregnant or plan pregnancy while on solifenacin, discuss with your prescriber promptly.
Breastfeeding (not recommended)
Solifenacin should not be used while breastfeeding. Firstly, human data is limited.
Driving and machinery
Solifenacin can cause blurred vision, dizziness, and drowsiness in some patients. Firstly, this is more common at 10mg than 5mg.
However, do not drive or use machinery until you know how the 10mg dose affects you.
Alcohol
Alcohol is not directly contraindicated. However, alcohol can worsen dry mouth and central effects. Alcohol can also worsen bladder symptoms independently.
Lactose content
Solifenacin 10mg tablets contain lactose (as monohydrate). Firstly, patients with rare hereditary problems of galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption should discuss with their prescriber.
Reduced sweating in hot weather
Antimuscarinics reduce sweating. Firstly, this can raise the risk of overheating in hot weather or during exercise.
Also, take particular care with fluid intake and cooling in hot conditions.
Side effects of Solifenacin Succinate 10mg Tablets
Very common (more than 1 in 10) at 10mg
Dry mouth is very common at 10mg (around 28% of patients vs 11% at 5mg). Firstly, this reflects M3 receptor blockade in salivary glands.
Also, this is often the first noticeable side effect. It may improve over time or with strategies (sugar-free chewing gum, sipping water).
Common (up to 1 in 10) at 10mg
Constipation is common. It is more frequent at 10mg than 5mg.
Also, blurred vision, dyspepsia (indigestion), abdominal pain, nausea, and urinary tract infection can occur.
However, dizziness, dry eyes, drowsiness, and dry nasal passages are also common.
Uncommon and rare
Uncommon side effects include urinary retention, hallucinations, confusion (particularly in older adults), and skin rash.
Also, palpitations and QT prolongation are uncommon but reported.
However, rare side effects include angioedema, severe skin reactions (Stevens-Johnson syndrome), and hepatic disorders.
Serious side effects requiring urgent help
Above all, seek urgent medical help for angioedema (swelling of face, lips, tongue, throat) or difficulty breathing. Call 999.
Also, seek urgent help for signs of anaphylaxis, severe skin reactions with blistering or peeling, complete inability to pass urine, or acute glaucoma symptoms (eye pain, visual changes).
Drug interactions with Solifenacin Succinate 10mg Tablets
Potent CYP3A4 inhibitors (10mg contraindicated)
Above all, potent CYP3A4 inhibitors raise solifenacin blood levels significantly. Firstly, examples include ketoconazole, itraconazole, ritonavir, atazanavir, clarithromycin, and telithromycin.
Also, patients on these medicines must NOT take solifenacin 10mg. They must stay on 5mg only.
CYP3A4 inducers
CYP3A4 inducers (rifampicin, phenytoin, carbamazepine, St John's Wort) can lower solifenacin blood levels. Firstly, this may reduce efficacy.
However, dose adjustment is not usually needed. Discuss with your prescriber if you take any of these.
Other antimuscarinic medicines
Do not combine with other antimuscarinic (anticholinergic) medicines without prescriber advice. Firstly, this multiplies side effects.
Also, examples include other bladder antimuscarinics (oxybutynin, tolterodine, trospium, fesoterodine, darifenacin), some antihistamines (chlorphenamine, hydroxyzine), tricyclic antidepressants (amitriptyline, nortriptyline), and some Parkinson's medicines.
However, mirabegron (a beta-3 agonist, different mechanism) can sometimes be combined with solifenacin under prescriber supervision.
QT-prolonging medicines
Caution with medicines known to prolong the QT interval. Firstly, examples include some antibiotics (macrolides, fluoroquinolones), antiarrhythmics (amiodarone, sotalol), and some antipsychotics.
However, discuss with your prescriber if you take any of these regularly.
Medicines that affect gut motility
Solifenacin reduces gut motility. Firstly, this can affect the absorption of other oral medicines.
Also, prokinetic medicines (metoclopramide, domperidone) work against antimuscarinic effects.
Warfarin
Solifenacin has no clinically significant interaction with warfarin. However, general monitoring of anticoagulation is prudent when starting or stopping any medicine.
Alcohol
Alcohol is not directly contraindicated. However, alcohol can worsen dry mouth and central effects, and can worsen bladder symptoms independently.
Frequently asked questions about Solifenacin Succinate 10mg Tablets
Why am I on 10mg instead of 5mg?
The 10mg dose is used when 5mg has not adequately controlled overactive bladder symptoms. Firstly, most patients start on 5mg for several weeks. If symptoms are not sufficiently improved and side effects are tolerated, the prescriber may increase to 10mg.
However, discuss with your prescriber if you are unsure why you are on 10mg.
How quickly does solifenacin work?
Some patients notice symptom improvement within the first week or two. Firstly, the full effect stabilises over 4-12 weeks.
However, the effect of treatment should be re-evaluated at 2-3 months.
Can I take solifenacin with food?
Yes. Solifenacin can be taken with or without food. Firstly, food does not significantly affect absorption.
However, take at approximately the same time each day for consistency.
What if 10mg gives me too many side effects?
Contact your prescriber. Firstly, common troublesome side effects at 10mg include severe dry mouth, constipation, and blurred vision.
However, your prescriber may reduce the dose back to 5mg, switch to a different antimuscarinic, or try mirabegron (which has a different side-effect profile).
Can I break the 10mg tablet in half for a 5mg dose?
No. Firstly, the tablet is not scored for splitting.
Also, the powder inside has a strong bitter taste. Breaking the tablet exposes this.
However, if you need a 5mg dose, use the separate solifenacin 5mg tablets.
Will solifenacin cause weight gain?
Weight gain is not a recognised common side effect of solifenacin.
Can I drive on solifenacin 10mg?
Most patients can drive normally on solifenacin. However, do not drive if you experience blurred vision, dizziness, or drowsiness.
Also, 10mg is more likely to cause these effects than 5mg. Take particular care when first starting or after a dose change.
Can I drink alcohol on solifenacin?
Alcohol is not directly contraindicated. However, alcohol can worsen dry mouth and central effects. Alcohol can also worsen bladder symptoms independently.
How do I manage dry mouth from solifenacin?
Dry mouth is very common at 10mg. Firstly, sip water regularly throughout the day. Sugar-free chewing gum or sweets can stimulate saliva.
Also, avoid excessive caffeine and alcohol. Good oral hygiene is important as dry mouth increases dental decay risk.
How do I manage constipation from solifenacin?
Constipation is common with antimuscarinics. Firstly, drink plenty of fluid, eat a high-fibre diet, and stay physically active.
Also, if constipation persists, discuss with your prescriber. A gentle laxative may be added.
Can I stop solifenacin suddenly?
Yes. Solifenacin can be stopped without a taper. Firstly, there is no withdrawal syndrome.
However, overactive bladder symptoms are likely to return once the drug clears.
What if I forget a dose?
Take it as soon as you remember on the same day. However, if it's nearly time for your next dose, skip the missed one.
Also, do not take a double dose to make up for a forgotten one.
Can I take solifenacin if I'm pregnant or breastfeeding?
Solifenacin is not recommended during pregnancy or breastfeeding. However, discuss with your prescriber if you become pregnant or plan pregnancy.
Is solifenacin the same as Vesicare?
Vesicare is the original brand name for solifenacin succinate, from Astellas.
However, generic solifenacin succinate tablets contain the same active ingredient at the same dose. They work in the same way.
Can I take solifenacin with other bladder medicines?
Discuss with your prescriber first. Firstly, do not combine with other antimuscarinics (oxybutynin, tolterodine, trospium, fesoterodine).
However, mirabegron (a beta-3 agonist, different mechanism) can sometimes be combined with solifenacin under prescriber supervision.
Can solifenacin cause confusion?
Antimuscarinic CNS effects (confusion, drowsiness, hallucinations) can occur, particularly in older adults on 10mg. Firstly, solifenacin has less brain penetration than oxybutynin but more than trospium.
However, if you notice cognitive changes, discuss with your prescriber promptly. Reduction to 5mg or switching to trospium or mirabegron may help.
How long can I take solifenacin 10mg for?
Solifenacin can be taken long-term for ongoing overactive bladder symptoms. Firstly, efficacy is maintained with continued use.
However, periodic review with your prescriber is important. This checks that the medicine is still needed and still tolerated.
Do I need a prescription for solifenacin from Courier Pharmacy?
Yes. Solifenacin is a prescription-only medicine (POM). Firstly, our independent prescriber can review your case and issue a prescription online if appropriate.
However, we may need to see recent kidney and liver function tests, and confirm you have tried 5mg, before prescribing 10mg.
Disclaimer
Disclaimer: This information is for education only and isn't a substitute for personal medical advice. Always follow the packaging directions and your prescriber's guidance, and ask your pharmacist or GP if you're unsure about your solifenacin treatment.
Medicines and Healthcare products Regulatory Agency (2024) Yellow Card reporting. Available at: https://yellowcard.mhra.gov.uk/
National Institute for Health and Care Excellence (2024) Urinary incontinence and pelvic organ prolapse in women: management (NG123). Available at: https://www.nice.org.uk/guidance/ng123
National Institute for Health and Care Excellence (2023) Lower urinary tract symptoms in men: management (CG97). Available at: https://www.nice.org.uk/guidance/cg97
