Solifenacin
Pronunciation: so-li-FEN-a-sin.
- Generic name
- solifenacin succinate
- Brand names
- VESIcare (United States, Australia), Vesicare (United Kingdom)
- Drug class
- Antimuscarinic (anticholinergic) medicine for overactive bladder
- Form
- Film-coated tablet. A separate oral-suspension product (VESIcare LS) exists in the United States for a distinct paediatric indication and is not covered by this adult-tablet page.
- Route
- Oral
- Legal status
- Legal/supply status is not independently established in the supplied evidence dossier for any country; do not assume prescription-only or any other status without a verified source.
Supply Rules Vary
Trade names by country: United States · United Kingdom · Canada · Australia
Australia: VESICARE (5) · Full directory
What solifenacin succinate is and how it works
Solifenacin is an antimuscarinic (anticholinergic) medicine that reduces involuntary bladder-muscle (detrusor) contractions, reducing urgency and how often the urge to urinate happens. (1) (2) (3)
Solifenacin tablets are used in adults for overactive-bladder symptoms such as urgency, frequency, and urge urinary incontinence. Because it is an anticholinergic medicine, it carries specific cautions around glaucoma, urinary and gastric retention, heat tolerance, and central nervous system effects that a prescriber must weigh against the individual's other conditions and medicines, particularly in older adults.
Mechanism of action: how solifenacin succinate works
Solifenacin is a competitive inhibitor of the muscarinic M3 subtype receptor, the receptor subtype predominantly responsible for acetylcholine-mediated contraction of detrusor (bladder) smooth muscle; this reduces detrusor contractility and thereby urgency and frequency. (1) (3) (2)
What solifenacin succinate is used for
Overactive bladder symptoms in adults
Solifenacin tablets are used to treat adults with overactive-bladder symptoms, including urge urinary incontinence, urgency, and increased urinary frequency, in the United States, United Kingdom, and Australia; approval status in other countries is not established here. (1) (2) (5) (4)
Before taking solifenacin succinate
Do not take / not appropriate for
- Tell the prescriber if you have urinary retention, gastric retention, or uncontrolled narrow-angle glaucoma; the prescriber will decide whether solifenacin is appropriate. (adult tablet) (1) (2)
- Tell the prescriber if you have severe gastrointestinal conditions such as toxic megacolon, or if you have myasthenia gravis; the responsible clinician decides whether starting or continuing treatment is appropriate. (adult tablet, per UK product information) (2)
- Tell the prescriber if you have had a hypersensitivity reaction to solifenacin or an ingredient of the specific product; the prescriber will decide whether solifenacin is appropriate. (adult tablet) (1) (2)
Tell your clinician about
- Any difficulty emptying your bladder, a weak urine stream, or a history of urinary or gastric retention.
- Glaucoma of any type, or any eye condition.
- A prolonged QT interval, other heart-rhythm problems, or a family history of sudden cardiac death.
- Reduced gastrointestinal movement, constipation problems, or inflammatory bowel disease.
- Kidney or liver disease, since the dose may need to be capped or the medicine avoided.
- Every other medicine you take, especially strong CYP3A4 inhibitors (such as ketoconazole) or other antimuscarinic medicines.
- Whether you will be exposed to hot environments or strenuous heat, because solifenacin can make it harder for your body to cool down.
- Pregnancy, plans for pregnancy, or breastfeeding.
- Your age and any memory, confusion, or cognitive concerns, since anticholinergic medicines can affect older adults more than younger adults.
How to take solifenacin succinate
- Take solifenacin exactly as your prescriber has instructed, usually as one tablet once a day, with or without food, swallowed whole with liquid.
- Do not change your dose or stop taking it without talking to your prescriber first, even if your symptoms improve or do not improve.
- If you have not had a bowel movement in more than 3 days while taking solifenacin, contact your prescriber; the prescriber will decide whether to continue, pause, or stop treatment.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5)
Missed dose
Follow the product instructions for missed doses, or ask the prescriber or pharmacist. Do not take a double dose to make up for a missed one.
Overdose
If too much solifenacin may have been taken, contact your prescriber, pharmacist, or a poison-control/emergency service urgently. In the United States call Poison Control at 1-800-222-1222 or emergency services; in other countries use the equivalent local urgent-advice or emergency number. Possible overdose symptoms include flushing, confusion, fever, a fast heartbeat, and hallucinations. (3) (2)
Side effects
Solifenacin's most common effects relate to its anticholinergic action (dry mouth, constipation, blurred vision). Some effects, including central nervous system effects and reduced heat tolerance, may be more noticeable in older adults.
Dry mouth
What to notice: The most frequently reported effect; can be more common at the higher 10 mg dose.
What to do: Sugar-free gum or sugar-free sweets can help; tell your prescriber if it is severe or affects eating. (1) (4)
Constipation
What to notice: Reduced bowel movements, bloating, or indigestion.
What to do: Increasing fluids and fibre may help; contact your prescriber if constipation lasts more than 3 days or is severe. (1) (4)
Blurred vision
What to notice: Vision changes that can affect driving or operating machinery.
What to do: Avoid driving or operating machinery until you know how solifenacin affects you; tell your prescriber if it persists. (1) (4)
Headache, nausea, or stomach discomfort
What to notice: Generally mild; taking tablets with food may help nausea.
What to do: Tell your prescriber if these are persistent or troublesome. (4)
Drowsiness (somnolence)
What to notice: Feeling unusually sleepy or less alert.
What to do: Avoid driving or operating machinery until you know how solifenacin affects you. (1)
Urinary tract infection
What to notice: High temperature, a burning sensation when urinating, back pain, or blood in the urine.
What to do: Contact your prescriber promptly for assessment. (4) (1)
Urinary retention
What to notice: Difficulty starting urination or emptying your bladder fully.
What to do: Contact your prescriber promptly; this can be more likely if you already have bladder-outlet obstruction. (1) (4)
Faecal impaction
What to notice: Stomach pain especially after meals, feeling or being sick, a long-lasting urge to pass stool without being able to, or not passing stool at all.
What to do: Contact your prescriber promptly. (4)
Swollen ankles or legs (oedema)
What to notice: Fluid build-up and swelling in the lower limbs.
What to do: Tell your prescriber, especially if it is new or worsening. (4)
Confusion or hallucinations
What to notice: New confusion, seeing or hearing things that are not there, or unusual disorientation, which can occur with anticholinergic medicines, especially in older adults.
What to do: Contact your prescriber promptly; do not assume this is unrelated to the medicine. (3)
Serious warnings
Angioedema and anaphylaxis — emergency
Symptoms: Swelling of the face, lips, tongue, or throat, which can be life-threatening if it affects the airway; hives, severe itching, or sudden breathing difficulty.
Action: Get emergency medical help immediately if there is any swelling of the face, lips, tongue, or throat, or difficulty breathing; a clinician or emergency service will decide whether Solifenacin needs to be stopped. (1) (2)
Urinary retention with reduced kidney function — urgent
Symptoms: Inability to urinate, a swollen or painful lower abdomen, or reduced urine output, particularly in people with pre-existing bladder outflow obstruction.
Action: Contact your prescriber urgently or seek emergency care if you cannot pass urine. (1)
Reduced heat tolerance and heat-related illness — urgent
Symptoms: Feeling unusually hot, dizziness, or confusion in hot weather or during strenuous activity or fever.
Action: Avoid becoming overheated or dehydrated in hot conditions; seek urgent medical care for fever or symptoms of heat stroke. (3)
QT prolongation and heart-rhythm effects — urgent
Symptoms: Fainting, palpitations, or a very fast or irregular heartbeat, particularly in people with existing heart-rhythm problems, low potassium/magnesium, or those taking other QT-prolonging medicines.
Action: Tell your prescriber about any heart-rhythm history before starting, and seek prompt medical care for fainting or a racing/irregular heartbeat. (1) (2)
Central anticholinergic effects, including confusion and hallucinations — urgent
Symptoms: New confusion, hallucinations, marked drowsiness, or difficulty concentrating, which can be more likely in older adults or those on other anticholinergic medicines.
Action: Contact your prescriber promptly; do not simply continue or stop the medicine on your own. (3) (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Strong CYP3A4 inhibitors (for example, ketoconazole and similar antifungal or antiviral medicines) | These can substantially raise solifenacin blood levels. | Your prescriber may cap your dose at 5 mg daily or avoid combining these medicines; do not adjust the dose yourself. (1) |
| Other antimuscarinic (anticholinergic) medicines | Combined anticholinergic burden can increase dry mouth, constipation, blurred vision, urinary retention, and confusion risk. | Tell your prescriber and pharmacist about every other medicine, including over-the-counter antihistamines and some other bladder or gut medicines. (2) (3) |
| Other medicines that prolong the QT interval | Combined use may increase the risk of heart-rhythm disturbance. | Tell your prescriber about all heart or psychiatric medicines you take before starting solifenacin. (1) (2) |
| Medicines that reduce gastrointestinal motility | Combined use can further slow gut movement and increase constipation or retention risk. | Tell your prescriber if you take other medicines that slow the gut. (2) |
Pregnancy, breastfeeding, kidney/liver function, age
Older adults
People aged 65 and over showed higher solifenacin blood levels than younger adults in studied data. Anticholinergic effects such as confusion, drowsiness, dizziness, blurred vision, constipation, and urinary retention need particular attention in this age group. Your prescriber will weigh these risks against the benefit for you individually. (1) (3)
Children and adolescents
This page covers only the adult tablet. A separate paediatric oral-suspension product with its own indication and dosing exists in the United States; adult tablet information must not be applied to a child. (1)
Pregnancy and breastfeeding
Discuss the balance of benefits and risks with your prescriber before starting or continuing solifenacin in pregnancy or while breastfeeding. (2)
Renal and hepatic impairment
Dose may need to be capped at a lower level with severe kidney impairment or moderate liver impairment, and solifenacin is not recommended with severe liver impairment. Your prescriber will determine whether and how to adjust your treatment. (1)
Monitoring
Before starting
- Confirm the diagnosis of overactive bladder and rule out other causes of urinary symptoms, including infection.
- Screen for glaucoma, urinary or gastric retention, myasthenia gravis, reduced gut motility, QT-prolongation risk factors, renal and hepatic function, and other anticholinergic medicines.
- Review age-related anticholinergic-burden risk, especially in older adults, and any history of confusion.
During treatment
- Watch for dry mouth, constipation, blurred vision, urinary retention, heat intolerance, heart-rhythm symptoms, and central effects such as confusion or drowsiness.
- Reassess continued need and dose after an adequate treatment trial, following the prescriber's individualised plan rather than a fixed public schedule.
- Ask about bowel habit; investigate promptly if no bowel movement for more than 3 days.
Storage
Keep solifenacin tablets in their original container at room temperature, away from excess heat and moisture, and out of the sight and reach of children.
Professional information
Clinician-facing context only. Use the current local indication, dosing table, renal/hepatic and CYP3A4 dose-cap tables, and monitoring guideline.
United States
Indication: Adult overactive bladder
Dose summary: No universal dose is displayed. A US label describes an initial 5 mg once-daily tablet, which may be increased to 10 mg once daily if well tolerated; exact starting dose, titration, and maximum dose follow the current local label and individual patient factors.
Renal context: A US label caps the dose at 5 mg daily in severe renal impairment (CLcr < 30 mL/min/1.73 m^2) and in moderate hepatic impairment (Child-Pugh B), and does not recommend use in severe hepatic impairment (Child-Pugh C); do not infer a web-based adjustment for an individual patient. (1)
Hepatic guidance
A US label caps the dose at 5 mg daily in moderate hepatic impairment (Child-Pugh B) and does not recommend use in severe hepatic impairment (Child-Pugh C), per the renal_summary above; use local product information and specialist judgement for country-specific guidance.
Overdose note
Overdose can produce anticholinergic toxicity, including flushing, confusion, fever, tachycardia, and hallucinations; supportive care and poison-centre or specialist advice are required. (1) (3) (2)
Frequently asked questions
Is solifenacin safe for older adults?
It can be used in older adults, but anticholinergic medicines like solifenacin carry a higher risk of confusion, drowsiness, constipation, and urinary retention in this age group, and blood levels of the medicine are higher in people 65 and over. Your prescriber will weigh this risk against the benefit for you. (1) (3)
Can solifenacin affect my thinking or memory?
Anticholinergic medicines, including solifenacin, can cause drowsiness, confusion, or hallucinations in some people, more often in older adults or those taking other anticholinergic medicines. Tell your prescriber promptly about any new confusion or memory change. (3)
Why do I need to be careful in hot weather?
Solifenacin can make it harder for your body to cool down, which can increase the risk of overheating or heat stroke in hot conditions or with strenuous activity or fever. (3)
Is the adult tablet the same as the children's solifenacin product?
No. A separate oral-suspension product exists for a distinct paediatric indication in the United States. This page covers only the adult tablet, and adult information should not be applied to a child. (1)
What is the mechanism of action of solifenacin succinate?
Solifenacin is a competitive inhibitor of the muscarinic M3 subtype receptor, the receptor subtype predominantly responsible for acetylcholine-mediated contraction of detrusor (bladder) smooth muscle; this reduces detrusor contractility and thereby urgency and frequency. (1) (3) (2)
References
- VESIcare (solifenacin succinate) tablets — prescribing informationU.S. National Library of Medicine DailyMed · United States · accessed 2026-07-26 · source 1
- Solifenacin 10 mg film-coated tablets — Summary of Product Characteristicselectronic Medicines Compendium (UK) · United Kingdom · accessed 2026-07-26 · source 2
- Solifenacin: MedlinePlus Drug InformationMedlinePlus, U.S. National Library of Medicine · United States · accessed 2026-07-26 · source 3
- Solifenacin: a medicine for an overactive bladderNHS (National Health Service, UK) · United Kingdom · accessed 2026-07-23 · source 4
- VESICARE solifenacin succinate 5 mg tablet blister pack — ARTG 117217Therapeutic Goods Administration (Australia) · Australia · accessed 2026-07-23 · source 5
Brand names by country
Single-ingredient solifenacin succinate names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- VESIcare5 mg, 10 mg · astellas pharma us, inc.
United Kingdom
Canada
- VESICARE
- MED-SOLIFENACIN
Australia
- VESICARE (5)current active artg entry · 5 mg, 10 mg · Astellas Pharma Australia Pty Ltd