Names and pronunciation
(sol-i-fen′a-sin) VESIcare, Vesicare LS
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Individual generic drug information
Extracted information for solifenacin only.
(sol-i-fen′a-sin) VESIcare, Vesicare LS
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Func. class.: Urinary antispasmodic, anticholinergic
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Chem. class.: Antimuscarinic
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Do not confuse: Vesicare/Vesanoid
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ACTION: Relaxes smooth muscles in urinary tract by inhibiting acetylcholine at postganglionic sites
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USES: Overactive bladder (urinary fre- quency, urgency, incontinence), neurogenic detrusor overactivitiy (NDO) in pediatrics
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Extracted information for solifenacin only.
CONTRAINDICATIONS: Hyper- sensitivity, uncontrolled closed-angle glau- coma, urinary retention, gastric retention Precautions: Pregnancy, breastfeeding, children, geriatric patients, renal/hepatic disease, controlled closed-angle glaucoma, bladder outflow obstruction, GI obstruc- tion, decreased GI motility, history of QT prolongation
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SIDE EFFECTS CNS: Dizziness, headache, confusion, depression, drowsiness CV: Palpitations, sinus tachycardia, chest pain, QTc prolongation EENT: Vision abnormalities GI: Nausea, anorexia, abdominal pain, constipation, dry mouth INTEG: Angioedema, exfoliative dermatitis
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INTERACTIONS Increase: QT prolongation—Class IA, III antidysrhythmias Increase: CNS depression—sedatives, hypnotics, benzodiazepines, opioids Increase: effects—CYP3A4 inhibitors (ketoconazole, clarithromycin, diclofe- nac, doxycycline, erythromycin, isonia- zid, nefazodone, propofol, protease inhibitors, verapamil), max dose 5 mg Decrease: effects—CYP3A4 inducers (carBAMazepine, nevirapine, PHENobar- bital, phenytoin) Drug/Herb Decrease: effects—St. John’s wort Drug/Food Increase: effect—grapefruit juice Drug/Lab Test Increase: LFTs
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Extracted information for solifenacin only.
DOSAGE AND ROUTES • Adult: PO 5 mg/day, max 10 mg/day • Child: PO ≥2 yr 9 to 15 kg: 2 mg (2 mL)/day, max 4 mg (4 mL)/day; >15 kg to 30 kg: 3 mg (3 mL/day), max 5 mg (5 mL)/day; 31-45 kg: 3 mg (3 mL/ day); 46-60 kg: 4 mg (4 mL/day) Renal/hepatic dose • Adult: PO (Child-Pugh B) max 5 mg/ day; CCr ≤30 mL/min, 5 mg/day With CYP3A4 inhibitors: Adult: PO 5 mg/ day (max)
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Available forms: Tabs 5, 10 mg; oral solution 1 mg/mL
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Administer: PO route • Without regard to meals • Swallow product whole with water, liquid
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Extracted information for solifenacin only.
Assess: • Urinary patterns: distention, nocturia, frequency, urgency, incontinence • Allergic reactions: rash • Cardiac patients: monitor ECG for QTc prolongation, avoid products that cause QT prolongation • Angioedema of the face, lips, tongue, larynx • Pregnancy/breastfeeding: use only if benefits outweigh fetal risk; do not breast- feed, excretion unknown
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Evaluate: • Therapeutic response: decreasing dys- uria, frequency, nocturia, incontinence
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CLINICAL CONSIDERATIONS
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Patient and caregiver information: • To avoid hazardous activities because dizziness may occur • That constipation, blurred vision may occur; to notify prescriber if abdominal pain with constipation occurs • To take without regard to food • To swallow tab whole; do not split, crush, chew • To call prescriber if severe abdominal pain or constipation lasts for ≥3 days • That heat prostration may occur if used in hot environment, sweating is de- creased • About anticholinergic effects: blurred vision, constipation, urinary re- tention, hyperthermia
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Extracted information for solifenacin only.
PHARMACOKINETICS 90% absorbed; 98% protein bound; extensively metabolized by CYP3A4; excreted in urine 69% (metabolites), feces 22%; half-life 45-68 hr; peak 4-8 hr, duration up to 24 hr
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Filter the extracted dose blocks for this individual drug.
• Child: PO ≥2 yr 9 to 15 kg: 2 mg (2 mL)/day, max 4 mg (4 mL)/day; >15 kg to 30 kg: 3 mg (3 mL/day), max 5 mg (5 mL)/day; 31-45 kg: 3 mg (3 mL/ day); 46-60 kg: 4 mg (4 mL/day) Renal/hepatic dose
Candidate age grouping · source page 1220