Pharmacology · Overactive bladder agents
Solifenacin !
A once-daily antimuscarinic for overactive bladder with some preference for M3 receptors and a long half-life.
Updated 2026-11-01
No structure of solifenacin bound to its receptor exists. The figure shows tiotropium, another muscarinic antagonist, in the acetylcholine pocket of the rat M3 receptor, the subtype that contracts the bladder; the pocket is nearly identical in the human receptor.
Mechanism of action
Solifenacin is a competitive muscarinic antagonist with some preference for M3 receptors, the ones that contract the bladder. Blocking them reduces urgent detrusor contractions. Its M3 preference may mean fewer effects on M1 receptors in the brain.
- Binds M3 receptors of the detrusor
- Acetylcholine cannot trigger urgent contractions
- Bladder holds more with less urgency
Pharmacokinetics
- Absorption
- Taken by mouth with or without food
- Metabolism
- Extensively by CYP3A4
- Half-life
- About 45 to 68 hours with regular use
Indications
- Overactive bladder with urge incontinence, urgency and frequency in adults Overactive bladder and urge incontinence →
Adverse effects
Common
- Dry mouth
- Constipation
- Blurred vision
- Urinary tract infection
Contraindications
- Urinary retention
- Gastric retention
- Uncontrolled narrow-angle glaucoma
- Hypersensitivity to the drug
Key interactions
- Strong CYP3A4 inhibitors (ketoconazole and others)
- Much higher solifenacin exposure; the dose is limited
- Other anticholinergic drugs
- Additive anticholinergic effects (class)
What is monitored
- Voiding and post-void residual in men with prostate enlargement
- Bowel habit
- Mental status in older adults
- ECG in people with QT risk
Administration and safety
- Swallowed whole with water, with or without food
Nursing care
- Teach to report swelling of the face, lips or tongue at once
- Advise care with driving if vision blurs or drowsiness appears
- Encourage fluids and fibre for constipation
Pregnancy and breastfeeding
No studies in pregnant women; animal studies did not show harm at the doses tested.
Test yourself
Think of the answer, then tap the question to see it.
Which receptor subtype does solifenacin prefer?
M3, the subtype that contracts the bladder.
Which enzyme metabolizes solifenacin and what follows from that?
CYP3A4; strong inhibitors such as ketoconazole raise its levels, so the dose is limited.
Which serious allergic reaction is listed for solifenacin?
Angioedema (and anaphylaxis), which can block the airway.
Related drugs
Related conditions
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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: DailyMed - SOLIFENACIN SUCCINATE tablet, coated (DailyMed (U.S. National Library of Medicine), 2026); Solifenacin: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 11 (McGraw Hill, 2023).
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Representative model, for educational purposes only.