What is solifenacin indicated for?

Solifenacin Indication

Solifenacin is indicated for the treatment of adults with overactive bladder (OAB) with symptoms of urge urinary incontinence, urgency, and urinary frequency. 1

Primary Indication

• The FDA-approved indication is specifically for overactive bladder syndrome in adults, targeting all major symptoms including urge urinary incontinence, urgency, urinary frequency, and nocturia 1

Clinical Use Framework

Second-Line Therapy Positioning

• Solifenacin should be used as second-line therapy after behavioral therapies have been tried, as recommended by the American Urological Association 2
• It functions as a muscarinic (M1 and M3) receptor antagonist with bladder selectivity 1

Symptom Coverage

• Solifenacin demonstrates efficacy for all symptoms of overactive bladder, including:
  • Reduction in urinary incontinence episodes 2
  • Decrease in urgency episodes 2
  • Reduction in urinary frequency 2
  • Improvement in nocturia 2

Combination Therapy Applications

Men with Lower Urinary Tract Symptoms

• Solifenacin can be combined with tamsulosin (an alpha-blocker) for men with both storage and voiding lower urinary tract symptoms 3
• The European Association of Urology recognizes this combination as effective for treating storage symptoms in patients with lower urinary tract symptoms 3

Important Caveat for BPH

• Solifenacin should NOT be used as monotherapy for benign prostatic hyperplasia (BPH) 4
• It is only appropriate as combination therapy with alpha-blockers in men who have both BPH and storage symptoms of overactive bladder 4

Refractory Cases

• For patients refractory to monotherapy, solifenacin may be combined with β3-adrenoceptor agonists (such as mirabegron) 3
• The combination of solifenacin 5 mg plus mirabegron 50 mg demonstrates superior efficacy to either medication alone 2

Critical Safety Contraindications

Solifenacin is absolutely contraindicated in patients with: 1

• Urinary retention
• Gastric retention
• Uncontrolled narrow-angle glaucoma
• Known hypersensitivity to solifenacin (including anaphylaxis and angioedema)

High-Risk Populations Requiring Extreme Caution

• Use with extreme caution in patients with impaired gastric emptying, history of urinary retention, or narrow-angle glaucoma 2