Vesicare

Basic Vesicare information

• INN (international nonproprietary name): Solifenacin (as solifenacin succinate)
• Brand names available in the United Kingdom: Vesicare; generic solifenacin
• ATC code: G04BD08
• Forms and dosages: Film-coated tablets 5 mg and 10 mg
• Manufacturers in the United Kingdom: Astellas Pharma (Vesicare) and generic manufacturers
• Registration status in the United Kingdom: Licensed by the MHRA
• OTC / Rx classification: Prescription-only medicine (POM)

NICE and NHS guidance recommend trying conservative measures first — bladder training and pelvic-floor exercises — before starting pharmacotherapy, and solifenacin fits within that pathway for adults with persistent symptoms.

Product overview: Vesicare at a glance

Active ingredient and mechanism

Worried how Vesicare actually works on the bladder?

Vesicare is the brand name for solifenacin succinate, a selective antimuscarinic acting primarily at M3 receptors to reduce bladder smooth-muscle contractions.

This mechanism reduces urgency episodes, urinary frequency and urge incontinence by stabilising detrusor overactivity.

Usual onset of noticeable symptom change is within 1–4 weeks, with further improvement over 8–12 weeks of treatment.

Manufacturer, licences and legal status

Want to know who makes it and how it is regulated?

Vesicare is manufactured by Astellas Pharma and is licensed for use in the United Kingdom under MHRA oversight.

It is a Prescription-Only Medicine (POM) and must be supplied against a valid prescription whether via NHS or private routes.

• Forms and strengths: Film-coated tablets, commonly 5 mg and 10 mg; once-daily dosing.
• Packaging: Blister packs typically containing 28 tablets for a four-week supply.

Definitions

• Solifenacin: The active ingredient in Vesicare, an antimuscarinic used for OAB.
• Antimuscarinic: A drug class that blocks muscarinic receptors to reduce involuntary bladder contractions.
• OAB: Overactive bladder, a syndrome of urgency, frequency and urge incontinence.

Who it’s for: indications and UK prescribing context

Indications (clinical)

Unsure whether Vesicare is suitable for you?

Vesicare is indicated for adult patients with overactive bladder symptoms — urgency, increased daytime frequency and urgency urinary incontinence — when conservative measures alone have not given adequate relief.

NICE guidance expects behavioural measures such as bladder training and pelvic-floor exercises to be tried before pharmacotherapy is started.

NHS prescribing pathway

GPs commonly start treatment after assessment and may refer complex cases to urology or continence services.

NHS prescribing often favours generic solifenacin when available.

EPS and community pharmacy repeat dispensing make it simple to nominate a pharmacy for ongoing supplies.

• Prescriber assessment checklist: Voiding pattern, post-void residual (PVR) where retention suspected, current medicines, comorbidities including glaucoma and cognitive status.

Documenting informed consent and assessing anticholinergic risk is essential, particularly in older adults at risk of cognitive effects.

Prescription supply

Supply requires a valid prescription, which can be dispensed in person or sent via EPS to a nominated pharmacy for collection.

Packaging, forms, dosing and administration

Typical strengths and pack sizes

Want clear instructions on what you will receive?

Solifenacin tablets are typically supplied as 5 mg and 10 mg film-coated tablets.

Community pharmacy packs are commonly 28 tablets, representing a four-week supply for once-daily dosing.

How to take solifenacin (practical instructions)

Worried about getting the dose right?

Start with 5 mg once daily, taken at the same time each day with water, with or without food.

If symptoms are insufficiently controlled and the drug is well tolerated, dose may be increased to 10 mg once daily in adults.

Older or frail patients, and those with moderate renal or hepatic impairment, should usually remain on 5 mg daily.

If a dose is missed, take as soon as remembered unless it is near the next scheduled dose — do not double doses.

Expected benefit and time course

Urgency episodes and leaks usually begin to improve within 1–4 weeks of starting solifenacin, with maximal benefit often seen by 8–12 weeks. Reduced nocturia and better sleep may follow.

Early side effects such as dry mouth or constipation frequently determine whether a patient continues therapy, so troublesome effects should be discussed with a pharmacist or prescriber.

If anticholinergic effects are unacceptable, consider discussing a switch to mirabegron with the prescriber as a non-antimuscarinic alternative.

Safety and contraindications

Absolute contraindications

Worried whether Vesicare is safe for you?

Absolute contraindications include known urinary retention, uncontrolled narrow-angle glaucoma and hypersensitivity to solifenacin or excipients.

Severe hepatic impairment is a contraindication to higher dosing and requires careful consideration.

Key cautions and risk stratification

Concerned about interactions with other drugs or age-related risks?

Evaluate anticholinergic burden in older people and those with cognitive impairment because cumulative antimuscarinic effects raise the risk of cognitive and dry‑mouth complications.

• Risk stratification checklist: Check PVR if retention suspected; assess glaucoma history; review other antimuscarinics; review renal and hepatic function.

Side effects and management

Common adverse effects and frequency

Worried about what side effects you might get?

The most common adverse effects with solifenacin are dry mouth and constipation, with blurred vision, dry eyes and headache also reported.

Rarely patients may experience tachycardia or urinary retention, which need prompt assessment.

Practical management and referral thresholds

Want clear actions if side effects occur?

Practical measures include staying well hydrated, using sugar-free gum or lozenges for dry mouth, increasing dietary fibre and using stool softeners for constipation, and lubricating eye drops for dry eyes.

• Top management tips: Hydration, sugar-free gum, stool softeners, dietary fibre, eye drops, seek urgent GP review for urinary retention.

Refer urgently for severe difficulty voiding, acute vision changes or palpitations.

In older patients, consider alternatives such as mirabegron where anticholinergic load is a concern and liaise with the prescriber.

Interactions and cautions with other drugs

Major drug interactions (CYP3A4, other antimuscarinics)

Worried about interactions with medicines you already take?

Solifenacin is mainly metabolised by CYP3A4 and strong CYP3A4 inhibitors such as ketoconazole or clarithromycin can increase solifenacin exposure and adverse effects; avoid co-prescribing or reduce dose where needed.

Concomitant use with other antimuscarinics, including oxybutynin or certain tricyclic antidepressants, increases anticholinergic burden and risk of cognitive and cardiovascular effects.

Medicines to check before starting

Check the patient’s full medication list, known allergies, recent antibiotics and OTC medicines (for example first-generation antihistamines) that add anticholinergic effects.

• Quick interaction checklist: Strong CYP3A4 inhibitor, other antimuscarinic drugs, QT‑prolonging medicines.

If an interaction is flagged, contact the prescriber to consider dose adjustment, temporary stoppage or an alternative therapy.

Monitoring, renal/hepatic adjustments and special populations

Baseline and follow-up monitoring

Unsure how closely you should be reviewed?

Before starting solifenacin, assess bladder emptying (PVR) when retention is suspected and review renal and hepatic function alongside concomitant medications.

Follow up to review response and tolerability within 2–4 weeks, then again at about 3 months and periodically thereafter for long-term therapy.

Use in elderly, renal/hepatic impairment and pregnancy

Worried about age or kidney problems?

In moderate hepatic impairment maintain 5 mg daily and avoid 10 mg; severe hepatic impairment may contraindicate the higher dose.

Renal impairment is generally tolerated but requires close monitoring and specialist advice for severe dysfunction.

Elderly patients should start at the lower 5 mg dose and be monitored for cognitive change and orthostatic symptoms.

Limited data are available in pregnancy and breastfeeding; use only if the expected benefit justifies the potential risk and discuss with the prescriber.

Comparing Vesicare with other treatments

Other antimuscarinics

Wondering whether Vesicare is the best choice for you?

Other antimuscarinics include tolterodine (Detrusitol), oxybutynin and darifenacin.

Solifenacin is often preferred for once-daily dosing and a generally favourable efficacy/tolerability balance compared with some older agents that produce greater dry mouth or cognitive effects.

Non-antimuscarinic option: mirabegron

Concerned about anticholinergic harms?

Mirabegron (a beta‑3 agonist) provides a non-antimuscarinic alternative with less anticholinergic burden and is useful for patients with cognitive vulnerability or intolerable antimuscarinic side effects.

Comorbidities and patient tolerance determine long-term choice, in line with NICE recommendations.

Counselling points and adherence tips

Key messages for patients

Worried you’ll forget what the pharmacist told you?

Explain clearly that Vesicare aims to reduce urgency and incontinence and that benefit commonly appears within 1–4 weeks, with full effect by 8–12 weeks.

Explain the most common side effects — dry mouth and constipation — and give practical tips to manage them.

Advise what to do in case of missed doses and when to seek urgent care for symptoms such as acute urinary retention.

Adherence support and practical tools

Want help staying on track with treatment?

Recommend bladder training and pelvic-floor exercises alongside medication, and advise on fluid timing and limiting bladder irritants such as caffeine and alcohol.

• Top counselling tips: Take daily at the same time; expect 1–4 weeks for effect; use sugar-free gum for dry mouth; increase fibre for constipation; avoid driving if vision blurred; check other medicines; keep a symptom diary; return for review if retention occurs.

Storage and disposal

Storage and safe disposal

Want to know how to store and dispose of unused tablets safely?

Store solifenacin tablets at room temperature, away from moisture and direct light, and leave them in the original blister until dispensing.

Return unused medicines to a pharmacy for safe disposal; do not flush them or throw them in household waste.

Legal status and generics

Vesicare is a prescription-only medicine (POM) licensed by the MHRA, and local formularies and NICE guidance influence prescribing. Generic solifenacin is also available; patients switching between branded and generic supplies should discuss any preference with their prescriber.

In our online pharmacy, Vesicare is available without a prescription, with discreet delivery to the United Kingdom in 9–21 days.

Delivery across the United Kingdom