1. About solifenacin
Solifenacin is a medicine used to treat symptoms of an overactive bladder. These can include:
- a sudden and urgent need to pee (urinary urgency)
- needing to pee more often than usual (urinary frequency)
- wetting yourself if you cannot make it to the loo in time (urinary incontinence)
Solifenacin works by relaxing the muscles around your bladder. This means your bladder can hold more liquid and you do not need to pee as often or as urgently.
Solifenacin is only available on prescription. It comes as tablets and as a liquid that you swallow.
Solifenacin also comes combined with tamsulosin, a medicine for prostate problems. Solifenacin with tamsulosin is known as Vesomni. Your doctor may prescribe this to treat a sudden and urgent need to pee if you have an enlarged prostate.
2. Key facts
- You'll usually take solifenacin once a day.
- Common side effects include dry mouth and blurred vision.
- You will usually take this medicine long term to help keep your symptoms under control.
- Solifenacin starts to work within 3 to 8 hours, but it can take up to 4 weeks to reach its full effect.
3. Who can and cannot take solifenacin
Solifenacin can be taken by adults (aged 18 years and over).
It's not suitable for everyone. To make sure it's safe for you, tell your doctor or pharmacist before starting solifenacin if you:
- have ever had an allergic reaction to solifenacin or any other medicine
- have liver or kidney problems
- have myasthenia gravis, a rare long-term condition that causes muscle weakness
- have glaucoma, as solifenacin can increase pressure in your eye
- have a severe stomach or bowel condition, including a rare complication of ulcerative colitis or Crohn's disease called toxic megacolon
- are not able to pee or empty your bladder completely (urinary retention)
- are pregnant, trying to get pregnant or breastfeeding
4. How and when to take solifenacin
Always read the information that comes with your medicine.
You'll usually take solifenacin once a day. You can take your dose at any time but try to take it at the same time each day.
Swallow your tablets whole with a drink of water, do not chew or crush them. You can take solifenacin with or without food.
The usual dose of solifenacin is 5mg, taken once a day. If your symptoms do not improve, your doctor may increase your dose to 10mg a day.
The usual dose for solifenacin with tamsulosin (Vesomni) is 1 tablet once a day.
What if I forget to take it?
If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, skip the missed dose and take your next one at the normal time.
Do not take a double dose to make up for a missed dose.
If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
What if I take too much?
Taking 1 extra dose of solifenacin is unlikely to harm you.
However, you may get more side effects, such as a dry mouth or headache.
The amount of solifenacin that can lead to an overdose varies from person to person, and too much solifenacin can be dangerous.
Immediate action required: Call 999 or go to A&E if:
You've taken more than your usual dose of solifenacin and you have:
- a fast heartbeat
- breathing problems
If you need to go to hospital, do not drive yourself. Get someone else to drive you, or to call you an ambulance.
Take the solifenacin packet with you, or the leaflet inside it, plus any remaining medicine.
5. Side effects
Like all medicines, solifenacin can cause side effects although not everyone gets them. Side effects often improve as your body gets used to the medicine.
Common side effects
Common side effects happen in more than 1 in 100 people. They are usually mild and short-lived.
Talk to your doctor or pharmacist if these side effects bother you or do not go away:
- dry mouth
- feeling dizzy, sleepy, or a spinning sensation (vertigo)
- diarrhoea or being sick (vomiting)
- farting and burping (wind)
- stomach pain
- dry eyes
- blurred vision
- problems or pain when peeing, and not being able to empty your bladder
Serious side effects
Serious side effects are rare.
Tell your doctor straight away if you have:
- stomach pain (especially after meals), feeling sick or being sick, a persistent urge to poo, not being able to poo or you have runny poos – these are all signs of faecal impaction, where large, hardened poo gets stuck and you cannot push it out
- difficulty fully emptying your bladder, or difficulty in starting to pee – these are signs of urinary retention, where pee builds up in your bladder because you're unable to pee
- high temperature or chills, burning sensation when peeing, pain in your back or side, or bloody or cloudy pee – these can be signs of a severe urinary tract infection (UTI)
- swollen ankles or legs (oedema) – where fluid builds up in your legs
Serious allergic reaction
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to solifenacin.
Immediate action required: Call 999 now if:
- your lips, mouth, throat or tongue suddenly become swollen
- you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
- your throat feels tight or you're struggling to swallow
- your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
- you suddenly become very confused, drowsy or dizzy
- someone faints and cannot be woken up
- a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)
You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.
These can be signs of a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of solifenacin. For a full list, see the leaflet inside your medicines packet.
You can report any suspected side effect using the Yellow Card safety scheme.
6. How to cope with side effects of solifenacin
What to do about:
- dry mouth – try chewing sugar-free gum or having sugar-free sweets. Having a dry mouth can cause tooth decay or a fungal infection. It also might stop medicine that you put under your tongue from dissolving properly, such as medicine for angina.
- headache – make sure you rest and drink plenty of fluids. Avoid alcohol. Ask your pharmacist to recommend a painkiller. Talk to your doctor if your headache is severe or lasts longer than 1 or 2 days.
- feeling dizzy, sleepy or a spinning sensation – do not drive, cycle, use tools, or operate machinery. Avoid drinking alcohol, as this may make your symptoms worse. Talk to your doctor if the dizziness or sleepiness bothers you.
- diarrhoea or being sick – drink lots of water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having strong-smelling pee. Do not take any other medicines without speaking to a pharmacist or doctor, if the effects last more than 1 or 2 days.
- constipation – get more fibre into your diet, such as fresh fruit and vegetables and cereals, and drink plenty of water. Try to exercise more regularly, for example, by going for a daily walk or run. If this does not help, talk to a pharmacist or doctor. Watch this short video about how to treat constipation.
- farting and burping – eat less foods that cause wind, like lentils, peas, beans and onions. It might also help to eat smaller and more frequent meals, eat and drink slowly, and exercise regularly. Ask your pharmacist about remedies you can buy to help with trapped wind.
- stomach pain – try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Try putting a heat pad or a covered hot water bottle on your stomach to help. If you are in a lot of sudden severe pain, speak to your pharmacist or doctor.
- dry eyes – ask your pharmacist or optician to recommend some eye drops. If you wear contact lenses and these become uncomfortable, you might have to wear glasses instead while you're taking this medicine.
- blurred vision – do not drive or ride a bike until you can see clearly again. Do not take your next dose of solifenacin if your vision is still blurred. Speak to your doctor or pharmacist if your vision has not returned to normal a day after taking your last dose.
- problems or pain when peeing – try to relax when you pee. Do not try to force the flow of urine. If it does not happen, try again later. Talk to a doctor urgently if you cannot pee at all.
7. Pregnancy and breastfeeding
Solifenacin and pregnancy
Solifenacin is not usually recommended in pregnancy because there's not enough information available to say if it's safe for you and your baby.
If you're trying to get pregnant or you're already pregnant, talk to your doctor about whether taking solifenacin is right for you.
Solifenacin and breastfeeding
Solifenacin is not usually recommended while breastfeeding. However, some breastfeeding mothers may still need it.
It is not known how much solifenacin gets into breast milk, but this is likely to be small. However, there's a risk your baby might have some side effects. Your doctor may therefore advise that you take an alternative medicine.
If your doctor says it's ok for you to keep taking solifenacin, monitor your baby for possible side effects, such as constipation, peeing less and colic.
Talk to your doctor, midwife or health visitor if you have any concerns about your baby while you're breastfeeding, including if you do not think your baby is putting on enough weight.
Non-urgent advice: Tell your doctor if you're:
- trying to get pregnant
For more information about how solifenacin can affect you and your baby during pregnancy, read this leaflet on treating urinary incontinence on the Best Use of Medicines in Pregnancy (BUMPs) website.
8. Cautions with other medicines
Some medicines and solifenacin can affect each other. This can increase the chance of side effects.
Tell your pharmacist or doctor if you're taking:
- any medicine that makes you drowsy, gives you a dry mouth, or makes it difficult for you to pee. Taking solifenacin might make these side effects worse
- ketoconazole or itraconazole, medicines used to treat fungal infections
- ritonavir, a medicine used to treat HIV
Mixing solifenacin with herbal remedies and supplements
Some herbal products such as turmeric may change the way your body processes solifenacin.
There's very little information about taking solifenacin with other herbal remedies and supplements.
Some herbal medicines can make you feel sleepy, cause a dry mouth, or make it difficult to pee. Their effect is similar to solifenacin. This can increase your risk of getting side effects or make your side effects worse.
Important: Medicine safety
Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.
9. Common questions about solifenacin
How does solifenacin work?
Solifenacin is a type of medicine called an antimuscarinic (or anticholinergic) muscle relaxant.
It works by relaxing the muscle that is found in the wall of the bladder. This helps to increase the volume of pee your bladder can hold and control the release of pee.
How long does it take to work?
Solifenacin starts to relax the muscle in your bladder after 3 to 8 hours of taking your first dose. However, it can take up to 4 weeks for it to reach its full effect and for your symptoms to get better.
How long will I take it for?
Usually, you’ll need to take solifenacin for a long time.
After 4 weeks your doctor will check that solifenacin is helping your symptoms. They’ll also do a review every 6 to 12 months after that to check it’s still working for you.
Take solifenacin until your doctor tells you to stop. Do not stop taking it just because you feel better.
Is it safe to take for a long time?
Do not take solifenacin for longer than you need to. Your doctor will check every 6 to 12 months that your treatment is still needed.
There may be an increased risk of confusion and possibly dementia in people taking solifenacin, but more study needs to be done. If you're worried about this, talk to your doctor.
What will happen if I stop taking it?
If you've been taking solifenacin for at least 6 months your doctor may suggest that you stop taking the medicine for up to 4 weeks to see how your symptoms change without it.
Some people find that the improvement in their symptoms continues after they've stopped taking the medicine. Talk to your doctor if you're thinking about stopping your medicine.
Do not stop taking solifenacin without talking to your doctor first.
Are there other medicines for urinary incontinence and overactive bladder?
Solifenacin belongs to a group of medicines called antimuscarinics. There are other antimuscarinics that can be used for overactive bladder:
They all seem to work just as well as solifenacin. However, if you get side effects with one antimuscarinic a different one may suit you better.
Also, solifenacin is taken once a day but some of the other medicines you have to take twice a day or more.
If antimuscarinics are unsuitable for you, they have not helped your overactive bladder, or you have had side effects, you may be offered a medicine called mirabegron, which works in a slightly different way.
Can I drink alcohol with it?
Try to avoid drinking alcohol when you first start taking solifenacin, or if your dose is increased, to see how you feel. Solifenacin combined with alcohol can make you feel very sleepy.
Drinking alcohol may make you more likely to need to get up in the night to pee.
Is there any food or drink I need to avoid?
You can eat normally while taking solifenacin. If you have urinary incontinence, cut down on alcohol and drinks containing caffeine, such as tea, coffee and cola.
Will I gain or lose weight?
Solifenacin should not cause you to lose or gain weight.
However, very rarely solifenacin can make you feel less hungry, so you may lose weight.
If you start to have problems with your weight while taking solifenacin, talk to your pharmacist or doctor.
Will it affect my contraception?
However, if solifenacin makes you sick or have severe diarrhoea, your contraceptive pills may not protect you from pregnancy. Look on the pill packet to find out what to do.
Will it affect my fertility?
There’s no clear evidence to suggest that taking solifenacin will reduce fertility in men or women.
However, speak to a pharmacist or your doctor before taking it if you're trying to get pregnant.
Can I drive or ride a bike?
Do not drive a car, ride a bike, use tools or operate machinery if solifenacin makes you sleepy, gives you blurred vision, or makes you feel dizzy, clumsy or unable to concentrate or make decisions.
This may be more likely when you first start taking it, but could happen at any time. For example, it could happen when you increase the dose or start another medicine.
Talk to a doctor or pharmacist if you're not sure whether it's safe for you to drive while taking solifenacin.
Are there lifestyle changes that can help overactive bladder?
There are some lifestyle changes that may help your symptoms. It’s a good idea to:
- cut back on drinks that contain caffeine, such as tea, coffee and cola, as caffeine can increase how much you pee
- not drink too much or too little fluid during the day, as this can make incontinence worse
- lose weight if you are overweight or obese, as being overweight can increase your risk of urinary incontinence – use the BMI healthy weight calculator to find out if you're a healthy weight for your height
- try pelvic floor muscle training (Kegel exercises)
- try bladder training
- discuss other options for urinary incontinence with your doctor, such as surgery and procedures