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Solifenacin succinate is an anticholinergic drug used in the management of an overactive bladder.
Mode of action
Solifenacin succinate has a high affinity for M3 (Muscarinic) receptors which are located o the smooth muscle walls. The M3 receptors commonly known as Muscarinic three receptors functions primarily to contract specific smooth muscles of the body. These smooth muscles include those of the bladder, small intestines, and the airway. This is a type of drug that prevents and treats urinary incontinence which is very common in elderly patients. When the bladder can't hold urine to a required time, the M3 receptors come into work when activated and helps hold the urine. Solifenacin succinate works to activate the receptors since it has a high affinity to the M3 receptors.
Brief description of illnesses it manages
One example of a condition that Solifenacin Succinate manages is the overactive bladder. An overactive bladder is a condition where the smooth muscle walls contract before expanding to the full size when filled with urine. This makes one feel the urge to continuously micturate and sometimes one may experience leaks. In a normal bladder the smooth muscles contract when the bladder is fully filled with urine.
Solifenacin tablets which exhibit antimuscarinic activity binds to M3 receptors reducing smooth muscle contraction. This allows the bladder to hold large amounts of urine before contracting.
This results on the reduction of the frequency and urge of micturition.
Solifenacin tablets are formulated in two strengths:- 5mg and 10mg. The tablets are taken once daily. Usually, the doctor may prescribe either 5mg or 10mg depending on the condition.
This drug may be prescribed either as a monotherapy where its prescribed alone or as a combination therapy. In the combination therapy, solifenacin succinate is administered together with mirabegron, a beta 3 adrenergic agonist.
The dosage of the drug might not be the same for all the patients. Your doctor might tailor the medication dosage according to your condition or response to treatment. To get satisfying results, take this medication on a regular basis so as to benefit from it.
After you have swallowed the drug, with lots of water, Solifenacin succinate reaches peak serum levels in 3-8 hours. It is highly protein bound and mainly binds to alpha 1 acid glycoprotein. The 98% rate of binding makes it affect or get affected by other drugs which are given concomitantly with it. A lot of monitoring should be maintained when using other drugs.
Solifenacin Succinate tablets are metabolized in the liver by CYP 3A4 thus cytochrome 3A4 inducers or inhibitors may interfere with the drug concentration. This also calls for frequent monitoring when used with other drugs concomitantly. This drug is mainly excreted in urine and has a half-life of between 45-68 hours.
Some minor side effects might be noted when taking this drug. Not all though and still, they are not supposed to be worse to an extent that they affect your activities daily living. These side effects experienced are as a result of binding of solifenacin succinate to other muscarinic receptors located at various sites. In case they reach to such a point, consult your doctor/ pharmacist. They include:
- Blurred vision
- Dry mouth
- Dry eyes.
- Stomach discomfort.
- Fatigue and weakness
- Dyspepsia which is discomfort in the abdomen.
- Urinary tract infections.
- A cough.
Decreased sweating thus you may experience heat strokes. This is avoided by taking a large number of fluids.
This drug may exhibit some hypersensitivity reactions which may present as urticaria, itching, swelling of the face, peripheral edema, dizziness or pruritis. You should contact your doctor or pharmacist in case you start experiencing any of the above side effects. You may also report to FDA 1-800-FDA-1088
Liver dysfunction- Solifenacin succinate is metabolized in the liver. A dysfunctional liver would mean the drug is not metabolized thus increased concentration and increased risk of side effects.
Kidney dysfunction- The drug is eliminated via the kidneys. This would lead to increased concentration of solifenacin succinate in blood thus increased risk to side effects.
Bladder problems example bladder obstruction and prostate hyperplasia due to increased urinary retention.
Open-angle glaucoma- Solifenacin succinate may cause relaxation of the ciliary muscles causing decreased drainage of the aqueous humor thus increased intraocular pressure.
Gastric ulcer or Gastro-oesophageal reflux Disease- Solifenacin tablets slow gastric emptying which may worsen the condition.
Avoid taking alcohol when taking this drug as it may cause blurred vision and drowsiness.
Solifenacin succinate is avoided in old age due to increased risk of side effects as there is decreased liver and kidney function.
This drug should be avoided in constipated patients as antimuscarinics reduce gastrointestinal secretion and cause relaxation of the smooth muscle walls thus reduced motility.
It is not known if Solifenacin succinate is excreted in milk. Therefore, it is important to consult your doctor before starting the medication.
In pregnancy this drug is classified under Pregnancy Category C thus should only be used in pregnancy if the benefits outweigh the risks.
Should not be used in people with irregular heart rhythms especially prolonged QT interval in the ECG as Solifenacin Succinate prolongs the QT interval.
Just as any other medication, some drugs affect the distribution of solifenacin succinate in the body. It is important to know these drugs so that by no chance will you take them concomitantly. These drugs include:
Azole derivatives example ketoconazole, itraconazole as they are CYP3A4 inhibitors leading to increased concentration of solifenacin succinate. Azole derivatives lead to decreased metabolism.
Anticoagulants example warfarin. Co-administration of the two drugs may lead to decreased warfarin metabolism hence increased bleeding.
The following is not a complete list of drugs that may interact with Solifenacin Succinate. It is important you inform your doctor of any medication you may be taking including supplements or herbs.
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