What if vesicare doesnt work

Information: You can report any suspected side effect using the Yellow Card safety scheme. Visit Yellow Card for further information. 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.

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. Avoid drinking alcohol, as this may make your symptoms worse. Talk to your doctor if the dizziness or sleepiness bothers you. 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. 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. 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. 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. If you wear contact lenses and these become uncomfortable, you might have to wear glasses instead while you're taking this medicine.

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. 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. 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.

Solifenacin and breastfeeding Solifenacin is not usually recommended while breastfeeding. Non-urgent advice: Tell your doctor if you're:. 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.

Important: Medicine safety Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements. How does solifenacin work? How long does it take to work? How long will I take it for? Is it safe to take for a long time? Is it safe to take with painkillers? What will happen if I stop taking it?

Do not stop taking solifenacin without talking to your doctor first. Are there other medicines for urinary incontinence and overactive bladder? There are other antimuscarinics that can be used for overactive bladder: oxybutynin tolterodine darifenacin fesoterodine propiverine trospium They all seem to work just as well as solifenacin.

Urology Care Foundation. Symonds I, et al. Prolapse and disorders of the urinary tracts. In: Essential Obstetrics and Gynaecology. Elsevier; Bladder control problems. Overactive bladder FAQS.

National Association for Continence. Overactive bladder. Ferri FF. Urinary incontinence. In: Ferri's Clinical Advisor Magowan, BA, et al. Female urinary incontinence. In: Clinical Obstetrics and Gynaecology. Lucacz ES. Lukacz ES. Evaluation of women with urinary incontinence. Flesh G. Urodynamic evaluation of women with incontinence. Male urinary incontinence adult. Mayo Clinic; Female urinary incontinence and voiding dysfunction adult. American Urological Association. Treatment of urinary incontinence in women.

American College of Obstetricians and Gynecologists. Clinical Updates in Women's Health Care. Urodynamic testing. Warner KJ. Allscripts EPSi. Mayo Clinic. Bladder control problems and nerve disease. Solifenacin succinate was launched in , and has been shown in both short and long term clinical trials to fulfill these requirements. Solifenacin is a competitive M3 receptor antagonist with a long half-life 45—68 hours.

It is available in two dosage strengths namely a 5 or 10 mg once-daily tablet. The efficacy and tolerability of solifenacin for the treatment of all symptoms of OAB has been evaluated in a number of large, placebo controlled, randomized trials. Long-term safety, efficacy, tolerability and persistence with treatment have been established in an open label 40 week continuation study. The prevalence of urinary incontinence has been estimated as Overactive bladder OAB is a symptom complex characterized by urinary urgency, which in turn drives the symptoms of frequency and nocturia with or without urgency incontinence.

It is estimated that one third of OAB patients have urgency incontinence. The presence of urgency incontinence confers significant morbidity above and beyond that of OAB sufferers who are continent Milsom et al ; Stewart et al The primary treatment for OAB and urgency incontinence is a combination of behavioral measures including bladder retraining and antimuscarinic drug therapy.

Despite the proven efficacy of these drugs for the relief of OAB symptoms, side effects impair tolerability and persistence with therapy, dosing regimens are not always simple, efficacy has been questioned, formulary listed dosage strengths are not always optimal and their cost may be prohibitive. The ideal antimuscarinic agent should effectively relieve the symptoms of OAB, with the minimum of side effects; it should be available as a once daily sustained release formulation and in dosage strength that allows easy dose titration for the majority of sufferers.

Solifenacin succinate is a relatively new antimuscarinic which has been shown in both short and long term clinical trials to fulfill these requirements Chapple The aim of this review is to describe the pharmacological properties, and clinical evidence for the use of solifenacin. The etiology of OAB is multifactorial. Although a large proportion of cases are idiopathic, recognized contributing factors include lower urinary tract pathology infection, calculi, and stones , neurological conditions stroke, dementias, multiple sclerosis , systemic conditions congestive heart failure, diabetes mellitus , functional and behavioral conditions caffeine and alcohol consumption, mobility , and side effects of medication Ouslander Involuntary detrusor muscle contractions may be associated with OAB.

Bladder contraction is mediated by acetylcholine; a peripheral neurotransmitter which acts on muscarinic receptors of the detrusor muscle. Of the five known muscarinic receptor subtypes M1—M5 , M2 and M3 receptors are found in the bladder and M3 receptors appears to be the most important for bladder contractility.

The true function of M2 receptors within the bladder is incompletely understood but it is thought that they may oppose sympathetically mediated smooth muscle relaxation or result in the activation of a non-specific cationic channel and activation of potassium channels Hedge et al , It is also thought that in certain disease states such as neurogenic bladder dysfunction the M2 receptors may become more important in mediating detrusor contractions Braverman et al Older antimuscarinic agents such as oxybutynin are neither bladder nor muscarinic receptor subtype selective and are thus associated with greater generalized anticholinergic side effects.

Commonly reported side effects of all antimuscarinic drugs include dry mouth, constipation, blurred vision, gastro-esophageal reflux, and cognitive impairment. Adverse events and multiple daily dosing regimens affect drug tolerability, compliance, and ultimately treatment efficacy. A study in examining the real world as opposed to clinical trial efficacy of predominantly immediate release oxybutynin demonstrated a significant impairment of treatment efficacy due to antimuscarinic side effects.

The slow release preparation of oxybutynin has been shown to be as efficacious as immediate release oxybutynin, however is associated with a much reduced side effect profile. Controlled release preparations are associated with reduced peak serum drug and metabolite levels, which lead to a reduced incidence and severity of adverse events Birns et al Recently concern has arisen regarding the potential for significant cognitive impairment of patients receiving antimuscarinic drugs which exert an effect on M1 receptors and which can cross the blood brain barrier.

Kay et al have shown using name face recognition testing that at a dose of 20 mg once daily oxybutynin has an effect similar to that of 10—20 years of cognitive deterioration. This is of major importance amongst elderly patients who may already exhibit a degree of cognitive impairment and for whom OAB is most prevalent. It is clearly also important among this group of patients who are often on multiple other medications some of which have anticholinergic effects. Kay et al showed that darifenacin which is highly M3 selective and tolterodine which does not cross the blood brain barrier to any significant degree do not affect cognitive function.

It is likely that solifenacin will in similar studies for the same reasons have no effect on cognitive function, and to date cognitive impairment has not been reported with this drug in clinical trials or clinical practice Kay et al Since the voluntary withdrawal of terodiline from the market by Pharmacia in due to concerns regarding cardiac function, in particular the occurrence of Torsades de Pointes in susceptible individuals cardiac function assessment has been an integral part of the safety profile of these drugs.

None of the currently prescribed antimuscarinics used for the treatment of OAB have proven adverse cardiac profiles despite vigorous testing Monahan et al In drug development solifenacin has been shown to have functional selectivity for the bladder over other organs in animal models. In vivo and in vitro studies have shown greater bladder selectivity over salivary gland tissue than tolterodine and oxybutynin. This relative bladder selectivity was the rationale for development of solifenacin in the treatment of OAB Hatanaka et al ; Ohtake et al Solifenacin is a competitive M3 receptor antagonist.

Peak plasma levels are reached 3—8 hours following oral administration. The major metabolite has been found to have similar binding profile to muscarinic receptors as that of solifenacin but less potency Hedge et al Other animal studies have shown that the metabolism of solifenacin is mediated by the liver enzyme CYP3A4 and major metabolites can be detected in the urine feces and bile Onderwater Solifenacin at therapeutic dosage does not appear to inhibit liver cytochrome P isoenzymes and therefore is unlikely to cause pharmacokinetic drug-drug interactions based on CYP dependent metabolism of co-administered drugs.

Solifenacin is not licensed for use in pediatric or pregnant patients Yamanouchi Pharma America Solifenacin is available in 2 dosage strengths namely a 5 or 10 mg once-daily tablet which can be taken with or without food. Phase 3 studies demonstrated a dose-dependent effect in the relief of the common symptoms of OAB namely frequency, urgency, nocturia and urgency incontinence. Patients are normally commenced on 5 mg and titrated according to clinical need and personal preference to 10 mg after 4—6 weeks of treatment.

Side effects are also dose dependent, and include dry mouth, constipation, and blurred vision. It is important to remember that in the original week phase 3 studies upon which initial efficacy and tolerability data were described, patients were randomized without choice to either the 5 mg or 10 mg dosage. Ultimately in the week extension study, patients were all recommenced on 5 mg solifenacin for the first 4 weeks of open label treatment after completion of the original week studies and 4 weeks thereafter offered the option of dose escalation.

There have been several large, randomized clinical trials evaluating the efficacy, safety, tolerability, and persistence with solifenacin Table 1. Each of these trials will be discussed. Clinical trials evaluating the efficacy of solifenacin in the treatment of overactive bladder. Change from baseline in mean number of urgency, all incontinence, urge incontinence episodes. Chapple et al a conducted a phase 2 study to evaluate the effective dose of solifenacin for the treatment of OAB.

This was a multicenter, double blind, placebo and tolterodine controlled trial. Following a single blind 2-week placebo run in, patients were randomized to 4 weeks of either placebo, solifenacin 2. The primary outcome measure of the study was the change from baseline, in the mean number of voids per 24 hours. Secondary outcome measures included the change in volume of urine voided per void, and the mean number of urgency and incontinence episodes per 24 hours.

Quality of life changes were assessed using the 27 item Contilife questionnaire. Results of the study showed a significant reduction in the mean number of voids per 24 hours, and an increase in the mean volume voided per void in the study group taking 5 mg, 10 mg, and 20 g of solifenacin, when compared with the placebo group.

There was no statistically significant reduction in voiding frequency, and volume voided per void in the tolterodine and 2. The efficacy and tolerability of solifenacin was found to be dose dependant, with the greatest reduction in frequency occurring with the 20 mg dose. Neither solifenacin nor tolterodine treated patients experienced a significant reduction in the number of urgency or incontinence episodes.

Quality of life assessment using the Contilife questionnaire showed an improvement in 4 domains daily life activities, emotional consequences, sexuality, and self-image in the solifenacin treated patients, compared with improvement in the daily life activities domain in the tolterodine treated group, when compared with placebo. Dry mouth and constipation were the most commonly reported adverse events. In men, the cause of bladder issues is often an enlarged prostate gland.

Bladder stones or cancer may also cause OAB symptoms. If your doctor can find the cause for your OAB, you can receive targeted treatment for the cause. In turn, you can relieve your OAB symptoms. In these cases, other medications are available.

Here are some of the more common medications used to treat OAB. Drugs can still help ease your symptoms. Some of these drugs work by relaxing your bladder. They stop involuntary contractions that bring on the urge to urinate. Other drugs help strengthen the tissues around your bladder that may have become weak. The stronger tissue can help improve your bladder control.

The largest class of drugs used to treat OAB is anticholinergic drugs. They work by blocking a chemical in your body called acetylcholine. This chemical sends a message to your bladder to contract. By blocking this chemical, these drugs reduce the contractions that cause you to release urine. In studies that compared the drugs, all anticholinergics worked equally as well in treating OAB.

Anticholinergics are sold under different brand names. Some are also available as generic drugs. These medications include:. All of these drugs except for Oxytrol come as either tablets or capsules that you take by mouth. Oxytrol is available as a skin patch. Seniors have the greatest risk of side effects from these drugs.