The Food and Drug Administration has approved solifenacin succinate oral suspension (Vesicare LS) to treat neurogenic detrusor overactivity (NDO) in children ages two years and older; solifenacin succinate tablets were approved in 2004 to treat overactive bladder in adults.

NDO can come from disease, injury to the nervous system or spinal cord, or congenital conditions such as spina bifida. With NDO, the detrusor muscle, which contracts to squeeze the bladder and allow urination, is hyperactive, so that it contracts when there is only a small amount of urine in the bladder, increasing urinary frequency, sense of urgency, and urinary incontinence. Solifenacin succinate is a muscarinic antagonist that has anticholinergic effects, including relaxation of the detrusor muscle.

The efficacy of solifenacin succinate oral suspension was evaluated in two 52-week, open-label, sequential dose titration studies in 95 pediatric patients with NDO. Improved capacity of the bladder and reductions in spontaneous bladder contractions and number of incontinence episodes were found in both studies.

The adverse effects of solifenacin are mostly secondary to its anticholinergic effects. The most common are constipation, dry mouth, and urinary tract infections. Potential serious adverse effects include angioedema and anaphylactic reactions, urinary retention in those with bladder outlet obstruction, worsening of gastrointestinal motility problems, central nervous system reactions (headache, confusion, hallucinations, somnolence, and blurred vision), worsening of narrow-angle glaucoma, and QT prolongation. Contraindications to solifenacin use include gastric retention and uncontrolled narrow-angle glaucoma.

Nurses should teach patients and their families to measure the solifenacin succinate dose accurately using an oral dosing syringe, not a household spoon. The bottle should be shaken well prior to pouring. After taking the drug, the patient should drink a liquid such as water or milk to clear its bitter taste. Parents and caretakers should be taught to seek emergency care if the patient exhibits allergic reactions (hives, rash, swelling; severe itching, swelling of face, mouth, or tongue; or trouble breathing).

For complete prescribing information for solifenacin succinate oral suspension, see http://www.accessdata.fda.gov/drugsatfda_docs/label/2020/209529s000lbl.pdf.