VESIcare LS® is indicated for the treatment of neurogenic detrusor overactivity (NDO) in pediatric patients aged 2 years and older.

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Dosing Information in Pediatric Patients Aged 2 Years and Older

The recommended starting and maximum VESIcare LS oral suspension doses are shown in mL in Table 1. VESIcare LS oral suspension has a concentration of 1 mg/1 mL. The recommended doses are weight-based and are administered once daily. After administration of the recommended starting dose, the dose may be increased to the lowest effective dose but should not exceed the maximum recommended dose.

<div class="scrollingtable"><table cellpadding="5.75pt" width="101.86%"> <caption> <span>Table 1: Once Daily Recommended Dosage According to Patient Body Weight</span> </caption> <col width="39%"/> <col width="32%"/> <col width="29%"/> <tbody class="Headless"> <tr class="First"> <td align="center" class="Botrule Lrule Rrule Toprule" valign="middle"> <p class="First"> <span class="Bold">Weight range</span> </p> </td><td align="center" class="Botrule Lrule Rrule Toprule" valign="middle"> <p class="First"> <span class="Bold">Starting dose </span> </p> </td><td align="center" class="Botrule Lrule Rrule Toprule" valign="middle"> <p class="First"> <span class="Bold">Maximum dose</span> </p> </td> </tr> <tr> <td align="center" class="Botrule Lrule Rrule" valign="middle"> <p class="First">9 kg to 15 kg</p> </td><td align="center" class="Botrule Lrule Rrule" valign="middle"> <p class="First">2 mL</p> </td><td align="center" class="Botrule Lrule Rrule" valign="middle"> <p class="First">4 mL</p> </td> </tr> <tr> <td align="center" class="Botrule Lrule Rrule" valign="middle"> <p class="First">greater than 15 kg to 30 kg</p> </td><td align="center" class="Botrule Lrule Rrule" valign="middle"> <p class="First">3 mL</p> </td><td align="center" class="Botrule Lrule Rrule" valign="middle"> <p class="First">5 mL</p> </td> </tr> <tr> <td align="center" class="Botrule Lrule Rrule" valign="middle"> <p class="First">greater than 30 kg to 45 kg</p> </td><td align="center" class="Botrule Lrule Rrule" valign="middle"> <p class="First">3 mL</p> </td><td align="center" class="Botrule Lrule Rrule" valign="middle"> <p class="First">6 mL</p> </td> </tr> <tr> <td align="center" class="Botrule Lrule Rrule" valign="middle"> <p class="First">greater than 45 kg to 60 kg</p> </td><td align="center" class="Botrule Lrule Rrule" valign="middle"> <p class="First">4 mL</p> </td><td align="center" class="Botrule Lrule Rrule" valign="middle"> <p class="First">8 mL</p> </td> </tr> <tr class="Last"> <td align="center" class="Botrule Lrule Rrule" valign="middle"> <p class="First">greater than 60 kg</p> </td><td align="center" class="Botrule Lrule Rrule" valign="middle"> <p class="First">5 mL</p> </td><td align="center" class="Botrule Lrule Rrule" valign="middle"> <p class="First">10 mL</p> </td> </tr> </tbody> </table></div>

Evaluate patients periodically for potential dose adjustment.

VESIcare LS oral suspension should be taken once daily. Instruct patients or their caregivers that patients should take VESIcare LS orally followed by liquid (e.g., water or milk). Instruct patients to take any missed doses as soon as they remember, unless more than 12 hours have passed since the missed dose. If more than 12 hours have passed, the missed dose can be skipped, and the next dose should be taken at the usual time.

Do not exceed the recommended VESIcare LS oral suspension starting dose in patients with severe renal impairment (CLcr < 30 mL/min/1.73 m2) [see Use in Specific Populations (8.6)].

Do not exceed the recommended VESIcare LS oral suspension starting dose in patients with moderate hepatic impairment (Child-Pugh B). Do not use VESIcare LS in patients with severe hepatic impairment (Child-Pugh C) [see Use in Specific Populations (8.7)].

Do not exceed the recommended VESIcare LS oral suspension starting dose when VESIcare LS is administered with strong CYP3A4 inhibitors such as ketoconazole [see Drug Interactions (7.1)].

Oral Suspension: 5 mg/5 mL (1 mg/mL) of solifenacin succinate in a white to off-white colored suspension.

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VESIcare LS is contraindicated in patients:

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Angioedema of the face, lips, tongue, and/or larynx have been reported with solifenacin succinate. In some cases, angioedema occurred after the first dose, however, cases have been reported to occur hours after the first dose or after multiple doses. Anaphylactic reactions have also been reported in patients treated with solifenacin succinate. Angioedema associated with upper airway swelling and anaphylactic reactions may be life-threatening.

VESIcare LS oral suspension is contraindicated in patients with a known or suspected hypersensitivity to solifenacin succinate [see Contraindications (4)]. If involvement of the tongue, hypopharynx, or larynx occurs, promptly discontinue VESIcare LS oral suspension and provide appropriate therapy and/or measures necessary to ensure a patent airway.

The use of VESIcare LS oral suspension, like other antimuscarinic drugs, in patients with clinically significant bladder outlet obstruction may result in urinary retention. The use of VESIcare LS oral suspension is not recommended in patients with clinically significant bladder outflow obstruction in the absence of clean intermittent catheterization because of the risk of urinary retention.

The use of VESIcare LS oral suspension, like other antimuscarinic drugs, in patients with conditions associated with decreased gastrointestinal motility may result in further decreased gastrointestinal motility. VESIcare LS oral suspension is contraindicated in patients with gastric retention [see Contraindications (4)]. The use of VESIcare LS oral suspension is not recommended in patients with conditions associated with decreased gastrointestinal motility.

Solifenacin succinate is associated with antimuscarinic central nervous system (CNS) adverse reactions [see Adverse Reactions (6.2)]. A variety of CNS antimuscarinic adverse reactions have been reported, including headache, confusion, hallucinations, and somnolence. Monitor patients for signs of antimuscarinic CNS adverse reactions, particularly after beginning treatment or increasing the dose. Advise patients not to drive or operate heavy machinery until they know how VESIcare LS affects them. If a patient experiences antimuscarinic CNS adverse reactions, consider dose reduction or drug discontinuation.

VESIcare LS should be used with caution in patients being treated for narrow-angle glaucoma [see Contraindications (4)].

In a study of the effect of solifenacin succinate on the QT interval conducted in 76 healthy adult women [see Clinical Pharmacology (12.2)], solifenacin succinate 30 mg (three times the largest maximum recommended dose in pediatric patients) was associated with a mean increase in the Fridericia-corrected QT interval of 8 msec (90% CI, 4, 13). The QT prolonging effect appeared less with solifenacin succinate 10 mg than with solifenacin succinate 30 mg, and the effect of solifenacin succinate 30 mg did not appear as large as that of the positive control moxifloxacin at its therapeutic dose.

The use of VESIcare LS is not recommended in patients at high risk of QT prolongation, including patients with a known history of QT prolongation and patients who are taking medications known to prolong the QT interval.

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

The safety of VESIcare LS oral suspension was evaluated in two open-label trials (Studies 1 and 2) [see Clinical Studies (14)]. The two studies included 95 pediatric patients aged 2 to 17 years with neurogenic detrusor overactivity (NDO) who were 53% female, 58% White, 34% Asian and 2% Black. Treatment was initiated at the weight-based starting recommended dose and was titrated up or down in 2.5 mg increments over 12 weeks to the lowest effective dose (not to exceed the maximum recommended dose). Subsequent to the dose titration period, patients continued their optimized dose for a 40-week maintenance period (mean exposure duration 301 days, range 1 to 413 days).

The most commonly reported adverse reactions were constipation, dry mouth, urinary tract infection, abdominal pain, urinalysis bacterial test positive, and somnolence. The incidence of adverse reactions was similar between patients taking the starting recommended dose and patients taking the maximum recommended dose with the exception of constipation, which was reported, in 8.5% of patients taking the maximum recommended dose compared to 0% of patients taking the starting recommended dose.

Table 2 lists the adverse reactions reported in Studies 1 and 2 at an incidence equal to or greater than 1%.

<div class="scrollingtable"><table cellpadding="0pt" width="100%"> <caption> <span>Table 2: Adverse Reactions Reported in ≥ 1% of Neurogenic Detrusor Overactivity (NDO) Patients Aged 2 to 17 Years Taking VESIcare LS Oral Suspension in Studies 1 and 2</span> </caption> <col width="44%"/> <col width="56%"/> <tbody class="Headless"> <tr class="First"> <td align="center" class="Botrule Lrule Rrule Toprule" valign="middle"> <p class="First"> <span class="Bold">Adverse Reaction</span> </p> </td><td align="center" class="Botrule Lrule Rrule Toprule" valign="top"> <p class="First"> <span class="Bold">Percentage (%) of Patients Reporting</span> </p> <p> <span class="Bold">Adverse Reactions</span> </p> <p> <span class="Bold">N=95</span> </p> </td> </tr> <tr> <td class="Botrule Lrule Rrule" valign="top"> <p class="First">Constipation</p> </td><td align="center" class="Botrule Lrule Rrule" valign="top"> <p class="First">7.4</p> </td> </tr> <tr> <td class="Botrule Lrule Rrule" valign="top"> <p class="First">Dry mouth</p> </td><td align="center" class="Botrule Lrule Rrule" valign="top"> <p class="First">3.2</p> </td> </tr> <tr> <td class="Botrule Lrule Rrule" valign="top"> <p class="First">Urinary tract infection</p> </td><td align="center" class="Botrule Lrule Rrule" valign="top"> <p class="First">2.1</p> </td> </tr> <tr> <td class="Botrule Lrule Rrule" valign="top"> <p class="First">Abdominal pain</p> </td><td align="center" class="Botrule Lrule Rrule" valign="top"> <p class="First">1.1</p> </td> </tr> <tr> <td class="Botrule Lrule Rrule" valign="top"> <p class="First">Urinalysis bacterial test positive</p> </td><td align="center" class="Botrule Lrule Rrule" valign="top"> <p class="First">1.1</p> </td> </tr> <tr class="Last"> <td class="Botrule Lrule Rrule" valign="top"> <p class="First">Somnolence</p> </td><td align="center" class="Botrule Lrule Rrule" valign="top"> <p class="First">1.1</p> </td> </tr> </tbody> </table></div>

Adverse reactions reported in ≥ 1% of solifenacin succinate-treated adult patients and at an incidence greater than in placebo-treated adult patients in clinical adult trials were:

Gastrointestinal disorders: dry mouth, constipation, nausea, dyspepsia, upper abdominal pain, vomiting

Infections and infestations: urinary tract infection, influenza, pharyngitis

Nervous system disorders: dizziness

Eye disorders: blurred vision, dry eyes

Renal and urinary disorders: urinary retention

General disorders and administration site conditions: lower limb edema, fatigue

Psychiatric disorders: depression

Respiratory, thoracic and mediastinal disorders: cough

Vascular disorders: hypertension

The following adverse reactions have been identified during post-approval use of solifenacin succinate. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

General disorders and administration site conditions: peripheral edema, hypersensitivity reactions (including angioedema with airway obstruction, rash, pruritus, urticaria, anaphylactic reaction);

Nervous system disorders: dizziness, headache, confusion, hallucinations, delirium, somnolence;

Cardiac disorders: QT prolongation, Torsade de Pointes, atrial fibrillation, tachycardia, palpitations;

Hepatobiliary disorders: liver disorders mostly characterized by abnormal liver function tests, AST (aspartate aminotransferase), ALT (alanine aminotransferase), GGT (gamma-glutamyl transferase);

Renal and urinary disorders: renal impairment, urinary retention;

Metabolism and nutrition disorders: decreased appetite, hyperkalemia;

Skin and subcutaneous tissue disorders: exfoliative dermatitis, erythema multiforme, dry skin;

Eye disorders: glaucoma;

Gastrointestinal disorders: gastroesophageal reflux disease, ileus, vomiting, abdominal pain, dysgeusia, sialadenitis;

Respiratory, thoracic and mediastinal disorders: dysphonia, nasal dryness;

Musculoskeletal and connective tissue disorders: muscular weakness.

Solifenacin is a substrate of CYP3A4. Concomitant use of ketoconazole, a strong CYP3A4 inhibitor, significantly increased the exposure of solifenacin [see Clinical Pharmacology (12.3)]. The dosage of VESIcare LS greater than the starting dose is not recommended when concomitantly used with strong CYP3A4 inhibitors [see Dosage and Administration (2.4)].

Risk Summary

There are no studies with the use of solifenacin succinate in pregnant women or adolescents to inform a drug-associated risk of major birth defects, miscarriages, or adverse maternal or fetal outcomes. No adverse developmental outcomes were observed in animal reproduction studies with oral administration of solifenacin succinate to pregnant mice during the period of organogenesis at a dose resulting in 1.2 times the systemic exposure at the maximum recommended human dose (MRHD) of 10 mg/day. However, administration of doses 3.6 times and greater than the MRHD during organogenesis produced maternal toxicity in the pregnant mice and resulted in developmental toxicity and reduced fetal body weights in offspring [see Data].

In the U.S. general population, the estimated background risk of major birth defects or miscarriage in clinically recognized pregnancies is 2-4% and 15-20%, respectively.

Animal Data

Oral administration of 14C-solifenacin succinate to pregnant mice resulted in the recovery of radiolabel in the fetus indicating that solifenacin-related product can cross the placental barrier. In pregnant mice, administration of solifenacin succinate at a dose of 250 mg/kg/day (7.9 times the systemic exposure at the MRHD of 10 mg), resulted in an increased incidence of cleft palate and increased maternal lethality. Administration of solifenacin succinate to pregnant mice during organogenesis at greater than or equal to 3.6 times (100 mg/kg/day and greater) the systemic exposure at the MRHD, resulted in reduced fetal body weights and reduced maternal body weight gain. No embryo-fetal toxicity or teratogenicity was observed in fetuses from pregnant mice treated with solifenacin succinate at a dose of 30 mg/kg/day (1.2 times the systemic exposure at the MRHD). Administration of solifenacin succinate to pregnant rats and rabbits at a dose of 50 mg/kg/day (< 1 times and 1.8 times the systemic exposure at the MRHD, respectively), resulted in no findings of embryo-fetal toxicity. Oral pre- and post-natal administration of solifenacin succinate at 100 mg/kg/day (3.6 times the systemic exposure at the MRHD) during the period of organogenesis through weaning, resulted in reduced peripartum and postnatal survival, reduced body weight gain by the pups, and delayed physical development (eye opening and vaginal patency). An increase in the percentage of male offspring was also observed in litters from offspring (F2 generation) exposed to maternal doses of 250 mg/kg/day. There were no effects on natural delivery in mice treated with 1.2 times (30 mg/kg/day) the expected systemic exposure at the MRHD.

Risk Summary

There is no information on the presence of solifenacin in human milk, the effects on the breastfed child, or the effects on milk production. Solifenacin is present in mouse milk [see Data]. When a drug is present in animal milk, it is likely that the drug will be present in human milk. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for VESIcare LS and any potential adverse effects on the breastfed child from VESIcare LS or from the underlying maternal condition.

Animal Data

Oral administration of 14C-solifenacin succinate to lactating mice resulted in the recovery of radioactivity in maternal milk. Lactating female mice orally administered solifenacin succinate at a maternally toxic dose of 100 mg/kg/day (3.6 times the systemic exposure at the MRHD) had increased postpartum pup mortality, pups with reduced body weights, or delays in the onset of reflex and physical development. Pups from lactating dams orally administered solifenacin succinate at a dose of 30 mg/kg/day (1.2 times the systemic exposure at the MRHD) had no discernible adverse findings. The concentrations of solifenacin in animal milk does not necessarily predict the concentration of drug in human milk.

The safety and effectiveness of VESIcare LS have been established in pediatric patients aged 2 years and older for the treatment of neurogenic detrusor overactivity (NDO) and the information on this use is discussed throughout the labeling. The safety and effectiveness of VESIcare LS have not been established in pediatric patients less than 2 years of age.

Solifenacin plasma concentrations are greater in adults with severe renal impairment compared to adults with normal renal function [see Clinical Pharmacology (12.3)]. Because increased solifenacin plasma concentrations increase the risk of antimuscarinic adverse reactions, the maximum recommended dose of VESIcare LS oral suspension in pediatric patients 2 years of age and older with severe renal impairment (CLcr < 30 mL/min/1.73 m2) is the starting dose [see Dosage and Administration (2.2)]. The recommended dose in patients with mild or moderate renal impairment is the same as in patients with normal renal function.

Solifenacin plasma concentrations are greater in adults with moderate hepatic impairment compared to adults with normal hepatic function [see Clinical Pharmacology (12.3)]. Because increased solifenacin plasma concentrations increase the risk of antimuscarinic adverse reactions, the maximum recommended dose of VESIcare LS oral suspension in pediatric patients 2 years of age and older with moderate hepatic impairment (Child-Pugh B) is the starting dose [see Dosage and Administration (2.3)] and VESIcare LS oral suspension is not recommended for use in patients with severe hepatic impairment (Child-Pugh C).

Overdosage with VESIcare LS oral suspension can potentially result in severe antimuscarinic effects and should be treated accordingly. The highest dose ingested in an accidental overdose of solifenacin succinate was 280 mg (28 times the maximum dosage) in a 5-hour period in adults. This case was associated with mental status changes. Some cases reported a decrease in the level of consciousness.

{ "type": "p", "children": [], "text": "Overdosage with VESIcare LS oral suspension can potentially result in severe antimuscarinic effects and should be treated accordingly. The highest dose ingested in an accidental overdose of solifenacin succinate was 280 mg (28 times the maximum dosage) in a 5-hour period in adults. This case was associated with mental status changes. Some cases reported a decrease in the level of consciousness." }

Intolerable antimuscarinic adverse reactions (fixed and dilated pupils, blurred vision, failure of heel-to-toe exam, tremors, and dry skin) occurred on day 3 in normal adult volunteers taking 50 mg daily (5 times the maximum recommended dosage) and resolved within 7 days following discontinuation of drug.

{ "type": "p", "children": [], "text": "Intolerable antimuscarinic adverse reactions (fixed and dilated pupils, blurred vision, failure of heel-to-toe exam, tremors, and dry skin) occurred on day 3 in normal adult volunteers taking 50 mg daily (5 times the maximum recommended dosage) and resolved within 7 days following discontinuation of drug." }

The highest overdose reported in a pediatric patient was the accidental ingestion of 95 mg of solifenacin succinate (9.5 times the maximum recommended dosage). The child experienced severe antimuscarinic adverse reactions and was treated with gastric lavage and supportive measures until all antimuscarinic signs and symptoms reversed.

{ "type": "p", "children": [], "text": "The highest overdose reported in a pediatric patient was the accidental ingestion of 95 mg of solifenacin succinate (9.5 times the maximum recommended dosage). The child experienced severe antimuscarinic adverse reactions and was treated with gastric lavage and supportive measures until all antimuscarinic signs and symptoms reversed." }

In the event of overdose with VESIcare LS oral suspension, treat with gastric lavage and appropriate supportive measures. ECG monitoring is also recommended.

{ "type": "p", "children": [], "text": "In the event of overdose with VESIcare LS oral suspension, treat with gastric lavage and appropriate supportive measures. ECG monitoring is also recommended." }

VESIcare LS (solifenacin succinate) oral suspension is a muscarinic receptor antagonist. Chemically, solifenacin succinate is a butanedioic acid compound with (1S)-(3R)-1-azabicyclo[2.2.2]oct-3-yl 3,4-dihydro-1-phenyl-2(1H)-iso-quinolinecarboxylate (1:1) having an empirical formula of C23H26N2O2•C4H6O4, and a molecular weight of 480.55. The structural formula of solifenacin succinate is:

{ "type": "p", "children": [], "text": "VESIcare LS (solifenacin succinate) oral suspension is a muscarinic receptor antagonist. Chemically, solifenacin succinate is a butanedioic acid compound with (1S)-(3R)-1-azabicyclo[2.2.2]oct-3-yl 3,4-dihydro-1-phenyl-2(1H)-iso-quinolinecarboxylate (1:1) having an empirical formula of C23H26N2O2•C4H6O4, and a molecular weight of 480.55. The structural formula of solifenacin succinate is:" }

Solifenacin succinate is a white to pale-yellowish-white crystal or crystalline powder. It is freely soluble at room temperature in water, glacial acetic acid, dimethyl sulfoxide, and methanol.

{ "type": "p", "children": [], "text": "Solifenacin succinate is a white to pale-yellowish-white crystal or crystalline powder. It is freely soluble at room temperature in water, glacial acetic acid, dimethyl sulfoxide, and methanol." }

VESIcare LS contains 1 mg/mL of solifenacin succinate as an oral suspension (1 mg solifenacin succinate is equivalent to 0.75 mg solifenacin). The inactive ingredients are polacrilin potassium, methylparaben, propylparaben, propylene glycol, simethicone emulsion 30%, carbomer homopolymer Type B, xylitol, acesulfame potassium, natural orange flavor, sodium hydroxide, and purified water. VESIcare LS is a white to off-white color aqueous homogenous oral suspension with an orange flavor.

{ "type": "p", "children": [], "text": "VESIcare LS contains 1 mg/mL of solifenacin succinate as an oral suspension (1 mg solifenacin succinate is equivalent to 0.75 mg solifenacin). The inactive ingredients are polacrilin potassium, methylparaben, propylparaben, propylene glycol, simethicone emulsion 30%, carbomer homopolymer Type B, xylitol, acesulfame potassium, natural orange flavor, sodium hydroxide, and purified water. VESIcare LS is a white to off-white color aqueous homogenous oral suspension with an orange flavor." }

Solifenacin is a competitive muscarinic receptor antagonist. Muscarinic receptors play an important role in several major cholinergically mediated functions, including contractions of urinary bladder smooth muscle.

The effect of 10 mg and 30 mg solifenacin succinate (three times the maximum recommended dose) on the QT interval was evaluated in adults at the time of peak plasma concentration of solifenacin in a multi-dose, randomized, double-blind, placebo and positive-controlled (moxifloxacin 400 mg) trial [see Warnings and Precautions (5.6)]. After receiving placebo and moxifloxacin sequentially, adult subjects were randomized to one of two treatment groups. One group (n=51) completed 3 additional sequential periods of dosing with solifenacin succinate 10, 20, and 30 mg while the second group (n=25) in parallel completed a sequence of placebo and moxifloxacin. Study subjects were female volunteers aged 19 to 79 years. The 30 mg dose of solifenacin succinate (three times the highest recommended dose) was chosen for use in this study because this dose results in a solifenacin exposure that covers those observed upon coadministration of 10 mg solifenacin succinate with strong CYP3A4 inhibitors (e.g., ketoconazole, 400 mg). Due to the sequential dose escalating nature of the study, baseline ECG measurements were separated from the final QT assessment (of the 30 mg dose level) by 33 days.

The median difference from baseline in heart rate associated with the 10 and 30 mg doses of solifenacin succinate compared to placebo was -2 and 0 beats/minute, respectively. Because a significant period effect on QTc was observed, the QTc effects were analyzed utilizing the parallel placebo control arm rather than the pre-specified intra-patient analysis. Representative results are shown in Table 3.

<div class="scrollingtable"><table cellpadding="5.75pt" width="100%"> <caption> <span>Table 3: QTc changes in msec (90% CI) from baseline at T<span class="Sub">max</span> (relative to placebo) in adults<a class="Sup" href="#footnote-1" name="footnote-reference-1">*</a></span> </caption> <col width="36%"/> <col width="64%"/> <thead> <tr class="First Last"> <th align="center" class="Botrule Lrule Rrule Toprule" valign="middle"><span class="Bold">Drug/Dose</span></th><th align="center" class="Botrule Lrule Rrule Toprule" valign="top"><span class="Bold">Fridericia Method</span> <br/> <span class="Bold">(using mean difference)</span></th> </tr> </thead> <tfoot> <tr> <td align="left" colspan="2"> <dl class="Footnote"> <dt> <a href="#footnote-reference-1" name="footnote-1">*</a> </dt> <dd>Results displayed are those derived from the parallel design portion of the study and represent the comparison of Group 1 to <br/>time-matched placebo effects in Group 2.</dd> </dl> </td> </tr> </tfoot> <tbody> <tr class="First"> <td align="center" class="Botrule Lrule Rrule Toprule" valign="top"> <p class="First">Solifenacin succinate 10 mg</p> </td><td align="center" class="Botrule Lrule Rrule Toprule" valign="top"> <p class="First">2 (-3, 6)</p> </td> </tr> <tr class="Last"> <td align="center" class="Botrule Lrule Rrule" valign="top"> <p class="First">Solifenacin succinate 30 mg</p> </td><td align="center" class="Botrule Lrule Rrule" valign="top"> <p class="First">8 (4, 13)</p> </td> </tr> </tbody> </table></div>

Moxifloxacin was included as a positive control in this study and, given the length of the study, its effect on the QT interval was evaluated in 3 different sessions. The placebo-subtracted mean changes (90% CI) in QTcF for moxifloxacin in the three sessions were 11 (7, 14), 12 (8, 17), and 16 (12, 21), respectively.

The QT interval prolonging effect of the highest solifenacin succinate dose (three times the maximum therapeutic dose) studied was not as large as that of the positive control moxifloxacin at its recommended dose. However, the confidence intervals overlapped, and this study was not designed to draw direct statistical conclusions between the drugs or the dose levels.

Absorption

After oral administration of VESIcare LS in pediatric patients with neurogenic detrusor overactivity (NDO) aged 2 to 17 years, peak plasma concentrations (Cmax) of solifenacin were reached within 2 to 6 hours after administration (tmax) and, at steady-state, the dose-normalized Cmax ranged from 2.5 - 29 ng/mL/mg. The absolute bioavailability of solifenacin in adults is approximately 90%, with plasma concentrations of solifenacin proportional to the dose administered.

Distribution

Solifenacin is approximately 98% (in vivo) bound to human plasma proteins, principally to α1-acid glycoprotein. Solifenacin is highly distributed to non-CNS tissues, having a median steady-state volume of distribution of 211 L in pediatric neurogenic detrusor overactivity (NDO) patients from 2 to 17 years old.

Elimination

The median elimination half-life of solifenacin is approximately 26 hours in pediatric neurogenic detrusor overactivity (NDO) patients 2 years of age and older.

Specific Populations

Drug Interaction Studies

Interaction studies have only been performed in adults. In pediatric patients 2 years of age and older, metabolism via CYP3A4 is the major route of elimination and the metabolic capacity of the liver is similar.

No increase in tumors was found following the administration of solifenacin succinate to male and female mice for 104 weeks at doses up to 200 mg/kg/day (5 and 9 times, respectively, of the exposure at the maximum recommended human dose [MRHD] of 10 mg), and male and female rats for 104 weeks at doses up to 20 and 15 mg/kg/day, respectively (< 1 times the exposure at the MRHD).

Solifenacin succinate was not mutagenic in the in vitro Salmonella typhimurium or Escherichia coli microbial mutagenicity test or chromosomal aberration test in human peripheral blood lymphocytes with or without metabolic activation or in the in vivo micronucleus test in rats.

Solifenacin succinate had no effect on reproductive function, fertility, or early embryonic development of the fetus in male and female mice treated with 250 mg/kg/day (13 times the exposure at the MRHD) of solifenacin succinate, and in male rats treated with 50 mg/kg/day (< 1 times the exposure at the MRHD) and female rats treated with 100 mg/kg/day (1.7 times the exposure at the MRHD) of solifenacin succinate.

Juvenile Animal Toxicology Data

Dose-related increased mortality without preceding clinical signs occurred in juvenile mice treated before weaning for a duration of 12 weeks, from day 10 after birth, with doses that achieved a pharmacological effect. Animals dosed from postnatal day 10 onwards had higher mortality compared to the mortality in adult mice. No increased frequency in mortality was observed in juvenile mice that were treated after weaning for a duration of 4 weeks, from day 21 after birth onwards. Plasma exposure at postnatal day 10 was higher than in adult mice; the systemic exposure at postnatal day 21 was comparable to the systemic exposure in adult mice.

The efficacy of VESIcare LS oral suspension was evaluated in two 52-week, open-label, baseline-controlled, sequential dose titration studies in a total of 95 pediatric patients 2 years of age and older with neurogenic detrusor overactivity (NDO). Study 1 (NCT01981954) included patients 2 to less than 5 years of age and Study 2 (NCT01565694) included patients 5 to 17 years of age. Entry criteria required that patients had a diagnosis of neurogenic detrusor overactivity (NDO) confirmed by urodynamics demonstrating the presence of involuntary detrusor contractions with detrusor pressure increase greater than 15 cm H2O and that patients or their caregivers practiced clean intermittent catheterization (CIC). VESIcare LS oral suspension was administered once daily. All patients initially received a weight-based starting dose, followed by dose titration to their lowest effective dose, up to a maximum dose. The duration of the dose titration period was up to 12 weeks and this period was followed by a dose maintenance period of at least 40 weeks.

{ "type": "p", "children": [], "text": "The efficacy of VESIcare LS oral suspension was evaluated in two 52-week, open-label, baseline-controlled, sequential dose titration studies in a total of 95 pediatric patients 2 years of age and older with neurogenic detrusor overactivity (NDO). Study 1 (NCT01981954) included patients 2 to less than 5 years of age and Study 2 (NCT01565694) included patients 5 to 17 years of age. Entry criteria required that patients had a diagnosis of neurogenic detrusor overactivity (NDO) confirmed by urodynamics demonstrating the presence of involuntary detrusor contractions with detrusor pressure increase greater than 15 cm H2O and that patients or their caregivers practiced clean intermittent catheterization (CIC). VESIcare LS oral suspension was administered once daily. All patients initially received a weight-based starting dose, followed by dose titration to their lowest effective dose, up to a maximum dose. The duration of the dose titration period was up to 12 weeks and this period was followed by a dose maintenance period of at least 40 weeks." }

In Study 1, a total of 19 patients aged 2 to less than 5 years of age received VESIcare LS oral suspension. Of these, 17 patients completed treatment through week 24 and had adequate urodynamic measurements for evaluation of efficacy. The optimized maintenance dose within this study population included 63% of patients at the maximum dose, 26% of patients at an intermediate dose, and 5% of patients at the starting dose. The study population included 7 males (41%) and 10 females (59%).

{ "type": "p", "children": [], "text": "In Study 1, a total of 19 patients aged 2 to less than 5 years of age received VESIcare LS oral suspension. Of these, 17 patients completed treatment through week 24 and had adequate urodynamic measurements for evaluation of efficacy. The optimized maintenance dose within this study population included 63% of patients at the maximum dose, 26% of patients at an intermediate dose, and 5% of patients at the starting dose. The study population included 7 males (41%) and 10 females (59%)." }

In Study 2, a total of 76 patients aged 5 to 17 years of age received VESIcare LS oral suspension. Of these, 49 patients (24 patients aged 5 to < 12 years and 25 patients aged 12 to 17 years) completed treatment through week 24 and had adequate urodynamic measurements for evaluation of efficacy. The optimized maintenance dose within this study population included 58% of patients at the maximum dose, 15% of patients at an intermediate dose, and 7% of patients at the starting dose. This study population included 24 males (49%) and 25 females (51%).

{ "type": "p", "children": [], "text": "In Study 2, a total of 76 patients aged 5 to 17 years of age received VESIcare LS oral suspension. Of these, 49 patients (24 patients aged 5 to < 12 years and 25 patients aged 12 to 17 years) completed treatment through week 24 and had adequate urodynamic measurements for evaluation of efficacy. The optimized maintenance dose within this study population included 58% of patients at the maximum dose, 15% of patients at an intermediate dose, and 7% of patients at the starting dose. This study population included 24 males (49%) and 25 females (51%)." }

The primary efficacy endpoint was change from baseline in the patients’ maximum cystometric (bladder) capacity (MCC) after 24 weeks of treatment with VESIcare LS oral suspension. As shown in Table 4, an improvement in MCC was observed in patients aged 2 to less than 5 years of age and in patients aged 5 to 17 years of age. The magnitude of the observed changes from baseline in the primary and secondary efficacy endpoints were comparable between patients 5 to less than 12 years of age and patients 12 to 17 years of age.

{ "type": "p", "children": [], "text": "The primary efficacy endpoint was change from baseline in the patients’ maximum cystometric (bladder) capacity (MCC) after 24 weeks of treatment with VESIcare LS oral suspension. As shown in Table 4, an improvement in MCC was observed in patients aged 2 to less than 5 years of age and in patients aged 5 to 17 years of age. The magnitude of the observed changes from baseline in the primary and secondary efficacy endpoints were comparable between patients 5 to less than 12 years of age and patients 12 to 17 years of age." }

The results for the primary efficacy endpoint in the 2 clinical studies of VESIcare LS oral suspension in pediatric patients with neurogenic detrusor overactivity (NDO) are shown in Table 4. Treatment effects were maintained over 52 weeks.

{ "type": "p", "children": [], "text": "The results for the primary efficacy endpoint in the 2 clinical studies of VESIcare LS oral suspension in pediatric patients with neurogenic detrusor overactivity (NDO) are shown in Table 4. Treatment effects were maintained over 52 weeks." }

<div class="scrollingtable"><table cellpadding="5.75pt" width="100%"> <caption> <span>Table 4: Change from Baseline in Maximum Cystometric Capacity (MCC) at 24 Weeks in Pediatric Patients with Neurogenic Detrusor Overactivity (NDO) Treated with VESIcare LS Oral Suspension in Studies 1 and 2</span> </caption> <col width="44%"/> <col width="27%"/> <col width="29%"/> <thead> <tr class="First Last"> <th align="left" class="Botrule Lrule Rrule Toprule" valign="middle"></th><th align="center" class="Botrule Rrule Toprule" valign="top"><span class="Bold">Aged 2 to Less than 5 Years</span> <br/> <span class="Bold">(N=17)</span> <br/> <span class="Bold">Mean (SD)</span></th><th align="center" class="Botrule Rrule Toprule" valign="top"><span class="Bold">Aged 5 to 17 Years</span> <br/> <span class="Bold">(N=49)</span> <br/> <span class="Bold">Mean (SD)</span></th> </tr> </thead> <tfoot> <tr class="First Last"> <td align="left" class="Botrule" colspan="3" valign="top">N is the number of patients who took at least one dose and provided valid values for MCC at baseline and Week 24.</td> </tr> <tr> <td align="left" colspan="3"> <dl class="Footnote"> <dt> <a href="#footnote-reference-2" name="footnote-2">*</a> </dt> <dd>Baseline values for patients aged 5 to 17 years are based on patients who took at least one dose and provided valid baseline <br/>and at least one post-baseline values for MCC.</dd> </dl> </td> </tr> </tfoot> <tbody> <tr class="First"> <td class="Botrule Lrule Rrule Toprule" colspan="3" valign="top"> <p class="First">Maximum Cystometric Capacity (mL)</p> </td> </tr> <tr class="Last"> <td class="Botrule Lrule Rrule" valign="top"> <p class="First">      Baseline</p> <p>      Week 24</p> <p>      Change from baseline</p> </td><td align="center" class="Botrule Rrule" valign="top"> <p class="First">98 (40)</p> <p>137 (37)</p> <p>39 (36)</p> <p>95% CI: 21, 57</p> </td><td align="center" class="Botrule Rrule" valign="top"> <p class="First">224 (133)<a class="Sup" href="#footnote-2" name="footnote-reference-2">*</a> </p> <p>279 (127)</p> <p>57 (108)</p> <p>95% CI: 26, 88</p> </td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table cellpadding=\"5.75pt\" width=\"100%\">\n<caption>\n<span>Table 4: Change from Baseline in Maximum Cystometric Capacity (MCC) at 24 Weeks in Pediatric Patients with Neurogenic Detrusor Overactivity (NDO) Treated with VESIcare LS Oral Suspension in Studies 1 and 2</span>\n</caption>\n<col width=\"44%\"/>\n<col width=\"27%\"/>\n<col width=\"29%\"/>\n<thead>\n<tr class=\"First Last\">\n<th align=\"left\" class=\"Botrule Lrule Rrule Toprule\" valign=\"middle\"></th><th align=\"center\" class=\"Botrule Rrule Toprule\" valign=\"top\"><span class=\"Bold\">Aged 2 to Less than 5 Years</span>\n<br/>\n<span class=\"Bold\">(N=17)</span>\n<br/>\n<span class=\"Bold\">Mean (SD)</span></th><th align=\"center\" class=\"Botrule Rrule Toprule\" valign=\"top\"><span class=\"Bold\">Aged 5 to 17 Years</span>\n<br/>\n<span class=\"Bold\">(N=49)</span>\n<br/>\n<span class=\"Bold\">Mean (SD)</span></th>\n</tr>\n</thead>\n<tfoot>\n<tr class=\"First Last\">\n<td align=\"left\" class=\"Botrule\" colspan=\"3\" valign=\"top\">N is the number of patients who took at least one dose and provided valid values for MCC at baseline and Week 24.</td>\n</tr>\n<tr>\n<td align=\"left\" colspan=\"3\">\n<dl class=\"Footnote\">\n<dt>\n<a href=\"#footnote-reference-2\" name=\"footnote-2\">*</a>\n</dt>\n<dd>Baseline values for patients aged 5 to 17 years are based on patients who took at least one dose and provided valid baseline <br/>and at least one post-baseline values for MCC.</dd>\n</dl>\n</td>\n</tr>\n</tfoot>\n<tbody>\n<tr class=\"First\">\n<td class=\"Botrule Lrule Rrule Toprule\" colspan=\"3\" valign=\"top\">\n<p class=\"First\">Maximum Cystometric Capacity (mL)</p>\n</td>\n</tr>\n<tr class=\"Last\">\n<td class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\">      Baseline</p>\n<p>      Week 24</p>\n<p>      Change from baseline</p>\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">\n<p class=\"First\">98 (40)</p>\n<p>137 (37)</p>\n<p>39 (36)</p>\n<p>95% CI: 21, 57</p>\n</td><td align=\"center\" class=\"Botrule Rrule\" valign=\"top\">\n<p class=\"First\">224 (133)<a class=\"Sup\" href=\"#footnote-2\" name=\"footnote-reference-2\">*</a>\n</p>\n<p>279 (127)</p>\n<p>57 (108)</p>\n<p>95% CI: 26, 88</p>\n</td>\n</tr>\n</tbody>\n</table></div>" }

Results for other urodynamic parameters and from patient urinary diaries, which were secondary efficacy endpoints in Studies 1 and 2, are shown in Tables 5 and 6, respectively.

{ "type": "p", "children": [], "text": "Results for other urodynamic parameters and from patient urinary diaries, which were secondary efficacy endpoints in Studies 1 and 2, are shown in Tables 5 and 6, respectively." }

<div class="scrollingtable"><table cellpadding="0pt" width="100%"> <caption> <span>Table 5: Changes from Baseline in Other Urodynamic Parameters at Week 24 in Pediatric Patients with Neurogenic Detrusor Overactivity (NDO) Treated with VESIcare LS Oral Suspension in Studies 1 and 2</span> </caption> <col width="44%"/> <col width="28%"/> <col width="28%"/> <tfoot> <tr class="First Last"> <td align="left" class="Botrule" colspan="6" valign="top">N is the number of patients who took at least one dose and provided valid values for MCC at baseline and Week 24.</td> </tr> <tr> <td align="left" colspan="3"> <dl class="Footnote"> <dt> <a href="#footnote-reference-3" name="footnote-3">*</a> </dt> <dd>Baseline values for patients aged 5 to 17 years are based on patients who took at least one dose and provided valid baseline <br/>and at least one post-baseline values for MCC.</dd> <dt> <a href="#footnote-reference-4" name="footnote-4">†</a> </dt> <dd>For patients who showed a detrusor contraction during the urodynamic assessment at Week 24.</dd> </dl> </td> </tr> </tfoot> <tbody class="Headless"> <tr class="First"> <td class="Botrule Lrule Rrule Toprule" valign="middle"></td><td align="center" class="Botrule Lrule Rrule Toprule" valign="top"> <p class="First"> <span class="Bold">Aged 2 to Less than 5 Years</span> </p> <p> <span class="Bold">(N=17)</span> </p> <p> <span class="Bold">Mean (SD)</span> </p> </td><td align="center" class="Botrule Lrule Rrule Toprule" valign="top"> <p class="First"> <span class="Bold">Aged 5 to 17 Years</span> </p> <p> <span class="Bold">(N=49)</span> </p> <p> <span class="Bold">Mean (SD)</span> </p> </td> </tr> <tr> <td class="Botrule Lrule Rrule" valign="top"> <p class="First">Bladder Compliance (mL/cm H<span class="Sub">2</span>O)</p> <p>      Baseline</p> <p>      Change from baseline</p> </td><td align="center" class="Botrule Lrule Rrule" valign="top"> <p class="First"> </p> <p>5.7 (4.9)</p> <p>5.8 (7.3)</p> <p>95% CI: 2.2, 9.6</p> </td><td align="center" class="Botrule Lrule Rrule" valign="top"> <p class="First"> </p> <p>14.6 (36.4)<a class="Sup" href="#footnote-3" name="footnote-reference-3">*</a> </p> <p>9.1 (28.6)</p> <p>95% CI: 1.0, 17.2</p> </td> </tr> <tr> <td class="Botrule Lrule Rrule" valign="top"> <p class="First">Number of Overactive Detrusor Contractions</p> <p>(&gt; 15 cm H<span class="Sub">2</span>O)</p> <p>      Baseline</p> <p>      Change from baseline</p> </td><td align="center" class="Botrule Lrule Rrule" valign="top"> <p class="First"> </p> <p> </p> <p>9.9 (11.6)</p> <p>-7.0 (9.3)</p> <p>95% CI: -11.8, -2.2</p> </td><td align="center" class="Botrule Lrule Rrule" valign="top"> <p class="First"> </p> <p> </p> <p>3.9 (4.7)<a class="Sup" href="#footnote-3">*</a> </p> <p>-2.3 (5.1)</p> <p>95% CI: -3.7, -0.8</p> </td> </tr> <tr class="Last"> <td class="Botrule Lrule Rrule" valign="top"> <p class="First">Percentage of Expected Bladder Volume Prior To First Detrusor Contraction &gt; 15 cm H<span class="Sub">2</span>O<a class="Sup" href="#footnote-4" name="footnote-reference-4">†</a> </p> <p>      Baseline (median)</p> <p>      Change from baseline (median)</p> </td><td align="center" class="Botrule Lrule Rrule" valign="top"> <p class="First"> </p> <p> </p> <p>15.8%</p> <p>31.1%</p> </td><td align="center" class="Botrule Lrule Rrule" valign="top"> <p class="First"> </p> <p> </p> <p>27.7%<a class="Sup" href="#footnote-3">*</a> </p> <p>13.3%</p> </td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table cellpadding=\"0pt\" width=\"100%\">\n<caption>\n<span>Table 5: Changes from Baseline in Other Urodynamic Parameters at Week 24 in Pediatric Patients with Neurogenic Detrusor Overactivity (NDO) Treated with VESIcare LS Oral Suspension in Studies 1 and 2</span>\n</caption>\n<col width=\"44%\"/>\n<col width=\"28%\"/>\n<col width=\"28%\"/>\n<tfoot>\n<tr class=\"First Last\">\n<td align=\"left\" class=\"Botrule\" colspan=\"6\" valign=\"top\">N is the number of patients who took at least one dose and provided valid values for MCC at baseline and Week 24.</td>\n</tr>\n<tr>\n<td align=\"left\" colspan=\"3\">\n<dl class=\"Footnote\">\n<dt>\n<a href=\"#footnote-reference-3\" name=\"footnote-3\">*</a>\n</dt>\n<dd>Baseline values for patients aged 5 to 17 years are based on patients who took at least one dose and provided valid baseline <br/>and at least one post-baseline values for MCC.</dd>\n<dt>\n<a href=\"#footnote-reference-4\" name=\"footnote-4\">†</a>\n</dt>\n<dd>For patients who showed a detrusor contraction during the urodynamic assessment at Week 24.</dd>\n</dl>\n</td>\n</tr>\n</tfoot>\n<tbody class=\"Headless\">\n<tr class=\"First\">\n<td class=\"Botrule Lrule Rrule Toprule\" valign=\"middle\"></td><td align=\"center\" class=\"Botrule Lrule Rrule Toprule\" valign=\"top\">\n<p class=\"First\">\n<span class=\"Bold\">Aged 2 to Less than 5 Years</span>\n</p>\n<p>\n<span class=\"Bold\">(N=17)</span>\n</p>\n<p>\n<span class=\"Bold\">Mean (SD)</span>\n</p>\n</td><td align=\"center\" class=\"Botrule Lrule Rrule Toprule\" valign=\"top\">\n<p class=\"First\">\n<span class=\"Bold\">Aged 5 to 17 Years</span>\n</p>\n<p>\n<span class=\"Bold\">(N=49)</span>\n</p>\n<p>\n<span class=\"Bold\">Mean (SD)</span>\n</p>\n</td>\n</tr>\n<tr>\n<td class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\">Bladder Compliance (mL/cm H<span class=\"Sub\">2</span>O)</p>\n<p>      Baseline</p>\n<p>      Change from baseline</p>\n</td><td align=\"center\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\"> </p>\n<p>5.7 (4.9)</p>\n<p>5.8 (7.3)</p>\n<p>95% CI: 2.2, 9.6</p>\n</td><td align=\"center\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\"> </p>\n<p>14.6 (36.4)<a class=\"Sup\" href=\"#footnote-3\" name=\"footnote-reference-3\">*</a>\n</p>\n<p>9.1 (28.6)</p>\n<p>95% CI: 1.0, 17.2</p>\n</td>\n</tr>\n<tr>\n<td class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\">Number of Overactive Detrusor Contractions</p>\n<p>(&gt; 15 cm H<span class=\"Sub\">2</span>O)</p>\n<p>      Baseline</p>\n<p>      Change from baseline</p>\n</td><td align=\"center\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\"> </p>\n<p> </p>\n<p>9.9 (11.6)</p>\n<p>-7.0 (9.3)</p>\n<p>95% CI: -11.8, -2.2</p>\n</td><td align=\"center\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\"> </p>\n<p> </p>\n<p>3.9 (4.7)<a class=\"Sup\" href=\"#footnote-3\">*</a>\n</p>\n<p>-2.3 (5.1)</p>\n<p>95% CI: -3.7, -0.8</p>\n</td>\n</tr>\n<tr class=\"Last\">\n<td class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\">Percentage of Expected Bladder Volume Prior To First Detrusor Contraction &gt; 15 cm H<span class=\"Sub\">2</span>O<a class=\"Sup\" href=\"#footnote-4\" name=\"footnote-reference-4\">†</a>\n</p>\n<p>      Baseline (median)</p>\n<p>      Change from baseline (median)</p>\n</td><td align=\"center\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\"> </p>\n<p> </p>\n<p>15.8%</p>\n<p>31.1%</p>\n</td><td align=\"center\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\"> </p>\n<p> </p>\n<p>27.7%<a class=\"Sup\" href=\"#footnote-3\">*</a>\n</p>\n<p>13.3%</p>\n</td>\n</tr>\n</tbody>\n</table></div>" }

<div class="scrollingtable"><table cellpadding="0pt" width="100%"> <caption> <span>Table 6: Changes from Baseline in Maximum Catheterized Urine Volume and Number of Incontinence Episodes at Week 24 in Pediatric Patients with Neurogenic Detrusor Overactivity (NDO) Treated with VESIcare LS Oral Suspension in Studies 1 and 2</span> </caption> <col width="44%"/> <col width="28%"/> <col width="28%"/> <tfoot> <tr> <td align="left" colspan="3"> <dl class="Footnote"> <dt> <a href="#footnote-reference-5" name="footnote-5">*</a> </dt> <dd>For patients aged 2 to less than 5 years, the number of incontinence episodes per 24 hours was evaluated as the number of periods <br/>between clean intermittent catheterizations with incontinence per 24 hours.</dd> </dl> </td> </tr> </tfoot> <tbody class="Headless"> <tr class="First"> <td class="Botrule Lrule Rrule Toprule" valign="middle"></td><td align="center" class="Botrule Lrule Rrule Toprule" valign="top"> <p class="First"> <span class="Bold">Aged 2 to Less than 5 Years</span> </p> <p> <span class="Bold">(N=17)</span> </p> </td><td align="center" class="Botrule Lrule Rrule Toprule" valign="top"> <p class="First"> <span class="Bold">Aged 5 to 17 Years</span> </p> <p> <span class="Bold">(N=49)</span> </p> </td> </tr> <tr> <td class="Botrule Lrule Rrule" valign="top"> <p class="First">Maximum Catheterized Urine Volume/Day (mL)</p> <p>      Baseline</p> <p>      Change from baseline</p> </td><td align="center" class="Botrule Lrule Rrule" valign="top"> <p class="First"> </p> <p>77 (43.0)</p> <p>45 (54.7)</p> <p>95% CI: 15, 76</p> </td><td align="center" class="Botrule Lrule Rrule" valign="top"> <p class="First"> </p> <p>204 (92.7)</p> <p>68 (88.1)</p> <p>95% CI: 43, 92</p> </td> </tr> <tr class="Last"> <td class="Botrule Lrule Rrule" valign="top"> <p class="First">Number of Incontinence Episodes/24 hours<a class="Sup" href="#footnote-5" name="footnote-reference-5">*</a> </p> <p>      Baseline</p> <p>      Change from baseline</p> </td><td align="center" class="Botrule Lrule Rrule" valign="top"> <p class="First"> </p> <p>3.9 (0.8)</p> <p>-1.6 (1.2)</p> <p>95% CI: -2.3, -0.9</p> </td><td align="center" class="Botrule Lrule Rrule" valign="top"> <p class="First"> </p> <p>3.4 (2.9)</p> <p>-1.6 (2.0)</p> <p>95% CI: -2.2, -1.0</p> </td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table cellpadding=\"0pt\" width=\"100%\">\n<caption>\n<span>Table 6: Changes from Baseline in Maximum Catheterized Urine Volume and Number of Incontinence Episodes at Week 24 in Pediatric Patients with Neurogenic Detrusor Overactivity (NDO) Treated with VESIcare LS Oral Suspension in Studies 1 and 2</span>\n</caption>\n<col width=\"44%\"/>\n<col width=\"28%\"/>\n<col width=\"28%\"/>\n<tfoot>\n<tr>\n<td align=\"left\" colspan=\"3\">\n<dl class=\"Footnote\">\n<dt>\n<a href=\"#footnote-reference-5\" name=\"footnote-5\">*</a>\n</dt>\n<dd>For patients aged 2 to less than 5 years, the number of incontinence episodes per 24 hours was evaluated as the number of periods <br/>between clean intermittent catheterizations with incontinence per 24 hours.</dd>\n</dl>\n</td>\n</tr>\n</tfoot>\n<tbody class=\"Headless\">\n<tr class=\"First\">\n<td class=\"Botrule Lrule Rrule Toprule\" valign=\"middle\"></td><td align=\"center\" class=\"Botrule Lrule Rrule Toprule\" valign=\"top\">\n<p class=\"First\">\n<span class=\"Bold\">Aged 2 to Less than 5 Years</span>\n</p>\n<p>\n<span class=\"Bold\">(N=17)</span>\n</p>\n</td><td align=\"center\" class=\"Botrule Lrule Rrule Toprule\" valign=\"top\">\n<p class=\"First\">\n<span class=\"Bold\">Aged 5 to 17 Years</span>\n</p>\n<p>\n<span class=\"Bold\">(N=49)</span>\n</p>\n</td>\n</tr>\n<tr>\n<td class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\">Maximum Catheterized Urine Volume/Day (mL)</p>\n<p>      Baseline</p>\n<p>      Change from baseline</p>\n</td><td align=\"center\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\"> </p>\n<p>77 (43.0)</p>\n<p>45 (54.7)</p>\n<p>95% CI: 15, 76</p>\n</td><td align=\"center\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\"> </p>\n<p>204 (92.7)</p>\n<p>68 (88.1)</p>\n<p>95% CI: 43, 92</p>\n</td>\n</tr>\n<tr class=\"Last\">\n<td class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\">Number of Incontinence Episodes/24 hours<a class=\"Sup\" href=\"#footnote-5\" name=\"footnote-reference-5\">*</a>\n</p>\n<p>      Baseline</p>\n<p>      Change from baseline</p>\n</td><td align=\"center\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\"> </p>\n<p>3.9 (0.8)</p>\n<p>-1.6 (1.2)</p>\n<p>95% CI: -2.3, -0.9</p>\n</td><td align=\"center\" class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\"> </p>\n<p>3.4 (2.9)</p>\n<p>-1.6 (2.0)</p>\n<p>95% CI: -2.2, -1.0</p>\n</td>\n</tr>\n</tbody>\n</table></div>" }

VESIcare LS is supplied as a white to off-white colored 5 mg/5 mL (1 mg/mL) aqueous oral suspension of solifenacin succinate, packaged in 150 mL amber polyethylene terephthalate (PET) bottles, which are capped with child-resistant high-density polyethylene-polypropylene caps with a pulp and vinyl seal liner.

{ "type": "p", "children": [], "text": "VESIcare LS is supplied as a white to off-white colored 5 mg/5 mL (1 mg/mL) aqueous oral suspension of solifenacin succinate, packaged in 150 mL amber polyethylene terephthalate (PET) bottles, which are capped with child-resistant high-density polyethylene-polypropylene caps with a pulp and vinyl seal liner." }

Carton contains one bottle (NDC 51248-250-99)

{ "type": "p", "children": [], "text": "Carton contains one bottle (NDC 51248-250-99)" }

Store at 20°C to 25°C (68°F to 77°F) with excursions permitted from 15°C to 30°C (59°F to 86°F) [see USP Controlled Room Temperature]. Store in original bottle to protect from degradation. Dispense in a tight, light-resistant container. Discard any unused product 28 days after opening the original bottle.

{ "type": "p", "children": [], "text": "Store at 20°C to 25°C (68°F to 77°F) with excursions permitted from 15°C to 30°C (59°F to 86°F) [see USP Controlled Room Temperature]. Store in original bottle to protect from degradation. Dispense in a tight, light-resistant container. Discard any unused product 28 days after opening the original bottle." }

Advise the patient and/or caregiver to read the FDA-approved patient labeling (Patient Information).

{ "type": "p", "children": [], "text": "Advise the patient and/or caregiver to read the FDA-approved patient labeling (Patient Information)." }

Angioedema and Anaphylactic Reactions

{ "type": "p", "children": [], "text": "\nAngioedema and Anaphylactic Reactions\n" }

Inform patients and/or their caregivers that angioedema and anaphylactic reactions have been reported in patients treated with solifenacin succinate. Angioedema and anaphylactic reactions may be life-threatening. Advise patients to promptly discontinue VESIcare LS therapy and seek immediate attention if they experience edema of the tongue or laryngopharynx, or difficulty breathing [see Contraindications (4) and Warnings and Precautions (5.1)].

{ "type": "p", "children": [], "text": "Inform patients and/or their caregivers that angioedema and anaphylactic reactions have been reported in patients treated with solifenacin succinate. Angioedema and anaphylactic reactions may be life-threatening. Advise patients to promptly discontinue VESIcare LS therapy and seek immediate attention if they experience edema of the tongue or laryngopharynx, or difficulty breathing [see Contraindications (4) and Warnings and Precautions (5.1)]." }

Urinary Retention

{ "type": "p", "children": [], "text": "\nUrinary Retention\n" }

Inform patients and/or their caregivers that VESIcare LS may cause urinary retention in patients with conditions associated with bladder outlet obstruction [see Warnings and Precautions (5.2)].

{ "type": "p", "children": [], "text": "Inform patients and/or their caregivers that VESIcare LS may cause urinary retention in patients with conditions associated with bladder outlet obstruction [see Warnings and Precautions (5.2)]." }

Gastrointestinal Disorders

{ "type": "p", "children": [], "text": "\nGastrointestinal Disorders\n" }

Inform patients and/or their caregivers that VESIcare LS oral suspension may cause further decrease in gastrointestinal motility in patients with conditions associated with decreased gastrointestinal motility. VESIcare LS oral suspension has been associated with constipation and dry mouth. Advise patients and/or their caregivers to contact their health care providers if they experience severe abdominal pain or become constipated for 3 or more days [see Warnings and Precautions (5.3)].

{ "type": "p", "children": [], "text": "Inform patients and/or their caregivers that VESIcare LS oral suspension may cause further decrease in gastrointestinal motility in patients with conditions associated with decreased gastrointestinal motility. VESIcare LS oral suspension has been associated with constipation and dry mouth. Advise patients and/or their caregivers to contact their health care providers if they experience severe abdominal pain or become constipated for 3 or more days [see Warnings and Precautions (5.3)]." }

Central Nervous System Effects

{ "type": "p", "children": [], "text": "\nCentral Nervous System Effects\n" }

Because VESIcare LS oral suspension, like other antimuscarinic agents, may cause central nervous system effects or blurred vision, advise patients and/or caregivers to exercise caution in decisions to engage in potentially dangerous activities until the drug’s effect on the patient has been determined [see Warnings and Precautions (5.4)].

{ "type": "p", "children": [], "text": "Because VESIcare LS oral suspension, like other antimuscarinic agents, may cause central nervous system effects or blurred vision, advise patients and/or caregivers to exercise caution in decisions to engage in potentially dangerous activities until the drug’s effect on the patient has been determined [see Warnings and Precautions (5.4)]." }

Narrow-Angle Glaucoma

{ "type": "p", "children": [], "text": "\nNarrow-Angle Glaucoma\n" }

Inform patients and/or caregivers that VESIcare LS, like other antimuscarinics, may cause worsening of the glaucoma condition in patients with narrow-angle glaucoma [see Warnings and Precautions (5.5)].

{ "type": "p", "children": [], "text": "Inform patients and/or caregivers that VESIcare LS, like other antimuscarinics, may cause worsening of the glaucoma condition in patients with narrow-angle glaucoma [see Warnings and Precautions (5.5)]." }

Dry Skin

{ "type": "p", "children": [], "text": "\nDry Skin\n" }

Inform patients and/or caregivers that VESIcare LS, like other antimuscarinics, may cause dry skin due to decreased sweating. Heat prostration due to decreased sweating can occur when antimuscarinic drugs are used in a hot environment [see Adverse Reactions (6.2)].

{ "type": "p", "children": [], "text": "Inform patients and/or caregivers that VESIcare LS, like other antimuscarinics, may cause dry skin due to decreased sweating. Heat prostration due to decreased sweating can occur when antimuscarinic drugs are used in a hot environment [see Adverse Reactions (6.2)]." }

Administration Instructions

{ "type": "p", "children": [], "text": "\nAdministration Instructions\n" }

Ensure that the patient has an appropriate measuring device and instructions for measuring the correct dose. Instruct patients or their caregivers to use an oral dosing syringe to correctly measure the prescribed amount of VESIcare LS oral suspension. Inform patients that oral dosing syringes may be obtained from their pharmacy. Instruct patients or their caregivers to shake the bottle well prior to administration of each dose and that patients should take VESIcare LS orally followed by liquid (e.g., water or milk) 1 time a day. Inform patients or their caregivers that simultaneous use of VESIcare LS oral suspension with food and/or other liquids may result in a bitter taste.

{ "type": "p", "children": [], "text": "Ensure that the patient has an appropriate measuring device and instructions for measuring the correct dose. Instruct patients or their caregivers to use an oral dosing syringe to correctly measure the prescribed amount of VESIcare LS oral suspension. Inform patients that oral dosing syringes may be obtained from their pharmacy. Instruct patients or their caregivers to shake the bottle well prior to administration of each dose and that patients should take VESIcare LS orally followed by liquid (e.g., water or milk) 1 time a day. Inform patients or their caregivers that simultaneous use of VESIcare LS oral suspension with food and/or other liquids may result in a bitter taste." }

{ "type": "", "children": [], "text": "" }

Instruct patients or their caregivers that patients should take VESIcare LS orally followed by liquid (e.g., water or milk). Instruct patients to take any missed doses as soon as they remember, unless more than 12 hours have passed since the missed dose. If more than 12 hours have passed, the missed dose can be skipped and the next dose should be taken at the usual time.

{ "type": "p", "children": [], "text": "Instruct patients or their caregivers that patients should take VESIcare LS orally followed by liquid (e.g., water or milk). Instruct patients to take any missed doses as soon as they remember, unless more than 12 hours have passed since the missed dose. If more than 12 hours have passed, the missed dose can be skipped and the next dose should be taken at the usual time." }

Marketed and Distributed by: Astellas Pharma US, Inc. Northbrook, IL 60062

{ "type": "p", "children": [], "text": "Marketed and Distributed by:\nAstellas Pharma US, Inc.\nNorthbrook, IL 60062" }

VESIcare LS is a registered trademark of Astellas US LLC. © 2004 – 2022 Astellas Pharma US, Inc. 366572-VES

{ "type": "p", "children": [], "text": "VESIcare LS is a registered trademark of Astellas US LLC.\n© 2004 – 2022 Astellas Pharma US, Inc.\n366572-VES" }

<div class="scrollingtable"><table width="99.02%"> <col width="100%"/> <tbody class="Headless"> <tr class="First"> <td align="center" class="Botrule Lrule Rrule Toprule" valign="top"> <p class="First"> <span class="Bold">Patient Information</span> </p> <p> <span class="Bold">VESIcare LS</span><span class="Bold"><span class="Sup">®</span></span><span class="Bold"> (VES-ih-care LS)</span> </p> <p> <span class="Bold">(solifenacin succinate)</span> </p> <p> <span class="Bold">oral suspension</span> </p> </td> </tr> <tr> <td class="Botrule Lrule Rrule" valign="top"> <p class="First"> <span class="Bold">What is VESIcare LS?</span> </p> <dl> <dt>•</dt> <dd>VESIcare LS is a prescription medicine for <span class="Bold">children aged 2 years of age and older</span> with a condition called <span class="Bold">neurogenic detrusor overactivity.</span> It is used to increase the amount of urine your bladder can hold and reduce urine leakage.</dd> </dl> </td> </tr> <tr> <td class="Botrule Lrule Rrule" valign="top"> <p class="First"> <span class="Bold">Who should not take VESIcare LS?</span> </p> <p> <span class="Bold">Do not</span> take VESIcare LS if you:</p> <dl> <dt>•</dt> <dd>have delayed or slow emptying of your stomach (gastric retention).</dd> <dt>•</dt> <dd>have an eye problem called “uncontrolled narrow-angle glaucoma”.</dd> <dt>•</dt> <dd>are allergic to solifenacin succinate or any of the ingredients in VESIcare LS. See the end of this leaflet for a complete list of ingredients.</dd> </dl> </td> </tr> <tr> <td class="Botrule Lrule Rrule" valign="top"> <p class="First"> <span class="Bold">Before you take VESIcare LS, tell your doctor if you have any medical conditions, including if you:</span> </p> <dl> <dt>•</dt> <dd>have any stomach or intestinal problems or problems with constipation.</dd> <dt>•</dt> <dd>have trouble emptying your bladder or you have a weak urine stream.</dd> <dt>•</dt> <dd>have liver problems.</dd> <dt>•</dt> <dd>have kidney problems.</dd> <dt>•</dt> <dd>have a heart problem called “QT prolongation”.</dd> <dt>•</dt> <dd>are pregnant or plan to become pregnant. It is not known if VESIcare LS will harm your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant.</dd> <dt>•</dt> <dd>are breastfeeding or plan to breastfeed. It is not known if VESIcare LS passes into your breast milk. Talk to your doctor about the best way to feed your baby if you take VESIcare LS.</dd> </dl> <p> <span class="Bold">Tell your doctor about all the medicines you take,</span> including prescription and over-the-counter medicines, vitamins, and herbal supplements. VESIcare LS may affect the way other medicines work, and other medicines may affect how VESIcare LS works.</p> </td> </tr> <tr> <td class="Botrule Lrule Rrule" valign="top"> <p class="First"> <span class="Bold">How should I take VESIcare LS?</span> </p> <dl> <dt>•</dt> <dd>Take VESIcare LS exactly as your doctor tells you to take it.</dd> <dt>•</dt> <dd>If you have questions about dosing, talk to your pharmacist for instructions on how to prepare and administer VESIcare LS.</dd> <dt>•</dt> <dd>Shake the bottle well before taking each dose.</dd> <dt>•</dt> <dd>You should take VESIcare LS by mouth 1 time a day.</dd> <dt>•</dt> <dd>Use an oral dosing device, such as an oral syringe, to correctly measure your dose. Ask your pharmacist for an appropriate oral dosing device.</dd> <dt>•</dt> <dd>You should take VESIcare LS followed by water or milk. Avoid taking VESIcare LS at the same time with food or other drinks, as this may result in a bitter taste.</dd> <dt>•</dt> <dd>Do not take 2 doses of VESIcare LS the same day. If you miss a dose of VESIcare LS, take it as soon as possible. If it has been 12 hours since taking the last dose of VESIcare LS, skip that dose and take the next dose at the usual time.</dd> <dt>•</dt> <dd>If you take too much VESIcare LS, call your doctor or go to the nearest hospital emergency room right away.</dd> </dl> </td> </tr> <tr> <td class="Botrule Lrule Rrule" valign="top"> <p class="First"> <span class="Bold">What should I avoid while taking VESIcare LS?</span> </p> <p>VESIcare LS can cause blurred vision or drowsiness. Do not drive or operate heavy machinery until you know how VESIcare LS affects you.</p> </td> </tr> <tr> <td class="Botrule Lrule Rrule Toprule" valign="top"> <p class="First"> <span class="Bold">What are the possible side effects of VESIcare LS?</span><span class="Bold"></span> </p> <p>VESIcare LS may cause serious side effects including:</p> <dl> <dt>•</dt> <dd> <span class="Bold">Serious allergic reaction.</span> Stop taking VESIcare LS and get medical help right away if you have:<dl> <dt>•</dt> <dd>hives, skin rash, or swelling</dd> <dt>•</dt> <dd>severe itching</dd> <dt>•</dt> <dd>swelling of your face, mouth, or tongue</dd> <dt>•</dt> <dd>trouble breathing</dd> </dl> </dd> <dt>•</dt> <dd> <span class="Bold">Central Nervous System (CNS) effects.</span> Talk to your doctor right away if you get any of these side effects:<dl> <dt>•</dt> <dd>headache</dd> <dt>•</dt> <dd>confusion</dd> <dt>•</dt> <dd>hear voices, see things, or sense things that are not there (hallucinations)</dd> <dt>•</dt> <dd>sleepiness</dd> </dl> </dd> </dl> <p>The most common side effects of VESIcare LS include:</p> <dl> <dt>•</dt> <dd>constipation. Call your doctor if you get severe stomach area (abdominal) pain or become constipated for 3 or more days.</dd> <dt>•</dt> <dd>dry mouth</dd> <dt>•</dt> <dd>urinary tract infection</dd> </dl> <p>Other side effects have been observed with anticholinergic medicines such as VESIcare LS and may include:</p> <dl> <dt>•</dt> <dd>blurred vision</dd> <dt>•</dt> <dd>dry eyes</dd> <dt>•</dt> <dd>dry skin due to decreased sweating. Heat exhaustion or heat stroke due to decreased sweating can happen when anticholinergic medications such as VESIcare LS are used in hot environments. Symptoms may include:<dl> <dt>•</dt> <dd>decreased sweating</dd> <dt>•</dt> <dd>dizziness</dd> <dt>•</dt> <dd>tiredness</dd> <dt>•</dt> <dd>nausea</dd> <dt>•</dt> <dd>increase in body temperature</dd> </dl> </dd> </dl> <p>Tell your doctor if you have any side effect that bothers you or that does not go away.</p> <p>These are not all the possible side effects of VESIcare LS. For more information, ask your doctor or pharmacist.</p> <p> <span class="Bold">Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.</span> </p> </td> </tr> <tr> <td class="Botrule Lrule Rrule" valign="top"> <p class="First"> <span class="Bold">How should I store VESIcare LS?</span> </p> <dl> <dt>•</dt> <dd>Store VESIcare LS at room temperature, between 68°F to 77°F (20°C to 25°C) with the cap closed.</dd> <dt>•</dt> <dd>Store VESIcare LS in the original bottle.</dd> <dt>•</dt> <dd>Throw away VESIcare LS oral suspension 28 days (4 weeks) after first opening.</dd> <dt>•</dt> <dd>Safely throw away VESIcare LS that has expired or is unused.</dd> </dl> <p> <span class="Bold">Keep VESIcare LS and all medicines out of the reach of children.</span> </p> </td> </tr> <tr> <td class="Botrule Lrule Rrule" valign="top"> <p class="First"> <span class="Bold">General information about the safe and effective use of VESIcare LS.</span> </p> <p>Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use VESIcare LS for a condition for which it was not prescribed. Do not give VESIcare LS to other people, even if they have the same symptoms you have. It may harm them.</p> <p>This leaflet summarizes the most important information about VESIcare LS. If you would like more information, talk with your doctor. You can ask your doctor or pharmacist for information about VESIcare LS that is written for health professionals.</p> </td> </tr> <tr> <td class="Botrule Lrule Rrule Toprule" valign="top"> <p class="First"> <span class="Bold">What are the ingredients in VESIcare LS?</span> </p> <p> <span class="Bold">Active ingredient:</span> solifenacin succinate</p> <p> <span class="Bold">Inactive ingredients:</span> polacrilin potassium, methylparaben, propylparaben, propylene glycol, simethicone emulsion 30%, carbomer homopolymer Type B, xylitol, acesulfame potassium, natural orange flavor, sodium hydroxide, and purified water.</p> </td> </tr> <tr class="Last"> <td class="Botrule Lrule Rrule Toprule" valign="top"> <p class="First">Marketed and Distributed by:</p> <p> <span class="Bold">Astellas Pharma US, Inc.</span> </p> <p>Northbrook, IL 60062<br/> <br/>VESIcare LS<span class="Sup"></span> is a registered trademark of Astellas US LLC.<br/> <br/>© 2004 – 2022 Astellas Pharma US, Inc.<br/> <br/>For more information, call 1-800-727-7003.<br/> <br/>366572-VES</p> </td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table width=\"99.02%\">\n<col width=\"100%\"/>\n<tbody class=\"Headless\">\n<tr class=\"First\">\n<td align=\"center\" class=\"Botrule Lrule Rrule Toprule\" valign=\"top\">\n<p class=\"First\">\n<span class=\"Bold\">Patient Information</span>\n</p>\n<p>\n<span class=\"Bold\">VESIcare LS</span><span class=\"Bold\"><span class=\"Sup\">®</span></span><span class=\"Bold\"> (VES-ih-care LS)</span>\n</p>\n<p>\n<span class=\"Bold\">(solifenacin succinate)</span>\n</p>\n<p>\n<span class=\"Bold\">oral suspension</span>\n</p>\n</td>\n</tr>\n<tr>\n<td class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\">\n<span class=\"Bold\">What is VESIcare LS?</span>\n</p>\n<dl>\n<dt>•</dt>\n<dd>VESIcare LS is a prescription medicine for <span class=\"Bold\">children aged 2 years of age and older</span> with a condition called <span class=\"Bold\">neurogenic detrusor overactivity.</span> It is used to increase the amount of urine your bladder can hold and reduce urine leakage.</dd>\n</dl>\n</td>\n</tr>\n<tr>\n<td class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\">\n<span class=\"Bold\">Who should not take VESIcare LS?</span>\n</p>\n<p>\n<span class=\"Bold\">Do not</span> take VESIcare LS if you:</p>\n<dl>\n<dt>•</dt>\n<dd>have delayed or slow emptying of your stomach (gastric retention).</dd>\n<dt>•</dt>\n<dd>have an eye problem called “uncontrolled narrow-angle glaucoma”.</dd>\n<dt>•</dt>\n<dd>are allergic to solifenacin succinate or any of the ingredients in VESIcare LS. See the end of this leaflet for a complete list of ingredients.</dd>\n</dl>\n</td>\n</tr>\n<tr>\n<td class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\">\n<span class=\"Bold\">Before you take VESIcare LS, tell your doctor if you have any medical conditions, including if you:</span>\n</p>\n<dl>\n<dt>•</dt>\n<dd>have any stomach or intestinal problems or problems with constipation.</dd>\n<dt>•</dt>\n<dd>have trouble emptying your bladder or you have a weak urine stream.</dd>\n<dt>•</dt>\n<dd>have liver problems.</dd>\n<dt>•</dt>\n<dd>have kidney problems.</dd>\n<dt>•</dt>\n<dd>have a heart problem called “QT prolongation”.</dd>\n<dt>•</dt>\n<dd>are pregnant or plan to become pregnant. It is not known if VESIcare LS will harm your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant.</dd>\n<dt>•</dt>\n<dd>are breastfeeding or plan to breastfeed. It is not known if VESIcare LS passes into your breast milk. Talk to your doctor about the best way to feed your baby if you take VESIcare LS.</dd>\n</dl>\n<p>\n<span class=\"Bold\">Tell your doctor about all the medicines you take,</span> including prescription and over-the-counter medicines, vitamins, and herbal supplements. VESIcare LS may affect the way other medicines work, and other medicines may affect how VESIcare LS works.</p>\n</td>\n</tr>\n<tr>\n<td class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\">\n<span class=\"Bold\">How should I take VESIcare LS?</span>\n</p>\n<dl>\n<dt>•</dt>\n<dd>Take VESIcare LS exactly as your doctor tells you to take it.</dd>\n<dt>•</dt>\n<dd>If you have questions about dosing, talk to your pharmacist for instructions on how to prepare and administer VESIcare LS.</dd>\n<dt>•</dt>\n<dd>Shake the bottle well before taking each dose.</dd>\n<dt>•</dt>\n<dd>You should take VESIcare LS by mouth 1 time a day.</dd>\n<dt>•</dt>\n<dd>Use an oral dosing device, such as an oral syringe, to correctly measure your dose. Ask your pharmacist for an appropriate oral dosing device.</dd>\n<dt>•</dt>\n<dd>You should take VESIcare LS followed by water or milk. Avoid taking VESIcare LS at the same time with food or other drinks, as this may result in a bitter taste.</dd>\n<dt>•</dt>\n<dd>Do not take 2 doses of VESIcare LS the same day. If you miss a dose of VESIcare LS, take it as soon as possible. If it has been 12 hours since taking the last dose of VESIcare LS, skip that dose and take the next dose at the usual time.</dd>\n<dt>•</dt>\n<dd>If you take too much VESIcare LS, call your doctor or go to the nearest hospital emergency room right away.</dd>\n</dl>\n</td>\n</tr>\n<tr>\n<td class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\">\n<span class=\"Bold\">What should I avoid while taking VESIcare LS?</span>\n</p>\n<p>VESIcare LS can cause blurred vision or drowsiness. Do not drive or operate heavy machinery until you know how VESIcare LS affects you.</p>\n</td>\n</tr>\n<tr>\n<td class=\"Botrule Lrule Rrule Toprule\" valign=\"top\">\n<p class=\"First\">\n<span class=\"Bold\">What are the possible side effects of VESIcare LS?</span><span class=\"Bold\"></span>\n</p>\n<p>VESIcare LS may cause serious side effects including:</p>\n<dl>\n<dt>•</dt>\n<dd>\n<span class=\"Bold\">Serious allergic reaction.</span> Stop taking VESIcare LS and get medical help right away if you have:<dl>\n<dt>•</dt>\n<dd>hives, skin rash, or swelling</dd>\n<dt>•</dt>\n<dd>severe itching</dd>\n<dt>•</dt>\n<dd>swelling of your face, mouth, or tongue</dd>\n<dt>•</dt>\n<dd>trouble breathing</dd>\n</dl>\n</dd>\n<dt>•</dt>\n<dd>\n<span class=\"Bold\">Central Nervous System (CNS) effects.</span> Talk to your doctor right away if you get any of these side effects:<dl>\n<dt>•</dt>\n<dd>headache</dd>\n<dt>•</dt>\n<dd>confusion</dd>\n<dt>•</dt>\n<dd>hear voices, see things, or sense things that are not there (hallucinations)</dd>\n<dt>•</dt>\n<dd>sleepiness</dd>\n</dl>\n</dd>\n</dl>\n<p>The most common side effects of VESIcare LS include:</p>\n<dl>\n<dt>•</dt>\n<dd>constipation. Call your doctor if you get severe stomach area (abdominal) pain or become constipated for 3 or more days.</dd>\n<dt>•</dt>\n<dd>dry mouth</dd>\n<dt>•</dt>\n<dd>urinary tract infection</dd>\n</dl>\n<p>Other side effects have been observed with anticholinergic medicines such as VESIcare LS and may include:</p>\n<dl>\n<dt>•</dt>\n<dd>blurred vision</dd>\n<dt>•</dt>\n<dd>dry eyes</dd>\n<dt>•</dt>\n<dd>dry skin due to decreased sweating. Heat exhaustion or heat stroke due to decreased sweating can happen when anticholinergic medications such as VESIcare LS are used in hot environments. Symptoms may include:<dl>\n<dt>•</dt>\n<dd>decreased sweating</dd>\n<dt>•</dt>\n<dd>dizziness</dd>\n<dt>•</dt>\n<dd>tiredness</dd>\n<dt>•</dt>\n<dd>nausea</dd>\n<dt>•</dt>\n<dd>increase in body temperature</dd>\n</dl>\n</dd>\n</dl>\n<p>Tell your doctor if you have any side effect that bothers you or that does not go away.</p>\n<p>These are not all the possible side effects of VESIcare LS. For more information, ask your doctor or pharmacist.</p>\n<p>\n<span class=\"Bold\">Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.</span>\n</p>\n</td>\n</tr>\n<tr>\n<td class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\">\n<span class=\"Bold\">How should I store VESIcare LS?</span>\n</p>\n<dl>\n<dt>•</dt>\n<dd>Store VESIcare LS at room temperature, between 68°F to 77°F (20°C to 25°C) with the cap closed.</dd>\n<dt>•</dt>\n<dd>Store VESIcare LS in the original bottle.</dd>\n<dt>•</dt>\n<dd>Throw away VESIcare LS oral suspension 28 days (4 weeks) after first opening.</dd>\n<dt>•</dt>\n<dd>Safely throw away VESIcare LS that has expired or is unused.</dd>\n</dl>\n<p>\n<span class=\"Bold\">Keep VESIcare LS and all medicines out of the reach of children.</span>\n</p>\n</td>\n</tr>\n<tr>\n<td class=\"Botrule Lrule Rrule\" valign=\"top\">\n<p class=\"First\">\n<span class=\"Bold\">General information about the safe and effective use of VESIcare LS.</span>\n</p>\n<p>Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use VESIcare LS for a condition for which it was not prescribed. Do not give VESIcare LS to other people, even if they have the same symptoms you have. It may harm them.</p>\n<p>This leaflet summarizes the most important information about VESIcare LS. If you would like more information, talk with your doctor. You can ask your doctor or pharmacist for information about VESIcare LS that is written for health professionals.</p>\n</td>\n</tr>\n<tr>\n<td class=\"Botrule Lrule Rrule Toprule\" valign=\"top\">\n<p class=\"First\">\n<span class=\"Bold\">What are the ingredients in VESIcare LS?</span>\n</p>\n<p>\n<span class=\"Bold\">Active ingredient:</span> solifenacin succinate</p>\n<p>\n<span class=\"Bold\">Inactive ingredients:</span> polacrilin potassium, methylparaben, propylparaben, propylene glycol, simethicone emulsion 30%, carbomer homopolymer Type B, xylitol, acesulfame potassium, natural orange flavor, sodium hydroxide, and purified water.</p>\n</td>\n</tr>\n<tr class=\"Last\">\n<td class=\"Botrule Lrule Rrule Toprule\" valign=\"top\">\n<p class=\"First\">Marketed and Distributed by:</p>\n<p>\n<span class=\"Bold\">Astellas Pharma US, Inc.</span>\n</p>\n<p>Northbrook, IL 60062<br/>\n<br/>VESIcare LS<span class=\"Sup\"></span> is a registered trademark of Astellas US LLC.<br/>\n<br/>© 2004 – 2022 Astellas Pharma US, Inc.<br/>\n<br/>For more information, call 1-800-727-7003.<br/>\n<br/>366572-VES</p>\n</td>\n</tr>\n</tbody>\n</table></div>" }

This Patient Information has been approved by the U.S. Food and Drug Administration.                       Revised: 10/2022

{ "type": "p", "children": [], "text": "This Patient Information has been approved by the U.S. Food and Drug Administration.                       Revised: 10/2022" }

NDC 51248-250-99

{ "type": "p", "children": [], "text": "NDC 51248-250-99" }

VESIcare LS®

{ "type": "p", "children": [], "text": "VESIcare LS®\n" }

(solifenacin succinate)

{ "type": "p", "children": [], "text": "(solifenacin succinate)" }

Oral Suspension

{ "type": "p", "children": [], "text": "Oral Suspension" }

5 mg/5 mL

{ "type": "p", "children": [], "text": "5 mg/5 mL" }

(1 mg/mL)

{ "type": "p", "children": [], "text": "(1 mg/mL) " }

Shake the bottle well before use.

{ "type": "p", "children": [], "text": "Shake the bottle well before use." }

Discard remaining VESIcare LS® 28 days after first opening.

{ "type": "p", "children": [], "text": "Discard remaining VESIcare LS® 28 days after first opening." }

150 mL

{ "type": "p", "children": [], "text": "150 mL" }

NDC 51248-250-99

{ "type": "p", "children": [], "text": "NDC 51248-250-99" }

VESIcare LS®

{ "type": "p", "children": [], "text": "VESIcare LS®\n" }

(solifenacin succinate)

{ "type": "p", "children": [], "text": "(solifenacin succinate)" }

Oral Suspension

{ "type": "p", "children": [], "text": "Oral Suspension" }

5 mg/5 mL

{ "type": "p", "children": [], "text": "5 mg/5 mL" }

(1 mg/mL)

{ "type": "p", "children": [], "text": "(1 mg/mL) " }

Rx only

{ "type": "p", "children": [], "text": "Rx only" }

Shake well before use.

{ "type": "p", "children": [], "text": "Shake well before use." }

150 mL

{ "type": "p", "children": [], "text": "150 mL" }

Solifenacin succinate tablets is indicated for the treatment of adults with overactive bladder with symptoms of urge urinary incontinence, urgency, and urinary frequency.

{ "type": "p", "children": [], "text": "Solifenacin succinate tablets is indicated for the treatment of adults with overactive bladder with symptoms of urge urinary incontinence, urgency, and urinary frequency." }

The recommended oral dose of solifenacin succinate tablets is 5 mg once daily. If the 5 mg dose is well tolerated, the dose may be increased to 10 mg once daily.

Solifenacin succinate tablets should be taken with water and swallowed whole. Solifenacin succinate tablets can be administered with or without food.

Do not exceed 5 mg once daily in patients with severe renal impairment (CLcr < 30 mL/min/1.73 m2) [see Use in SpecificPopulations (8.6)].

Do not exceed 5 mg once daily in patients with moderate hepatic impairment (Child-Pugh B). Do not use solifenacin succinate tablets in patients with severe hepatic impairment (Child-Pugh C) [see Use in Specific Populations (8.7)].

Do not exceed 5 mg once daily when solifenacin succinate tablets is administered with strong CYP3A4 inhibitors such as ketoconazole [see Drug Interactions (7.1)].

The 5 mg tablets are light yellow, round shaped, film coated debossed with “S5” on one side and plain on other side.

{ "type": "p", "children": [], "text": "The 5 mg tablets are light yellow, round shaped, film coated debossed with “S5” on one side and plain on other side." }

The 10 mg tablets are light pink, round shaped, film coated debossed with "S10" on one side and plain on other side.

{ "type": "p", "children": [], "text": "The 10 mg tablets are light pink, round shaped, film coated debossed with \"S10\" on one side and plain on other side." }

Solifenacin succinate is contraindicated in patients:

{ "type": "p", "children": [], "text": "Solifenacin succinate is contraindicated in patients:" }

{ "type": "ul", "children": [ "With urinary retention [see Warnings and Precautions (5.2)],", "With gastric retention [see Warnings and Precautions (5.3)],", "With uncontrolled narrow-angle glaucoma [see Warnings and Precautions (5.5)], and", "Who have demonstrated hypersensitivity to solifenacin succinate or the inactive ingredients in solifenacin tablets. Reported adverse reactions have included anaphylaxis and angioedema [see Adverse Reactions (6.2)]." ], "text": "" }

Angioedema of the face, lips, tongue, and/or larynx have been reported with solifenacin succinate. In some cases, angioedema occurred after the first dose, however, cases have been reported to occur hours after the first dose or after multiple doses. Anaphylactic reactions have also been reported in patients treated with solifenacin succinate. Angioedema associated with upper airway swelling and anaphylactic reactions may be life-threatening. Solifenacin succinate is contraindicated in patients with a known or suspected hypersensitivity to solifenacin succinate [see Contraindications (4)]. If involvement of the tongue, hypopharynx, or larynx occurs, promptly discontinue solifenacin succinate and provide appropriate therapy and/or measures necessary to ensure a patent airway.

The use of solifenacin succinate, like other antimuscarinic drugs, in patients with clinically significant bladder outlet obstruction including patients with urinary retention, may result in further urinary retention and kidney injury. The use of solifenacin succinate is not recommended in patients with clinically significant bladder outlet obstruction and is contraindicated in patients with urinary retention [see Contraindications (4)].

The use of solifenacin succinate, like other antimuscarinic drugs, in patients with conditions associated with decreased gastrointestinal motility may result in further decreased gastrointestinal motility. Solifenacin succinate is contraindicated in patients with gastric retention [see Contraindications (4)]. The use of solifenacin succinate is not recommended in patients with conditions associated with decreased gastrointestinal motility.

Solifenacin succinate is associated with antimuscarinic central nervous system (CNS) adverse reactions [see Adverse Reactions(6.2)]. A variety of CNS antimuscarinic adverse reactions have been reported, including headache, confusion, hallucinations, and somnolence. Monitor patients for signs of antimuscarinic CNS adverse reactions, particularly after beginning treatment or increasing the dose. Advise patients not to drive or operate heavy machinery until they know how solifenacin succinate affects them. If a patient experiences antimuscarinic CNS adverse reactions, consider dose reduction or drug discontinuation.

Solifenacin succinate should be used with caution in patients being treated for narrow-angle glaucoma [see Contraindications (4)].

In a study of the effect of solifenacin succinate on the QT interval conducted in 76 healthy women [see ClinicalPharmacology (12.2)], solifenacin succinate 30 mg (three times the largest maximum recommended dose in adult patients) was associated with a mean increase in the Fridericia-corrected QT interval of 8 msec (90% CI, 4, 13). The QT prolonging effect appeared less with solifenacin succinate 10 mg than with solifenacin succinate 30 mg, and the effect of solifenacin succinate 30 mg did not appear as large as that of the positive control moxifloxacin at its therapeutic dose.

The use of solifenacin succinate is not recommended in patients at high risk of QT prolongation, including patients with a known history of QT prolongation and patients who are taking medications known to prolong the QT interval.

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Solifenacin has been evaluated for safety in 1811 adult patients in four randomized, placebo-controlled trials (Studies 1-4) [see Clinical Studies (14)]. Expected adverse reactions of antimuscarinic agents are dry mouth, constipation, blurred vision (accommodation abnormalities), urinary retention, and dry eyes. The incidence of dry mouth and constipation in patients treated with solifenacin succinate was higher in the 10 mg dose group compared to the 5 mg dose group.

In the four 12-week double-blind clinical trials, severe fecal impaction, colonic obstruction, and intestinal obstruction were reported in one patient each, all in the solifenacin succinate 10 mg group. Angioneurotic edema was reported in one patient taking solifenacin succinate 5 mg. Compared to 12 weeks of treatment with solifenacin succinate, the incidence and severity of adverse reactions were similar in patients who remained on drug for up to 12 months in Study 5 [see Clinical Studies (14)].

The most frequent adverse reaction leading to study discontinuation was dry mouth (1.5%). Table 1 lists the rates of identified adverse reactions, in the four randomized, placebo-controlled trials at an incidence greater than placebo and in 1% or more of patients treated with solifenacin succinate 5 or 10 mg once daily for up to 12 weeks.

Table 1: Adverse Reactions Reported by ≥ 1% of Patients and Exceeding Placebo in Studies 1, 2, 3 and 4

<div class="scrollingtable"><table border="0" cellpadding="0" cellspacing="0" width="709.8875"> <colgroup> <col width="48.4309133489461%"/> <col width="21.92037470726%"/> <col width="14.3325526932084%"/> <col width="15.3161592505855%"/> </colgroup> <tbody class="Headless"> <tr class="Botrule First"> <td align="justify" class="Lrule Rrule" valign="top"> <br/> </td><td align="justify" class="Rrule" valign="top">Placebo<br/> <br/>(%)<br/> </td><td align="justify" class="Rrule" valign="top">Solifenacin Succinate<br/>5 mg (%)<br/> </td><td align="justify" class="Rrule" valign="top">Solifenacin Succinate<br/>10 mg (%)<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">Number of Patients<br/> </td><td align="justify" class="Rrule" valign="top">1216<br/> </td><td align="justify" class="Rrule" valign="top">578<br/> </td><td align="justify" class="Rrule" valign="top">1233<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">GASTROINTESTINAL DISORDERS<br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">Dry Mouth<br/> </td><td align="justify" class="Rrule" valign="top">4.2<br/> </td><td align="justify" class="Rrule" valign="top">10.9<br/> </td><td align="justify" class="Rrule" valign="top">27.6<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">Constipation<br/> </td><td align="justify" class="Rrule" valign="top">2.9<br/> </td><td align="justify" class="Rrule" valign="top">5.4<br/> </td><td align="justify" class="Rrule" valign="top">13.4<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">Nausea<br/> </td><td align="justify" class="Rrule" valign="top">2.0<br/> </td><td align="justify" class="Rrule" valign="top">1.7<br/> </td><td align="justify" class="Rrule" valign="top">3.3<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">Dyspepsia<br/> </td><td align="justify" class="Rrule" valign="top">1.0<br/> </td><td align="justify" class="Rrule" valign="top">1.4<br/> </td><td align="justify" class="Rrule" valign="top">3.9<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">Abdominal Pain Upper<br/> </td><td align="justify" class="Rrule" valign="top">1.0<br/> </td><td align="justify" class="Rrule" valign="top">1.9<br/> </td><td align="justify" class="Rrule" valign="top">1.2<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">Vomiting NOS<br/> </td><td align="justify" class="Rrule" valign="top">0.9<br/> </td><td align="justify" class="Rrule" valign="top">0.2<br/> </td><td align="justify" class="Rrule" valign="top">1.1<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">INFECTIONS AND INFESTATIONS<br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">Urinary Tract Infection NOS<br/> </td><td align="justify" class="Rrule" valign="top">2.8<br/> </td><td align="justify" class="Rrule" valign="top">2.8<br/> </td><td align="justify" class="Rrule" valign="top">4.8<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">Influenza<br/> </td><td align="justify" class="Rrule" valign="top">1.3<br/> </td><td align="justify" class="Rrule" valign="top">2.2<br/> </td><td align="justify" class="Rrule" valign="top">0.9<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">Pharyngitis NOS<br/> </td><td align="justify" class="Rrule" valign="top">1.0<br/> </td><td align="justify" class="Rrule" valign="top">0.3<br/> </td><td align="justify" class="Rrule" valign="top">1.1<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">NERVOUS SYSTEM DISORDERS<br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">Dizziness<br/> </td><td align="justify" class="Rrule" valign="top">1.8<br/> </td><td align="justify" class="Rrule" valign="top">1.9<br/> </td><td align="justify" class="Rrule" valign="top">1.8<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">EYE DISORDERS<br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">Vision Blurred<br/> </td><td align="justify" class="Rrule" valign="top">1.8<br/> </td><td align="justify" class="Rrule" valign="top">3.8<br/> </td><td align="justify" class="Rrule" valign="top">4.8<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">Dry Eyes NOS<br/> </td><td align="justify" class="Rrule" valign="top">0.6<br/> </td><td align="justify" class="Rrule" valign="top">0.3<br/> </td><td align="justify" class="Rrule" valign="top">1.6<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">RENAL AND URINARY DISORDERS<br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">Urinary Retention<br/> </td><td align="justify" class="Rrule" valign="top">0.6<br/> </td><td align="justify" class="Rrule" valign="top">0<br/> </td><td align="justify" class="Rrule" valign="top">1.4<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">GENERAL DISORDERS AND ADMINISTRATION SITE CONDITIONS<br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">Edema Lower Limb<br/> </td><td align="justify" class="Rrule" valign="top">0.7<br/> </td><td align="justify" class="Rrule" valign="top">0.3<br/> </td><td align="justify" class="Rrule" valign="top">1.1<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">Fatigue<br/> </td><td align="justify" class="Rrule" valign="top">1.1<br/> </td><td align="justify" class="Rrule" valign="top">1.0<br/> </td><td align="justify" class="Rrule" valign="top">2.1<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">PSYCHIATRIC DISORDERS<br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">Depression NOS<br/> </td><td align="justify" class="Rrule" valign="top">0.8<br/> </td><td align="justify" class="Rrule" valign="top">1.2<br/> </td><td align="justify" class="Rrule" valign="top">0.8<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">RESPIRATORY, THORACIC AND MEDIASTINAL DISORDERS<br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">Cough<br/> </td><td align="justify" class="Rrule" valign="top">0.2<br/> </td><td align="justify" class="Rrule" valign="top">0.2<br/> </td><td align="justify" class="Rrule" valign="top">1.1<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top">VASCULAR DISORDERS<br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td><td align="justify" class="Rrule" valign="top"> <br/> </td> </tr> <tr class="Last"> <td align="justify" class="Lrule Rrule" valign="top">Hypertension NOS<br/> </td><td align="justify" class="Rrule" valign="top">0.6<br/> </td><td align="justify" class="Rrule" valign="top">1.4<br/> </td><td align="justify" class="Rrule" valign="top">0.5<br/> </td> </tr> </tbody> </table></div>

The following adverse reactions have been identified during post-approval use of solifenacin succinate in the U.S. and/or outside of the U.S. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

General disorders and administration site conditions: peripheral edema, hypersensitivity reactions (including angioedema with airway obstruction, rash, pruritus, urticaria, anaphylactic reaction);

Nervous system disorders: dizziness, headache, confusion, hallucinations, delirium, somnolence; Cardiac disorders: QT prolongation, Torsade de Pointes, atrial fibrillation, tachycardia, palpitations;

Hepatobiliary disorders: liver disorders mostly characterized by abnormal liver function tests, AST (aspartate aminotransferase), ALT (alanine aminotransferase), GGT (gamma-glutamyl transferase);

Renal and urinary disorders: renal impairment, urinary retention; Metabolism and nutrition disorders: decreased appetite, hyperkalemia;

Skin and subcutaneous tissue disorders: exfoliative dermatitis, erythema multiforme, dry skin; Eye disorders: glaucoma;

Gastrointestinal disorders: gastroesophageal reflux disease, ileus, vomiting, abdominal pain, dysgeusia, sialadenitis; Respiratory, thoracic and mediastinal disorders: dysphonia, nasal dryness;

Musculoskeletal and connective tissue disorders: muscular weakness.

Solifenacin is a substrate of CYP3A4. Concomitant use of ketoconazole, a strong CYP3A4 inhibitor, significantly increased the exposure of solifenacin [see Clinical Pharmacology (12.3)]. The dosage of solifenacin succinate greater than 5 mg once daily is not recommended when concomitantly used with strong CYP3A4 inhibitors [see Dosage and Administration(2.4)].

Risk Summary

There are no studies with the use of solifenacin succinate in pregnant women to inform a drug-associated risk of major birth defects, miscarriages, or adverse maternal or fetal outcomes. No adverse developmental outcomes were observed in animal reproduction studies with oral administration of solifenacin succinate to pregnant mice during the period of organogenesis at a dose resulting in 1.2 times the systemic exposure at the maximum recommended human dose (MRHD) of 10 mg/day. However, administration of doses 3.6 times and greater than the MRHD during organogenesis produced maternal toxicity in the pregnant mice and resulted in developmental toxicity and reduced fetal body weights in offspring [see Data].

In the U.S. general population, the estimated background risk of major birth defects or miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively.

    Data

Animal Data

Oral administration of 14C-solifenacin succinate to pregnant mice resulted in the recovery of radiolabel in the fetus indicating that solifenacin-related product can cross the placental barrier. In pregnant mice, administration of solifenacin succinate at a dose of 250 mg/kg/day (7.9 times the systemic exposure at the MRHD of 10 mg), resulted in an increased incidence of cleft palate and increased maternal lethality. Administration of solifenacin succinate to pregnant mice during organogenesis at greater than or equal to 3.6 times (100 mg/kg/day and greater) the systemic exposure at the MRHD, resulted in reduced fetal body weights and reduced maternal body weight gain. No embryo-fetal toxicity or teratogenicity was observed in fetuses from pregnant mice treated with solifenacin succinate at a dose of 30 mg/kg/day (1.2 times the systemic exposure at the MRHD). Administration of solifenacin succinate to pregnant rats and rabbits at a dose of 50 mg/kg/day (< 1 times and 1.8 times the systemic exposure at the MRHD, respectively), resulted in no findings of embryo-fetal toxicity. Oral pre- and post-natal administration of solifenacin succinate at 100 mg/kg/day (3.6 times the systemic exposure at the MRHD) during the period of organogenesis through weaning, resulted in reduced peripartum and postnatal survival, reduced body weight gain by the pups, and delayed physical development (eye opening and vaginal patency). An increase in the percentage of male offspring was also observed in litters from offspring (F2 generation) exposed to maternal doses of 250 mg/kg/day. There were no effects on natural delivery in mice treated with 1.2 times (30 mg/kg/day) the expected systemic exposure at the MRHD.

Risk Summary There is no information on the presence of solifenacin in human milk, the effects on the breastfed child, or the effects on milk production. Solifenacin is present in mouse milk [see Data]. When a drug is present in animal milk, it is likely that the drug will be present in human milk. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for solifenacin succinate and any potential adverse effects on the breastfed child from solifenacin succinate or from the underlying maternal condition. Data Animal Data Oral administration of 14C-solifenacin succinate to lactating mice resulted in the recovery of radioactivity in maternal milk. Lactating female mice orally administered solifenacin succinate at a maternally toxic dose of 100 mg/kg/day (3.6 times the systemic exposure at the MRHD) had increased postpartum pup mortality, pups with reduced body weights, or delays in the onset of reflex and physical development. Pups from lactating dams orally administered solifenacin succinate at a dose of 30 mg/kg/day (1.2 times the systemic exposure at the MRHD) had no discernible adverse findings. The concentrations of solifenacin in animal milk does not necessarily predict the concentration of drug in human milk.

The safety and effectiveness of solifenacin succinate tablets have not been established in pediatric patients.

In placebo-controlled clinical studies, similar safety and effectiveness were observed between geriatric patients (623 patients ≥ 65 years and 189 patients ≥ 75 years) and younger adult patients (1188 patients < 65 years) treated with solifenacin succinate [see Clinical Pharmacology (12.3)].

Solifenacin plasma concentrations are greater in patients with severe renal impairment compared to subjects with normal renal function [see Clinical Pharmacology (12.3)]. Because increased solifenacin plasma concentrations increase the risk of antimuscarinic adverse reactions, the maximum recommended dose of solifenacin succinate in patients with severe renal impairment (CLcr < 30 mL/min/1.73 m2) is 5 mg once daily [see Dosage and Administration (2.2)]. The recommended dose in patients with mild or moderate renal impairment is the same as in patients with normal renal function.

Solifenacin plasma concentrations are greater in patients with moderate hepatic impairment compared to subjects with normal hepatic function [see Clinical Pharmacology (12.3)]. Because increased solifenacin plasma concentrations increase the risk of antimuscarinic adverse reactions, the maximum recommended dose of solifenacin succinate in patients with moderate hepatic impairment (Child-Pugh B) is 5 mg once daily [see Dosage and Administration (2.3)] and solifenacin succinate is not recommended for use in patients with severe hepatic impairment (Child-Pugh C).

The pharmacokinetics of solifenacin is not significantly influenced by gender.

Overdosage with solifenacin succinate can potentially result in severe antimuscarinic effects and should be treated accordingly. The highest dose ingested in an accidental overdose of solifenacin succinate was 280 mg (28 times the maximum dosage) in a 5-hour period. This case was associated with mental status changes. Some cases reported a decrease in the level of consciousness.

{ "type": "p", "children": [], "text": "Overdosage with solifenacin succinate can potentially result in severe antimuscarinic effects and should be treated accordingly. The highest dose ingested in an accidental overdose of solifenacin succinate was 280 mg (28 times the maximum dosage) in a 5-hour period. This case was associated with mental status changes. Some cases reported a decrease in the level of consciousness." }

Intolerable antimuscarinic adverse reactions (fixed and dilated pupils, blurred vision, failure of heel-to-toe exam, tremors, and dry skin) occurred on day 3 in normal volunteers taking 50 mg daily (5 times the maximum recommended therapeutic dose) and resolved within 7 days following discontinuation of drug.

{ "type": "p", "children": [], "text": "Intolerable antimuscarinic adverse reactions (fixed and dilated pupils, blurred vision, failure of heel-to-toe exam, tremors, and dry skin) occurred on day 3 in normal volunteers taking 50 mg daily (5 times the maximum recommended therapeutic dose) and resolved within 7 days following discontinuation of drug." }

In the event of overdose with solifenacin succinate, treat with gastric lavage and appropriate supportive measures. ECG monitoring is also recommended.

{ "type": "p", "children": [], "text": "In the event of overdose with solifenacin succinate, treat with gastric lavage and appropriate supportive measures. ECG monitoring is also recommended." }

Solifenacin succinate is a muscarinic receptor antagonist. Chemically, solifenacin succinate is  a butanedioic acid compound with (1S)-(3R)-1-azabicyclo[2.2.2]oct-3-yl 3,4-dihydro-1-phenyl-2(1H)-iso-quinolinecarboxylate (1:1) having an empirical formula of C23H26N2O2•C4H6O4, and a molecular weight of 480.55. The structural formula of solifenacin succinate is:

{ "type": "p", "children": [], "text": "Solifenacin succinate is a muscarinic receptor antagonist. Chemically, solifenacin succinate is  a butanedioic acid compound with (1S)-(3R)-1-azabicyclo[2.2.2]oct-3-yl 3,4-dihydro-1-phenyl-2(1H)-iso-quinolinecarboxylate (1:1) having an empirical formula of C23H26N2O2•C4H6O4, and a molecular weight of 480.55. The structural formula of solifenacin succinate is:" }

Solifenacin succinate is a white to pale-yellowish-white crystal or crystalline powder. It is freely soluble at room temperature in water, glacial acetic acid, dimethyl sulfoxide, and methanol. Each solifenacin succinate tablet contains 5 or 10 mg of solifenacin succinate and is for oral administration. In addition to the active ingredient solifenacin succinate, each solifenacin succinate tablet also contains the following inactive ingredients: lactose monohydrate, corn starch, hypromellose 2910, magnesium stearate. The coating material contains hypromellose 2910, talc, polyethylene glycol 8000 and titanium dioxide with yellow ferric oxide (5 mg solifenacin succinate tablet) or red ferric oxide (10 mg solifenacin succinate tablet).

{ "type": "p", "children": [], "text": "Solifenacin succinate is a white to pale-yellowish-white crystal or crystalline powder. It is freely soluble at room temperature in water, glacial acetic acid, dimethyl sulfoxide, and methanol. Each solifenacin succinate tablet contains 5 or 10 mg of solifenacin succinate and is for oral administration. In addition to the active ingredient solifenacin succinate, each solifenacin succinate tablet also contains the following inactive ingredients: lactose monohydrate, corn starch, hypromellose 2910, magnesium stearate. The coating material contains hypromellose 2910, talc, polyethylene glycol 8000 and titanium dioxide with yellow ferric oxide (5 mg solifenacin succinate tablet) or red ferric oxide (10 mg solifenacin succinate tablet)." }

Solifenacin is a competitive muscarinic receptor antagonist. Muscarinic receptors play an important role in several major cholinergically mediated functions, including contractions of urinary bladder smooth muscle.

Cardiac Electrophysiology

The effect of 10 mg and 30 mg solifenacin succinate (three times the maximum recommended dose) on the QT interval was evaluated at the time of peak plasma concentration of solifenacin in a multi-dose, randomized, double-blind, placebo and positive-controlled (moxifloxacin 400 mg) trial [see Warnings and Precautions (5.6)]. After receiving placebo and moxifloxacin sequentially, subjects were randomized to one of two treatment groups. One group (n=51) completed 3 additional sequential periods of dosing with solifenacin succinate 10, 20, and 30 mg while the second group (n=25) in parallel completed a sequence of placebo and moxifloxacin. Study subjects were female volunteers aged 19 to 79 years. The 30 mg dose of solifenacin succinate (three times the highest recommended dose) was chosen for use in this study because this dose results in a solifenacin exposure that covers those observed upon coadministration of 10 mg solifenacin succinate  with strong CYP3A4 inhibitors (e.g., ketoconazole, 400 mg). Due to the sequential dose escalating nature of the study, baseline ECG measurements were separated from the final QT assessment (of the 30 mg dose level) by 33 days.

The median difference from baseline in heart rate associated with the 10 and 30 mg doses of solifenacin succinate compared to placebo was -2 and 0 beats/minute, respectively. Because a significant period effect on QTc was observed, the QTc effects were analyzed utilizing the parallel placebo control arm rather than the pre-specified intra-patient analysis. Representative results are shown in Table 2.

Table 2: QTc changes in msec (90% CI) from baseline at Tmax (relative to placebo)1

<div class="scrollingtable"><table border="0" cellpadding="0" cellspacing="0" width="622.3735"> <colgroup> <col width="37.5040068383374%"/> <col width="62.4959931616626%"/> </colgroup> <tbody class="Headless"> <tr class="Botrule First"> <td align="center" class="Lrule Rrule" valign="top"><span class="Bold">Drug/Dose</span> <br/> </td><td class="Rrule" valign="top"><span class="Bold">Fridericia method (using mean difference)</span> <br/> </td> </tr> <tr class="Botrule"> <td align="center" class="Lrule Rrule" valign="top">Solifenacin succinate 10 mg<br/> </td><td align="center" class="Rrule" valign="top">2 (-3,6)<br/> </td> </tr> <tr class="Last"> <td align="center" class="Lrule Rrule" valign="top">Solifenacin succinate 30 mg<br/> </td><td align="center" class="Rrule" valign="top">8 (4,13)<br/> </td> </tr> </tbody> </table></div>

1.    Results displayed are those derived from the parallel design portion of the study and represent the comparison of Group 1 to time-matched placebo effects in Group 2.

Moxifloxacin was included as a positive control in this study and, given the length of the study, its effect on the QT interval was evaluated in 3 different sessions. The placebo-subtracted mean changes (90% CI) in QTcF for moxifloxacin in the three sessions were 11 (7, 14), 12 (8, 17), and 16 (12, 21), respectively.

The QT interval prolonging effect of the highest solifenacin succinate dose (three times the maximum therapeutic dose) studied was not as large as that of the positive control moxifloxacin at its recommended dose. However, the confidence intervals overlapped, and this study was not designed to draw direct statistical conclusions between the drugs or the dose levels.

Absorption

After oral administration of solifenacin succinate in healthy volunteers, peak plasma concentrations (Cmax) of solifenacin were reached within 3 to 8 hours after administration and, at steady-state, ranged from 32.3 to 62.9 ng/mL for the 5 and 10 mg solifenacin succinate tablets, respectively. The absolute bioavailability of solifenacin is approximately 90%, with plasma concentrations of solifenacin proportional to the dose administered.

Effect of Food

Solifenacin succinate may be administered without regard to meals. A single 10 mg dose administration of solifenacin succinate with food increased Cmax and AUC of solifenacin by 4% and 3%, respectively.

Distribution

Solifenacin is approximately 98% (in vivo) bound to human plasma proteins, principally to α1-acid glycoprotein. Solifenacin is highly distributed to non-CNS tissues, having a mean steady-state volume of distribution of 600 L.

Elimination

The elimination half-life (t1/2) of solifenacin following chronic dosing is approximately 45-68 hours.

Metabolism

Solifenacin is extensively metabolized in the liver. The primary pathway for elimination is by way of CYP3A4; however, alternate metabolic pathways exist. The primary metabolic routes of solifenacin are through N-oxidation of the quinuclidin ring and 4R-hydroxylation of the tetrahydroisoquinoline ring. One pharmacologically active metabolite (4R-hydroxy solifenacin), occurring at low concentrations and unlikely to contribute significantly to clinical activity, and three pharmacologically inactive metabolites (N-glucuronide and the N-oxide and 4R-hydroxy- N-oxide of solifenacin) have been found in human plasma after oral dosing.

Excretion

Following the administration of 10 mg of 14C-solifenacin succinate to healthy volunteers, 69% of the radioactivity was recovered in the urine and 23% in the feces over 26 days. Less than 15% (as mean value) of the dose was recovered in the urine as intact solifenacin. The major metabolites identified in urine were N-oxide of solifenacin, 4R-hydroxy solifenacin, and 4R-hydroxy-N-oxide of solifenacin and, in feces, 4R-hydroxy solifenacin.

Specific Populations

Geriatric Patients

Multiple dose studies of solifenacin succinate in geriatric volunteers (65 to 80 years) showed that Cmax, AUC and t1/2 values of solifenacin were 20-25% higher compared to the younger adult volunteers (18 to 55 years). [see Use in SpecificPopulations (8.5)].

Patients with Renal Impairment

In studies with solifenacin succinate 10 mg, there was a 2.1-fold increase in AUC and a 1.6-fold increase in t1/2 of solifenacin in patients with severe renal impairment compared to subjects with normal renal function [see Use inSpecific  Populations (8.6)].

Patients with Hepatic Impairment

In studies with solifenacin succinate 10 mg, there was a 2-fold increase in the t1/2 and a 35% increase in AUC of solifenacin in patients with moderate hepatic impairment compared to subjects with normal hepatic function [see Usein Specific  Populations (8.7)]. Solifenacin succinate has not been studied in patients with severe hepatic impairment.

Drug Interaction Studies

Strong CYP3A4 Inhibitors

In a crossover study, following blockade of CYP3A4 by coadministration of the strong CYP3A4 inhibitor, ketoconazole 400 mg once daily for 21 days, the mean Cmax and AUC of solifenacin increased by 1.5 and 2.7-fold, respectively [see Dosage and Administration (2.4) and Drug Interactions (7.1)].

CYP3A4 Inducers

Because solifenacin is a substrate of CYP3A4, inducers of CYP3A4 may decrease the concentration of solifenacin.

Warfarin

In a crossover study, subjects received a single oral dose of warfarin 25 mg on the 10th day of dosing with either solifenacin succinate 10 mg or matching placebo once daily for 16 days. For R-warfarin, when it was coadministered with solifenacin succinate, the mean Cmax increased by 3% and AUC decreased by 2%. For S-warfarin, when it was coadministered with solifenacin succinate, the mean Cmax and AUC increased by 5% and 1%, respectively.

Oral Contraceptives

In a crossover study, subjects received 2 cycles of 21 days of oral contraceptives containing 30 ug ethinyl estradiol and 150 ug levonorgestrel. During the second cycle, subjects received additional solifenacin succinate 10 mg or matching placebo once daily for 10 days starting from the 12th day of receipt of oral contraceptives. For ethinyl estradiol, when it was administered with solifenacin succinate, the mean Cmax and AUC increased by 2% and 3%, respectively. For levonorgestrel, when it was administered with solifenacin succinate, the mean Cmax and AUC decreased by 1%.

Digoxin

In a crossover study, subjects received digoxin (loading dose of 0.25 mg on day 1, followed by 0.125 mg from days 2 to 8) for 8 days. Consecutively, they received solifenacin succinate 10 mg or matching placebo with digoxin 0.125 mg for an additional 10 days. When digoxin was coadministered with solifenacin succinate, the mean Cmax and AUC increased by 13% and 4%, respectively.

Drugs Metabolized by Cytochrome P450 Enzymes

In vitro studies demonstrated that, at therapeutic concentrations, solifenacin does not inhibit CYP1A1/2, 2C9, 2C19, 2D6, or 3A4 derived from human liver microsomes.

No increase in tumors was found following the administration of solifenacin succinate to male and female mice for 104 weeks at doses up to 200 mg/kg/day (5 and 9 times, respectively, of the exposure at the maximum recommended human dose [MRHD] of 10 mg), and male and female rats for 104 weeks at doses up to 20 and 15 mg/kg/day, respectively (< 1 times the exposure at the MRHD). Solifenacin succinate was not mutagenic in the in vitro Salmonella typhimurium or Escherichia coli microbial mutagenicity test or chromosomal aberration test in human peripheral blood lymphocytes with or without metabolic activation or in the in vivo micronucleus test in rats.Solifenacin succinate had no effect on reproductive function, fertility, or early embryonic development of the fetus in male and female mice treated with 250 mg/kg/day (13 times the exposure at the MRHD) of solifenacin succinate, and in male rats treated with 50 mg/kg/day (< 1 times the exposure at the MRHD) and female rats treated with 100 mg/kg/day (1.7 times the exposure at the MRHD) of solifenacin succinate.

Juvenile Animal Toxicology Data

Dose-related increased mortality without preceding clinical signs occurred in juvenile mice treated before weaning for a duration of 12 weeks, from day 10 after birth, with doses that achieved a pharmacological effect. Animals dosed from postnatal day 10 onwards had higher mortality compared to the mortality in adult mice. No increased frequency in mortality was observed in juvenile mice that were treated after weaning for a duration of 4 weeks, from day 21 after birth onwards. Plasma exposure at postnatal day 10 was higher than in adult mice; the systemic exposure at postnatal day 21 was comparable to the systemic exposure in adult mice.

Solifenacin succinate was evaluated in four twelve-week, double-blind, randomized, placebo-controlled, parallel group, multicenter clinical trials for the treatment of overactive bladder in adult patients having symptoms of urinary frequency, urgency, and/or urge or mixed incontinence (with a predominance of urge). Entry criteria required that patients have symptoms of overactive bladder for ≥ 3 months duration. These studies involved 3027 patients (1811 on solifenacin succinate and 1216 on placebo), and approximately 90% of these patients completed the 12-week studies. Two of the four studies evaluated the 5 and 10 mg solifenacin succinate doses (Studies 1 and 2) and the other two evaluated only the 10 mg dose (Studies 3 and 4). All patients completing the 12-week studies were eligible to enter an open-label, long-term extension study (Study 5) and 81% of patients enrolling completed the additional 40-week treatment period. The majority of patients were Caucasian (93%) and female (80%) with a mean age of 58 years.

{ "type": "p", "children": [], "text": "Solifenacin succinate was evaluated in four twelve-week, double-blind, randomized, placebo-controlled, parallel group, multicenter clinical trials for the treatment of overactive bladder in adult patients having symptoms of urinary frequency, urgency, and/or urge or mixed incontinence (with a predominance of urge). Entry criteria required that patients have symptoms of overactive bladder for ≥ 3 months duration. These studies involved 3027 patients (1811 on solifenacin succinate and 1216 on placebo), and approximately 90% of these patients completed the 12-week studies. Two of the four studies evaluated the 5 and 10 mg solifenacin succinate doses (Studies 1 and 2) and the other two evaluated only the 10 mg dose (Studies 3 and 4). All patients completing the 12-week studies were eligible to enter an open-label, long-term extension study (Study 5) and 81% of patients enrolling completed the additional 40-week treatment period. The majority of patients were Caucasian (93%) and female (80%) with a mean age of 58 years." }

The primary endpoint in all four trials was the mean change from baseline to 12 weeks in number of micturitions/24 hours. Secondary endpoints included mean change from baseline to 12 weeks in number of incontinence episodes/24 hours, and mean volume voided per micturition.

{ "type": "p", "children": [], "text": "The primary endpoint in all four trials was the mean change from baseline to 12 weeks in number of micturitions/24 hours. Secondary endpoints included mean change from baseline to 12 weeks in number of incontinence episodes/24 hours, and mean volume voided per micturition." }

The efficacy of solifenacin succinate was similar across patient age groups and gender. The mean reduction in the number of micturitions per 24 hours was significantly greater with solifenacin succinate 5 mg (2.3; p < 0.001) and solifenacin succinate10 mg (2.7; p < 0.001) compared to placebo (1.4). The mean reduction in the number of incontinence episodes per 24 hours was significantly greater with solifenacin succinate 5 mg (1.5; p < 0.001) and solifenacin succinate 10 mg (1.8; p < 0.001) treatment groups compared to the placebo treatment group (1.1). The mean increase in the volume voided per micturition was significantly greater with solifenacin succinate 5 mg (32.3 mL; p < 0.001) and solifenacin succinate 10 mg (42.5 mL; p < 0.001) compared with placebo (8.5 mL).

{ "type": "p", "children": [], "text": "The efficacy of solifenacin succinate was similar across patient age groups and gender. The mean reduction in the number of micturitions per 24 hours was significantly greater with solifenacin succinate 5 mg (2.3; p < 0.001) and solifenacin succinate10 mg (2.7; p < 0.001) compared to placebo (1.4). The mean reduction in the number of incontinence episodes per 24 hours was significantly greater with solifenacin succinate 5 mg (1.5; p < 0.001) and solifenacin succinate 10 mg (1.8; p < 0.001) treatment groups compared to the placebo treatment group (1.1). The mean increase in the volume voided per micturition was significantly greater with solifenacin succinate 5 mg (32.3 mL; p < 0.001) and solifenacin succinate 10 mg (42.5 mL; p < 0.001) compared with placebo (8.5 mL)." }

The results for the primary and secondary endpoints in the four individual 12-week clinical studies of solifenacin succinate are reported in Tables 3 through 6.

{ "type": "p", "children": [], "text": "The results for the primary and secondary endpoints in the four individual 12-week clinical studies of solifenacin succinate are reported in Tables 3 through 6." }

Table 3: Mean Changes from Baseline to Week 12 in Efficacy Endpoints in Study 1

{ "type": "p", "children": [], "text": "Table 3: Mean Changes from Baseline to Week 12 in Efficacy Endpoints in Study 1" }

<div class="scrollingtable"><table border="0" cellpadding="0" cellspacing="0" width="1102"> <colgroup> <col width="44.7912885662432%"/> <col width="17.6406533575318%"/> <col width="20.4174228675136%"/> <col width="17.1506352087114%"/> </colgroup> <tbody class="Headless"> <tr class="Botrule First"> <td align="center" class="Lrule Rrule" valign="top"><span class="Bold">Parameter</span> <br/> </td><td align="center" class="Rrule" valign="top"><span class="Bold">Placebo</span> <br/> <span class="Bold">(N=253)</span> <br/> <span class="Bold">Mean (SE)</span> <br/> </td><td align="center" class="Rrule" valign="top"><span class="Bold">Solifenacin Succinate</span> <br/> <span class="Bold">5 mg (N=266)</span> <br/> <span class="Bold">Mean (SE)</span> <br/> </td><td align="center" class="Rrule" valign="top"><span class="Bold">Solifenacin Succinate</span> <br/> <span class="Bold">10 mg (N=264)</span> <br/> <span class="Bold">Mean (SE)</span> <br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Urinary Frequency (Number of Micturitions/24 hours)<span class="Italics"><span class="Sup">1</span></span> <br/> </td><td class="Rrule" valign="top"> <br/> </td><td class="Rrule" valign="top"> <br/> </td><td class="Rrule" valign="top"> <br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Baseline<br/> </td><td align="center" class="Rrule" valign="top">12.2 (0.26)<br/> </td><td align="right" class="Rrule" valign="top">12.1 (0.24)<br/> </td><td class="Rrule" valign="top">12.3 (0.24)<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Reduction<br/> </td><td align="center" class="Rrule" valign="top">1.2 (0.21)<br/> </td><td align="right" class="Rrule" valign="top">2.2 (0.18)<br/> </td><td class="Rrule" valign="top">2.6 (0.20)<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">P value vs. placebo<br/> </td><td class="Rrule" valign="top"> <br/> </td><td class="Rrule" valign="top">&lt; 0.001<br/> </td><td class="Rrule" valign="top">&lt; 0.001<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Number of Incontinence Episodes/24 hours<span class="Italics"><span class="Sup">2</span></span> <br/> </td><td class="Rrule" valign="top"> <br/> </td><td class="Rrule" valign="top"> <br/> </td><td class="Rrule" valign="top"> <br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Baseline<br/> </td><td align="center" class="Rrule" valign="top">2.7 (0.23)<br/> </td><td align="right" class="Rrule" valign="top">2.6 (0.22)<br/> </td><td class="Rrule" valign="top">2.6 (0.23)<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Reduction<br/> </td><td align="center" class="Rrule" valign="top">0.8 (0.18)<br/> </td><td align="right" class="Rrule" valign="top">1.4 (0.15)<br/> </td><td class="Rrule" valign="top">1.5 (0.18)<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">P value vs. placebo<br/> </td><td class="Rrule" valign="top"> <br/> </td><td align="center" class="Rrule" valign="top">&lt; 0.01<br/> </td><td align="center" class="Rrule" valign="top">&lt; 0.01<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Volume Voided per Micturition [mL]<span class="Italics"><span class="Sup">2</span></span> <br/> </td><td class="Rrule" valign="top"> <br/> </td><td class="Rrule" valign="top"> <br/> </td><td class="Rrule" valign="top"> <br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Baseline<br/> </td><td align="center" class="Rrule" valign="top">143.8 (3.37)<br/> </td><td align="right" class="Rrule" valign="top">149.6 (3.35)<br/> </td><td class="Rrule" valign="top">147.2 (3.15)<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Increase<br/> </td><td align="center" class="Rrule" valign="top">7.4 (2.28)<br/> </td><td align="right" class="Rrule" valign="top">32.9 (2.92)<br/> </td><td class="Rrule" valign="top">39.2 (3.11)<br/> </td> </tr> <tr class="Last"> <td class="Lrule Rrule" valign="top">P value vs. placebo<br/> </td><td class="Rrule" valign="top"> <br/> </td><td class="Rrule" valign="top">&lt; 0.001<br/> </td><td class="Rrule" valign="top">&lt; 0.001<br/> </td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"1102\">\n<colgroup>\n<col width=\"44.7912885662432%\"/>\n<col width=\"17.6406533575318%\"/>\n<col width=\"20.4174228675136%\"/>\n<col width=\"17.1506352087114%\"/>\n</colgroup>\n<tbody class=\"Headless\">\n<tr class=\"Botrule First\">\n<td align=\"center\" class=\"Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Parameter</span>\n<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\"><span class=\"Bold\">Placebo</span>\n<br/>\n<span class=\"Bold\">(N=253)</span>\n<br/>\n<span class=\"Bold\">Mean (SE)</span>\n<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\"><span class=\"Bold\">Solifenacin Succinate</span>\n<br/>\n<span class=\"Bold\">5 mg (N=266)</span>\n<br/>\n<span class=\"Bold\">Mean (SE)</span>\n<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\"><span class=\"Bold\">Solifenacin Succinate</span>\n<br/>\n<span class=\"Bold\">10 mg (N=264)</span>\n<br/>\n<span class=\"Bold\">Mean (SE)</span>\n<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Urinary Frequency (Number of Micturitions/24 hours)<span class=\"Italics\"><span class=\"Sup\">1</span></span>\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Baseline<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">12.2 (0.26)<br/>\n</td><td align=\"right\" class=\"Rrule\" valign=\"top\">12.1 (0.24)<br/>\n</td><td class=\"Rrule\" valign=\"top\">12.3 (0.24)<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Reduction<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">1.2 (0.21)<br/>\n</td><td align=\"right\" class=\"Rrule\" valign=\"top\">2.2 (0.18)<br/>\n</td><td class=\"Rrule\" valign=\"top\">2.6 (0.20)<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">P value vs. placebo<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">&lt; 0.001<br/>\n</td><td class=\"Rrule\" valign=\"top\">&lt; 0.001<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Number of Incontinence Episodes/24 hours<span class=\"Italics\"><span class=\"Sup\">2</span></span>\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Baseline<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">2.7 (0.23)<br/>\n</td><td align=\"right\" class=\"Rrule\" valign=\"top\">2.6 (0.22)<br/>\n</td><td class=\"Rrule\" valign=\"top\">2.6 (0.23)<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Reduction<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">0.8 (0.18)<br/>\n</td><td align=\"right\" class=\"Rrule\" valign=\"top\">1.4 (0.15)<br/>\n</td><td class=\"Rrule\" valign=\"top\">1.5 (0.18)<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">P value vs. placebo<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">&lt; 0.01<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">&lt; 0.01<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Volume Voided per Micturition [mL]<span class=\"Italics\"><span class=\"Sup\">2</span></span>\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Baseline<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">143.8 (3.37)<br/>\n</td><td align=\"right\" class=\"Rrule\" valign=\"top\">149.6 (3.35)<br/>\n</td><td class=\"Rrule\" valign=\"top\">147.2 (3.15)<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Increase<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">7.4 (2.28)<br/>\n</td><td align=\"right\" class=\"Rrule\" valign=\"top\">32.9 (2.92)<br/>\n</td><td class=\"Rrule\" valign=\"top\">39.2 (3.11)<br/>\n</td>\n</tr>\n<tr class=\"Last\">\n<td class=\"Lrule Rrule\" valign=\"top\">P value vs. placebo<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">&lt; 0.001<br/>\n</td><td class=\"Rrule\" valign=\"top\">&lt; 0.001<br/>\n</td>\n</tr>\n</tbody>\n</table></div>" }

{ "type": "", "children": [], "text": "" }

Table 4: Mean Changes from Baseline to Week 12 in Efficacy Endpoints in Study 2

{ "type": "p", "children": [], "text": "Table 4: Mean Changes from Baseline to Week 12 in Efficacy Endpoints in Study 2" }

<div class="scrollingtable"><table border="0" cellpadding="0" cellspacing="0" width="709.821"> <colgroup> <col width="43.3764287052651%"/> <col width="19.3929173693086%"/> <col width="19.9550309162451%"/> <col width="17.2756230091812%"/> </colgroup> <tbody class="Headless"> <tr class="Botrule First"> <td align="center" class="Lrule Rrule" valign="top"><span class="Bold">Parameter</span> <br/> </td><td align="center" class="Rrule" valign="top"><span class="Bold">Placebo</span> <br/> <span class="Bold">(N=281)</span> <br/> <span class="Bold">Mean (SE)</span> <br/> </td><td align="center" class="Rrule" valign="top"><span class="Bold">Solifenacin Succinate</span> <br/> <span class="Bold">5 mg (N=286)</span> <br/> <span class="Bold">Mean (SE)</span> <br/> </td><td align="center" class="Rrule" valign="top"><span class="Bold">Solifenacin Succinate</span> <br/> <span class="Bold">10 mg (N=290)</span> <br/> <span class="Bold">Mean (SE)</span> <br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Urinary Frequency (Number of Micturitions/24 hours)<span class="Italics"><span class="Sup">1</span></span> <br/> </td><td class="Rrule" valign="top"> <br/> </td><td class="Rrule" valign="top"> <br/> </td><td class="Rrule" valign="top"> <br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Baseline<br/> </td><td align="center" class="Rrule" valign="top">12.3 (0.23)<br/> </td><td align="right" class="Rrule" valign="top">12.1 (0.23)<br/> </td><td class="Rrule" valign="top">12.1 (0.21)<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Reduction<br/> </td><td align="center" class="Rrule" valign="top">1.7 (0.19)<br/> </td><td align="right" class="Rrule" valign="top">2.4 (0.17)<br/> </td><td class="Rrule" valign="top">2.9 (0.18)<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">P value vs. placebo<br/> </td><td class="Rrule" valign="top"> <br/> </td><td class="Rrule" valign="top">&lt; 0.001<br/> </td><td class="Rrule" valign="top">&lt; 0.001<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Number of Incontinence Episodes/24 hours<span class="Italics"><span class="Sup">2</span></span> <br/> </td><td class="Rrule" valign="top"> <br/> </td><td class="Rrule" valign="top"> <br/> </td><td class="Rrule" valign="top"> <br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Baseline<br/> </td><td align="center" class="Rrule" valign="top">3.2 (0.24)<br/> </td><td align="right" class="Rrule" valign="top">2.6 (0.18)<br/> </td><td class="Rrule" valign="top">2.8 (0.20)<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Reduction<br/> </td><td align="center" class="Rrule" valign="top">1.3 (0.19)<br/> </td><td align="right" class="Rrule" valign="top">1.6 (0.16)<br/> </td><td class="Rrule" valign="top">1.6 (0.18)<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">P value vs. placebo<br/> </td><td class="Rrule" valign="top"> <br/> </td><td align="center" class="Rrule" valign="top">&lt; 0.01<br/> </td><td align="center" class="Rrule" valign="top">0.016<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Volume Voided per Micturition [mL]<span class="Italics"><span class="Sup">2</span></span> <br/> </td><td class="Rrule" valign="top"> <br/> </td><td class="Rrule" valign="top"> <br/> </td><td class="Rrule" valign="top"> <br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Baseline<br/> </td><td align="center" class="Rrule" valign="top">147.2 (3.18)<br/> </td><td align="right" class="Rrule" valign="top">148.5 (3.16)<br/> </td><td class="Rrule" valign="top">145.9 (3.42)<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Increase<br/> </td><td align="center" class="Rrule" valign="top">11.3 (2.52)<br/> </td><td align="right" class="Rrule" valign="top">31.8 (2.94)<br/> </td><td class="Rrule" valign="top">36.6 (3.04)<br/> </td> </tr> <tr class="Last"> <td class="Lrule Rrule" valign="top">P value vs. placebo<br/> </td><td class="Rrule" valign="top"> <br/> </td><td class="Rrule" valign="top">&lt; 0.001<br/> </td><td class="Rrule" valign="top">&lt; 0.001<br/> </td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"709.821\">\n<colgroup>\n<col width=\"43.3764287052651%\"/>\n<col width=\"19.3929173693086%\"/>\n<col width=\"19.9550309162451%\"/>\n<col width=\"17.2756230091812%\"/>\n</colgroup>\n<tbody class=\"Headless\">\n<tr class=\"Botrule First\">\n<td align=\"center\" class=\"Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Parameter</span>\n<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\"><span class=\"Bold\">Placebo</span>\n<br/>\n<span class=\"Bold\">(N=281)</span>\n<br/>\n<span class=\"Bold\">Mean (SE)</span>\n<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\"><span class=\"Bold\">Solifenacin Succinate</span>\n<br/>\n<span class=\"Bold\">5 mg (N=286)</span>\n<br/>\n<span class=\"Bold\">Mean (SE)</span>\n<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\"><span class=\"Bold\">Solifenacin Succinate</span>\n<br/>\n<span class=\"Bold\">10 mg (N=290)</span>\n<br/>\n<span class=\"Bold\">Mean (SE)</span>\n<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Urinary Frequency (Number of Micturitions/24 hours)<span class=\"Italics\"><span class=\"Sup\">1</span></span>\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Baseline<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">12.3 (0.23)<br/>\n</td><td align=\"right\" class=\"Rrule\" valign=\"top\">12.1 (0.23)<br/>\n</td><td class=\"Rrule\" valign=\"top\">12.1 (0.21)<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Reduction<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">1.7 (0.19)<br/>\n</td><td align=\"right\" class=\"Rrule\" valign=\"top\">2.4 (0.17)<br/>\n</td><td class=\"Rrule\" valign=\"top\">2.9 (0.18)<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">P value vs. placebo<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">&lt; 0.001<br/>\n</td><td class=\"Rrule\" valign=\"top\">&lt; 0.001<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Number of Incontinence Episodes/24 hours<span class=\"Italics\"><span class=\"Sup\">2</span></span>\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Baseline<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">3.2 (0.24)<br/>\n</td><td align=\"right\" class=\"Rrule\" valign=\"top\">2.6 (0.18)<br/>\n</td><td class=\"Rrule\" valign=\"top\">2.8 (0.20)<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Reduction<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">1.3 (0.19)<br/>\n</td><td align=\"right\" class=\"Rrule\" valign=\"top\">1.6 (0.16)<br/>\n</td><td class=\"Rrule\" valign=\"top\">1.6 (0.18)<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">P value vs. placebo<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">&lt; 0.01<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">0.016<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Volume Voided per Micturition [mL]<span class=\"Italics\"><span class=\"Sup\">2</span></span>\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Baseline<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">147.2 (3.18)<br/>\n</td><td align=\"right\" class=\"Rrule\" valign=\"top\">148.5 (3.16)<br/>\n</td><td class=\"Rrule\" valign=\"top\">145.9 (3.42)<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Increase<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">11.3 (2.52)<br/>\n</td><td align=\"right\" class=\"Rrule\" valign=\"top\">31.8 (2.94)<br/>\n</td><td class=\"Rrule\" valign=\"top\">36.6 (3.04)<br/>\n</td>\n</tr>\n<tr class=\"Last\">\n<td class=\"Lrule Rrule\" valign=\"top\">P value vs. placebo<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">&lt; 0.001<br/>\n</td><td class=\"Rrule\" valign=\"top\">&lt; 0.001<br/>\n</td>\n</tr>\n</tbody>\n</table></div>" }

{ "type": "", "children": [], "text": "" }

Table 5: Mean Changes from Baseline to Week 12 in Efficacy Endpoints in Study 3

{ "type": "p", "children": [], "text": "Table 5: Mean Changes from Baseline to Week 12 in Efficacy Endpoints in Study 3" }

<div class="scrollingtable"><table border="0" cellpadding="0" cellspacing="0" width="709.821"> <colgroup> <col width="55.8647180063706%"/> <col width="22.0442195990257%"/> <col width="22.0910623946037%"/> </colgroup> <tbody class="Headless"> <tr class="Botrule First"> <td align="center" class="Lrule Rrule" valign="top"><span class="Bold">Parameter</span> <br/> </td><td align="center" class="Rrule" valign="top"><span class="Bold">Placebo</span> <br/> <span class="Bold">(N=309)</span> <br/> <span class="Bold">Mean (SE)</span> <br/> </td><td align="center" class="Rrule" valign="top"><span class="Bold">Solifenacin Succinate</span> <br/> <span class="Bold">10 mg (N=306)</span> <br/> <span class="Bold">Mean (SE)</span> <br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Urinary Frequency (Number of Micturitions/24 hours)<span class="Italics"><span class="Sup">1</span></span> <br/> </td><td class="Rrule" valign="top"> <br/> </td><td class="Rrule" valign="top"> <br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Baseline<br/> </td><td align="center" class="Rrule" valign="top">11.5 (0.18)<br/> </td><td align="center" class="Rrule" valign="top">11.7 (0.18)<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Reduction<br/> </td><td align="center" class="Rrule" valign="top">1.5 (0.15)<br/> </td><td align="center" class="Rrule" valign="top">3.0 (0.15)<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">P value vs. placebo<br/> </td><td class="Rrule" valign="top"> <br/> </td><td align="center" class="Rrule" valign="top">&lt; 0.001<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Number of Incontinence Episodes/24 hours<span class="Italics"><span class="Sup">2</span></span> <br/> </td><td class="Rrule" valign="top"> <br/> </td><td class="Rrule" valign="top"> <br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Baseline<br/> </td><td align="center" class="Rrule" valign="top">3.0 (0.20)<br/> </td><td align="center" class="Rrule" valign="top">3.1 (0.22)<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Reduction<br/> </td><td align="center" class="Rrule" valign="top">1.1 (0.16)<br/> </td><td align="center" class="Rrule" valign="top">2.0 (0.19)<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">P value vs. placebo<br/> </td><td class="Rrule" valign="top"> <br/> </td><td align="center" class="Rrule" valign="top">&lt; 0.001<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Volume Voided per Micturition [mL]<span class="Italics"><span class="Sup">2</span></span> <br/> </td><td class="Rrule" valign="top"> <br/> </td><td class="Rrule" valign="top"> <br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Baseline<br/> </td><td align="center" class="Rrule" valign="top">190.3 (5.48)<br/> </td><td align="center" class="Rrule" valign="top">183.5 (4.97)<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Increase<br/> </td><td align="center" class="Rrule" valign="top">2.7 (3.15)<br/> </td><td align="center" class="Rrule" valign="top">47.2 (3.79)<br/> </td> </tr> <tr class="Last"> <td class="Lrule Rrule" valign="top">P value vs. placebo<br/> </td><td class="Rrule" valign="top"> <br/> </td><td align="center" class="Rrule" valign="top">&lt; 0.001<br/> </td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"709.821\">\n<colgroup>\n<col width=\"55.8647180063706%\"/>\n<col width=\"22.0442195990257%\"/>\n<col width=\"22.0910623946037%\"/>\n</colgroup>\n<tbody class=\"Headless\">\n<tr class=\"Botrule First\">\n<td align=\"center\" class=\"Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Parameter</span>\n<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\"><span class=\"Bold\">Placebo</span>\n<br/>\n<span class=\"Bold\">(N=309)</span>\n<br/>\n<span class=\"Bold\">Mean (SE)</span>\n<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\"><span class=\"Bold\">Solifenacin Succinate</span>\n<br/>\n<span class=\"Bold\">10 mg (N=306)</span>\n<br/>\n<span class=\"Bold\">Mean (SE)</span>\n<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Urinary Frequency (Number of Micturitions/24 hours)<span class=\"Italics\"><span class=\"Sup\">1</span></span>\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Baseline<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">11.5 (0.18)<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">11.7 (0.18)<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Reduction<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">1.5 (0.15)<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">3.0 (0.15)<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">P value vs. placebo<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">&lt; 0.001<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Number of Incontinence Episodes/24 hours<span class=\"Italics\"><span class=\"Sup\">2</span></span>\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Baseline<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">3.0 (0.20)<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">3.1 (0.22)<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Reduction<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">1.1 (0.16)<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">2.0 (0.19)<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">P value vs. placebo<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">&lt; 0.001<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Volume Voided per Micturition [mL]<span class=\"Italics\"><span class=\"Sup\">2</span></span>\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Baseline<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">190.3 (5.48)<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">183.5 (4.97)<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Increase<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">2.7 (3.15)<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">47.2 (3.79)<br/>\n</td>\n</tr>\n<tr class=\"Last\">\n<td class=\"Lrule Rrule\" valign=\"top\">P value vs. placebo<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">&lt; 0.001<br/>\n</td>\n</tr>\n</tbody>\n</table></div>" }

{ "type": "", "children": [], "text": "" }

Table 6: Mean Changes from Baseline to Week 12 in Efficacy Endpoints in Study 4

{ "type": "p", "children": [], "text": "Table 6: Mean Changes from Baseline to Week 12 in Efficacy Endpoints in Study 4" }

<div class="scrollingtable"><table border="0" cellpadding="0" cellspacing="0" width="709.821"> <colgroup> <col width="55.8647180063706%"/> <col width="22.0442195990257%"/> <col width="22.0910623946037%"/> </colgroup> <tbody class="Headless"> <tr class="Botrule First"> <td align="center" class="Lrule Rrule" valign="top"><span class="Bold">Parameter</span> <br/> </td><td align="center" class="Rrule" valign="top"><span class="Bold">Placebo</span> <br/> <span class="Bold">(N=295)</span> <br/> <span class="Bold">Mean (SE)</span> <br/> </td><td align="center" class="Rrule" valign="top"><span class="Bold">Solifenacin Succinate</span> <br/> <span class="Bold">10 mg (N=298)</span> <br/> <span class="Bold">Mean (SE)</span> <br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Urinary Frequency (Number of Micturitions/24 hours)<span class="Italics"><span class="Sup">1</span></span> <br/> </td><td class="Rrule" valign="top"> <br/> </td><td class="Rrule" valign="top"> <br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Baseline<br/> </td><td align="center" class="Rrule" valign="top">11.8 (0.18)<br/> </td><td align="center" class="Rrule" valign="top">11.5 (0.18)<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Reduction<br/> </td><td align="center" class="Rrule" valign="top">1.3 (0.16)<br/> </td><td align="center" class="Rrule" valign="top">2.4 (0.15)<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">P value vs. placebo<br/> </td><td class="Rrule" valign="top"> <br/> </td><td align="center" class="Rrule" valign="top">&lt; 0.001<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Number of Incontinence Episodes/24 hours<span class="Italics"><span class="Sup">2</span></span> <br/> </td><td class="Rrule" valign="top"> <br/> </td><td class="Rrule" valign="top"> <br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Baseline<br/> </td><td align="center" class="Rrule" valign="top">2.9 (0.18)<br/> </td><td align="center" class="Rrule" valign="top">2.9 (0.17)<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Reduction<br/> </td><td align="center" class="Rrule" valign="top">1.2 (0.15)<br/> </td><td align="center" class="Rrule" valign="top">2.0 (0.15)<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">P value vs. placebo<br/> </td><td class="Rrule" valign="top"> <br/> </td><td align="center" class="Rrule" valign="top">&lt; 0.001<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Volume Voided per Micturition [mL]<span class="Italics"><span class="Sup">2</span></span> <br/> </td><td class="Rrule" valign="top"> <br/> </td><td class="Rrule" valign="top"> <br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Baseline<br/> </td><td align="center" class="Rrule" valign="top">175.7 (4.44)<br/> </td><td align="center" class="Rrule" valign="top">174.1 (4.15)<br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Increase<br/> </td><td align="center" class="Rrule" valign="top">13.0 (3.45)<br/> </td><td align="center" class="Rrule" valign="top">46.4 (3.73)<br/> </td> </tr> <tr class="Last"> <td class="Lrule Rrule" valign="top">P value vs. placebo<br/> </td><td class="Rrule" valign="top"> <br/> </td><td align="center" class="Rrule" valign="top">&lt; 0.001<br/> </td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"709.821\">\n<colgroup>\n<col width=\"55.8647180063706%\"/>\n<col width=\"22.0442195990257%\"/>\n<col width=\"22.0910623946037%\"/>\n</colgroup>\n<tbody class=\"Headless\">\n<tr class=\"Botrule First\">\n<td align=\"center\" class=\"Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Parameter</span>\n<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\"><span class=\"Bold\">Placebo</span>\n<br/>\n<span class=\"Bold\">(N=295)</span>\n<br/>\n<span class=\"Bold\">Mean (SE)</span>\n<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\"><span class=\"Bold\">Solifenacin Succinate</span>\n<br/>\n<span class=\"Bold\">10 mg (N=298)</span>\n<br/>\n<span class=\"Bold\">Mean (SE)</span>\n<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Urinary Frequency (Number of Micturitions/24 hours)<span class=\"Italics\"><span class=\"Sup\">1</span></span>\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Baseline<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">11.8 (0.18)<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">11.5 (0.18)<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Reduction<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">1.3 (0.16)<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">2.4 (0.15)<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">P value vs. placebo<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">&lt; 0.001<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Number of Incontinence Episodes/24 hours<span class=\"Italics\"><span class=\"Sup\">2</span></span>\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Baseline<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">2.9 (0.18)<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">2.9 (0.17)<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Reduction<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">1.2 (0.15)<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">2.0 (0.15)<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">P value vs. placebo<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">&lt; 0.001<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Volume Voided per Micturition [mL]<span class=\"Italics\"><span class=\"Sup\">2</span></span>\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Baseline<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">175.7 (4.44)<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">174.1 (4.15)<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Increase<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">13.0 (3.45)<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">46.4 (3.73)<br/>\n</td>\n</tr>\n<tr class=\"Last\">\n<td class=\"Lrule Rrule\" valign=\"top\">P value vs. placebo<br/>\n</td><td class=\"Rrule\" valign=\"top\">\n<br/>\n</td><td align=\"center\" class=\"Rrule\" valign=\"top\">&lt; 0.001<br/>\n</td>\n</tr>\n</tbody>\n</table></div>" }

{ "type": "", "children": [], "text": "" }

Solifenacin succinate tablets are supplied as round, film-coated tablets

{ "type": "p", "children": [], "text": "Solifenacin succinate tablets are supplied as round, film-coated tablets" }

NDC: 72162-1848-3: 30 Film Coated Tablets in a BOTTLE

{ "type": "p", "children": [], "text": "NDC: 72162-1848-3: 30 Film Coated Tablets in a BOTTLE" }

NDC: 72162-1848-9: 90 Film Coated Tablets in a BOTTLE

{ "type": "p", "children": [], "text": "NDC: 72162-1848-9: 90 Film Coated Tablets in a BOTTLE" }

5 mg tablets: Light yellow, round shaped, film coated tablets debossed with “S5” on one side and plain on other side.

{ "type": "p", "children": [], "text": "5 mg tablets: Light yellow, round shaped, film coated tablets debossed with “S5” on one side and plain on other side." }

Store at 25ºC (77ºF) with excursions permitted from 15ºC to 30ºC (59°F to 86ºF) [see USP Controlled Room Temperature].

{ "type": "p", "children": [], "text": "Store at 25ºC (77ºF) with excursions permitted from 15ºC to 30ºC (59°F to 86ºF) [see USP Controlled Room Temperature]." }

Repackaged/Relabeled by:Bryant Ranch Prepack, Inc.Burbank, CA 91504

{ "type": "p", "children": [], "text": "Repackaged/Relabeled by:Bryant Ranch Prepack, Inc.Burbank, CA 91504" }

Advise the patient to read the FDA-approved patient labeling (Patient Information).

{ "type": "p", "children": [], "text": "Advise the patient to read the FDA-approved patient labeling (Patient Information)." }

Angioedema and Anaphylactic Reactions

{ "type": "p", "children": [], "text": "Angioedema and Anaphylactic Reactions" }

Inform patients that angioedema and anaphylactic reactions have been reported in patients treated with solifenacin succinate. Angioedema and anaphylactic reactions may be life-threatening. Advise patients to promptly discontinue solifenacin succinate therapy and seek immediate attention if they experience edema of the tongue or laryngopharynx, or difficulty breathing [see Contraindications (4) and Warnings and Precautions (5.1)].

{ "type": "p", "children": [], "text": "Inform patients that angioedema and anaphylactic reactions have been reported in patients treated with solifenacin succinate. Angioedema and anaphylactic reactions may be life-threatening. Advise patients to promptly discontinue solifenacin succinate therapy and seek immediate attention if they experience edema of the tongue or laryngopharynx, or difficulty breathing [see Contraindications (4) and Warnings and Precautions (5.1)].\n" }

Urinary Retention

{ "type": "p", "children": [], "text": "Urinary Retention" }

Inform patients that solifenacin succinate may cause urinary retention in patients with conditions associated with bladder outlet obstruction [see Warnings and Precautions (5.2)].

{ "type": "p", "children": [], "text": "Inform patients that solifenacin succinate may cause urinary retention in patients with conditions associated with bladder outlet obstruction [see Warnings and Precautions (5.2)].\n" }

Gastrointestinal Disorders

{ "type": "p", "children": [], "text": "Gastrointestinal Disorders" }

Inform patients that solifenacin succinate may cause further decrease in gastrointestinal motility in patients with conditions associated with decreased gastrointestinal motility. Solifenacin succinate has been associated with constipation and dry mouth. Advise patients to contact their health care providers if they experience severe abdominal pain or become constipated for 3 or more days [see Warnings and Precautions (5.3)].

{ "type": "p", "children": [], "text": "Inform patients that solifenacin succinate may cause further decrease in gastrointestinal motility in patients with conditions associated with decreased gastrointestinal motility. Solifenacin succinate has been associated with constipation and dry mouth. Advise patients to contact their health care providers if they experience severe abdominal pain or become constipated for 3 or more days [see Warnings and Precautions (5.3)].\n" }

Central Nervous System Effects

{ "type": "p", "children": [], "text": "Central Nervous System Effects" }

Because solifenacin succinate, like other antimuscarinic agents, may cause central nervous system effects or blurred vision, advise patients to exercise caution in decisions to engage in potentially dangerous activities until the drug’s effect on the patient has been determined [see Warnings and Precautions (5.4)].

{ "type": "p", "children": [], "text": "Because solifenacin succinate, like other antimuscarinic agents, may cause central nervous system effects or blurred vision, advise patients to exercise caution in decisions to engage in potentially dangerous activities until the drug’s effect on the patient has been determined [see Warnings and Precautions (5.4)].\n" }

Narrow-Angle Glaucoma

{ "type": "p", "children": [], "text": "Narrow-Angle Glaucoma" }

Inform patients that solifenacin succinate, like other antimuscarinics, may cause worsening of the glaucoma condition in patients with narrow-angle glaucoma [see Warnings and Precautions (5.5)].

{ "type": "p", "children": [], "text": "Inform patients that solifenacin succinate, like other antimuscarinics, may cause worsening of the glaucoma condition in patients with narrow-angle glaucoma [see Warnings and Precautions (5.5)].\n" }

Dry Skin

{ "type": "p", "children": [], "text": "Dry Skin" }

Inform patients that solifenacin succinate, like other antimuscarinics, may cause dry skin due to decreased sweating. Heat prostration due to decreased sweating can occur when solifenacin succinate is used in a hot environment [see Adverse Reactions (6.2)].

{ "type": "p", "children": [], "text": "Inform patients that solifenacin succinate, like other antimuscarinics, may cause dry skin due to decreased sweating. Heat prostration due to decreased sweating can occur when solifenacin succinate is used in a hot environment [see Adverse Reactions (6.2)].\n" }

Revised: November, 2021

{ "type": "p", "children": [], "text": "\nRevised: November, 2021\n" }

<div class="scrollingtable"><table border="0" cellpadding="0" cellspacing="0" width="704.7005"> <colgroup> <col width="100%"/> </colgroup> <tbody class="Headless"> <tr class="Botrule First"> <td align="center" class="Lrule Rrule" valign="top"><span class="Bold">Patient Information</span> <br/> <span class="Bold">Solifenacin Succinate Tablets</span> <br/> <span class="Bold">(</span><span class="Bold">sol ee FEN a sin</span><span class="Bold">)</span><span class="Bold"></span> <br/> </td> </tr> <tr class="Botrule"> <td class="Lrule Rrule" valign="top">Read the Patient Information that comes with solifenacin succinate tablets before you start taking it and each time you get a refill. There may be new information. This leaflet does not take the place of talking with your doctor about your medical condition or treatment.<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top"><span class="Bold"> What is solifenacin succinate tablets?</span> <br/>Solifenacin succinate tablets is a prescription medicine for <span class="Bold">adults </span>used to treat the following symptoms due to a condition called<br/> <span class="Bold">overactive bladder:</span> <br/> <ul class="Disc"> <li>Urge urinary incontinence: a strong need to urinate with leaking or wetting accidents</li> <li>Urgency: a strong need to urinate right away</li> <li>Frequency: urinating often</li> </ul>Solifenacin succinate tablets 5 mg and 10 mg tablets are not approved for use in children.<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top"><span class="Bold">Who should not take solifenacin succinate tablets? </span> <br/> <span class="Bold">Do not </span>take solifenacin succinate tablets if you:<br/> <ul class="Disc"> <li>are not able to empty your bladder (urinary retention)</li> <li>have delayed or slow emptying of your stomach (gastric retention)</li> <li>have an eye problem called “uncontrolled narrow-angle glaucoma”</li> <li>are allergic to solifenacin succinate or any of the ingredients in solifenacin succinate tablets. See the end of this leaflet for a complete list of ingredients.</li> </ul> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top"><span class="Bold">What should I tell my doctor before taking solifenacin succinate tablets? </span> <br/>Before you take solifenacin succinate tablets, tell your doctor if you:<span class="Bold"></span> <br/> <ul class="Disc"> <li>have any stomach or intestinal problems or problems with constipation</li> <li>have trouble emptying your bladder or you have a weak urine stream</li> <li>have an eye problem called “narrow-angle glaucoma”</li> <li>have liver problems</li> <li>have kidney problems</li> <li>have a rare heart problem called “QT prolongation”</li> <li>are pregnant or plan to become pregnant. It is not known if solifenacin succinate will harm your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant.</li> <li>are breastfeeding or plan to breastfeed. It is not known if solifenacin succinate passes into your breast milk. You and your doctor should decide if you will take solifenacin succinate or breastfeed.</li> </ul> <span class="Bold"> Tell your doctor about all the medicines you take, </span>including prescription and nonprescription medicines, vitamins, and herbal supplements. Solifenacin succinate tablets may affect the way other medicines work, and other medicines may affect how solifenacin succinate tablets works.<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top"><span class="Bold">How should I take solifenacin succinate tablets?</span> <br/> <ul class="Disc"> <li>Take solifenacin succinate tablets exactly as your doctor tells you to take it.</li> <li>You should take 1 solifenacin succinate tablet 1 time a day.</li> <li>You should take solifenacin succinate tablets with water and swallow the tablet whole.</li> <li>You can take solifenacin succinate tablets with or without food.</li> <li>If you miss a dose of solifenacin succinate tablets, begin taking solifenacin succinate tablets again the next day. Do not take 2 doses of solifenacin succinate tablets the same day.</li> <li>If you take too much solifenacin  succinate tablets, call your doctor or go to the nearest hospital emergency room right away.</li> </ul> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top"><span class="Bold">What should I avoid while taking solifenacin succinate tablets?</span> <br/>Solifenacin succinate tablets can cause blurred vision or drowsiness. Do not drive or operate heavy machinery until you know how solifenacin succinate tablets affects you.<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top"><span class="Bold">What are the possible side effects of  solifenacin succinate tablets?</span> <br/>Solifenacin succinate tablets may cause serious side effects including:<br/> <ul class="Disc"> <li> <span class="Bold">Serious allergic reaction. </span>Stop taking solifenacin succinate tablets and get medical help right away if you have:<ul class="Disc"> <li>hives, skin rash or swelling</li> <li>severe itching</li> <li>swelling of your face, mouth or tongue</li> <li>trouble breathing</li> </ul> </li> </ul>The most common side effects of solifenacin succinate tablets include:<br/> <ul class="Disc"> <li>dry mouth</li> <li>constipation. Call your doctor if you get severe stomach area (abdominal) pain or become constipated for 3 or more days.</li> <li>urinary tract infection</li> <li>blurred vision</li> </ul>Other side effects have been observed with anticholinergic drugs such as solifenacin succinate tablets and may include:<br/> <ul class="Disc"> <li>dry skin due to decreased sweating. Heat exhaustion or heat stroke can happen due to decreased sweating when solifenacin succinate tablets is used in hot environments. Symptoms may include:<ul class="Disc"> <li>decreased sweating</li> <li>dizziness</li> <li>tiredness</li> <li>nausea</li> <li>increase in body temperature</li> </ul> </li> </ul>Tell your doctor if you have any side effect that bothers you or that does not go away.<br/>These are not all the possible side effects of solifenacin succinate tablets. For more information, ask your doctor or pharmacist.<br/> <span class="Bold">Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.</span> <br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top"><span class="Bold">How should I store solifenacin succinate tablets?</span> <br/> <ul class="Disc"> <li>Store solifenacin succinate tablets between 59°F to 86°F (15°C to 30°C). Keep the bottle closed.</li> <li>Safely throw away medicine that is out of date or no longer needed.</li> </ul> <span class="Bold">Keep solifenacin succinate tablets and all medicines out of the reach of children.</span> <br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top"><span class="Bold">General information about the safe and effective use of solifenacin succinate tablets</span> <br/>Medicines are sometimes prescribed for purposes other than those listed in Patient Information leaflets. Do not use solifenacin succinate tablets for a condition for which it was not prescribed. Do not give solifenacin succinate tablets to other people, even if they have the same symptoms you have. It may harm them.<br/>This leaflet summarizes the most important information about solifenacin succinate tablets. If you would like more information, talk with your doctor. You can ask your doctor or pharmacist for information about solifenacin succinate that is written for health professionals.<br/> </td> </tr> <tr class="Botrule"> <td align="justify" class="Lrule Rrule" valign="top"><span class="Bold">What are the ingredients in solifenacin succinate tablets?</span> <br/> <span class="Bold">Active ingredient: </span>solifenacin succinate<br/> <span class="Bold">Inactive ingredients: </span>lactose monohydrate, corn starch, hypromellose 2910, magnesium stearate. The coating material contains hypromellose 2910, talc, polyethylene glycol 8000 and titanium dioxide with yellow ferric oxide (5 mg solifenacin succinate tablet) or red ferric oxide (10 mg solifenacin succinate tablet).<br/> </td> </tr> <tr class="Last"> <td align="justify" class="Lrule Rrule" valign="top"><span class="Bold">What is overactive bladder?</span> <br/>Overactive bladder occurs when you cannot control your bladder contractions. When these muscle contractions happen too often or cannot be controlled you can get symptoms of overactive bladder, which are urinary frequency, urinary urgency, and urinary incontinence (leakage).<br/> <br/> <span class="Bold">Manufactured by</span>:<br/>Alkem Laboratories Ltd.,<br/> INDIA.<br/> <br/> <span class="Bold">Distributed by:</span> <br/>Ascend Laboratories, LLC<br/>Parsippany, NJ 07054<br/>For more information call [1-877-ASCRX01 (877-272-7901)]<br/> </td> </tr> </tbody> </table></div>

{ "type": "table", "children": [], "text": "<div class=\"scrollingtable\"><table border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"704.7005\">\n<colgroup>\n<col width=\"100%\"/>\n</colgroup>\n<tbody class=\"Headless\">\n<tr class=\"Botrule First\">\n<td align=\"center\" class=\"Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Patient Information</span>\n<br/>\n<span class=\"Bold\">Solifenacin Succinate Tablets</span>\n<br/>\n<span class=\"Bold\">(</span><span class=\"Bold\">sol ee FEN a sin</span><span class=\"Bold\">)</span><span class=\"Bold\"></span>\n<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td class=\"Lrule Rrule\" valign=\"top\">Read the Patient Information that comes with solifenacin succinate tablets before you start taking it and each time you get a refill. There may be new information. This leaflet does not take the place of talking with your doctor about your medical condition or treatment.<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td align=\"justify\" class=\"Lrule Rrule\" valign=\"top\"><span class=\"Bold\"> What is solifenacin succinate tablets?</span>\n<br/>Solifenacin succinate tablets is a prescription medicine for <span class=\"Bold\">adults </span>used to treat the following symptoms due to a condition called<br/>\n<span class=\"Bold\">overactive bladder:</span>\n<br/>\n<ul class=\"Disc\">\n<li>Urge urinary incontinence: a strong need to urinate with leaking or wetting accidents</li>\n<li>Urgency: a strong need to urinate right away</li>\n<li>Frequency: urinating often</li>\n</ul>Solifenacin succinate tablets 5 mg and 10 mg tablets are not approved for use in children.<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td align=\"justify\" class=\"Lrule Rrule\" valign=\"top\"><span class=\"Bold\">Who should not take solifenacin succinate tablets? </span>\n<br/>\n<span class=\"Bold\">Do not </span>take solifenacin succinate tablets if you:<br/>\n<ul class=\"Disc\">\n<li>are not able to empty your bladder (urinary retention)</li>\n<li>have delayed or slow emptying of your stomach (gastric retention)</li>\n<li>have an eye problem called “uncontrolled narrow-angle glaucoma”</li>\n<li>are allergic to solifenacin succinate or any of the ingredients in solifenacin succinate tablets. See the end of this leaflet for a complete list of ingredients.</li>\n</ul>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td align=\"justify\" class=\"Lrule Rrule\" valign=\"top\"><span class=\"Bold\">What should I tell my doctor before taking solifenacin succinate tablets? </span>\n<br/>Before you take solifenacin succinate tablets, tell your doctor if you:<span class=\"Bold\"></span>\n<br/>\n<ul class=\"Disc\">\n<li>have any stomach or intestinal problems or problems with constipation</li>\n<li>have trouble emptying your bladder or you have a weak urine stream</li>\n<li>have an eye problem called “narrow-angle glaucoma”</li>\n<li>have liver problems</li>\n<li>have kidney problems</li>\n<li>have a rare heart problem called “QT prolongation”</li>\n<li>are pregnant or plan to become pregnant. It is not known if solifenacin succinate will harm your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant.</li>\n<li>are breastfeeding or plan to breastfeed. It is not known if solifenacin succinate passes into your breast milk. You and your doctor should decide if you will take solifenacin succinate or breastfeed.</li>\n</ul>\n<span class=\"Bold\"> Tell your doctor about all the medicines you take, </span>including prescription and nonprescription medicines, vitamins, and herbal supplements. Solifenacin succinate tablets may affect the way other medicines work, and other medicines may affect how solifenacin succinate tablets works.<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td align=\"justify\" class=\"Lrule Rrule\" valign=\"top\"><span class=\"Bold\">How should I take solifenacin succinate tablets?</span>\n<br/>\n<ul class=\"Disc\">\n<li>Take solifenacin succinate tablets exactly as your doctor tells you to take it.</li>\n<li>You should take 1 solifenacin succinate tablet 1 time a day.</li>\n<li>You should take solifenacin succinate tablets with water and swallow the tablet whole.</li>\n<li>You can take solifenacin succinate tablets with or without food.</li>\n<li>If you miss a dose of solifenacin succinate tablets, begin taking solifenacin succinate tablets again the next day. Do not take 2 doses of solifenacin succinate tablets the same day.</li>\n<li>If you take too much solifenacin  succinate tablets, call your doctor or go to the nearest hospital emergency room right away.</li>\n</ul>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td align=\"justify\" class=\"Lrule Rrule\" valign=\"top\"><span class=\"Bold\">What should I avoid while taking solifenacin succinate tablets?</span>\n<br/>Solifenacin succinate tablets can cause blurred vision or drowsiness. Do not drive or operate heavy machinery until you know how solifenacin succinate tablets affects you.<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td align=\"justify\" class=\"Lrule Rrule\" valign=\"top\"><span class=\"Bold\">What are the possible side effects of  solifenacin succinate tablets?</span>\n<br/>Solifenacin succinate tablets may cause serious side effects including:<br/>\n<ul class=\"Disc\">\n<li>\n<span class=\"Bold\">Serious allergic reaction. </span>Stop taking solifenacin succinate tablets and get medical help right away if you have:<ul class=\"Disc\">\n<li>hives, skin rash or swelling</li>\n<li>severe itching</li>\n<li>swelling of your face, mouth or tongue</li>\n<li>trouble breathing</li>\n</ul>\n</li>\n</ul>The most common side effects of solifenacin succinate tablets include:<br/>\n<ul class=\"Disc\">\n<li>dry mouth</li>\n<li>constipation. Call your doctor if you get severe stomach area (abdominal) pain or become constipated for 3 or more days.</li>\n<li>urinary tract infection</li>\n<li>blurred vision</li>\n</ul>Other side effects have been observed with anticholinergic drugs such as solifenacin succinate tablets and may include:<br/>\n<ul class=\"Disc\">\n<li>dry skin due to decreased sweating. Heat exhaustion or heat stroke can happen due to decreased sweating when solifenacin succinate tablets is used in hot environments. Symptoms may include:<ul class=\"Disc\">\n<li>decreased sweating</li>\n<li>dizziness</li>\n<li>tiredness</li>\n<li>nausea</li>\n<li>increase in body temperature</li>\n</ul>\n</li>\n</ul>Tell your doctor if you have any side effect that bothers you or that does not go away.<br/>These are not all the possible side effects of solifenacin succinate tablets. For more information, ask your doctor or pharmacist.<br/>\n<span class=\"Bold\">Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.</span>\n<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td align=\"justify\" class=\"Lrule Rrule\" valign=\"top\"><span class=\"Bold\">How should I store solifenacin succinate tablets?</span>\n<br/>\n<ul class=\"Disc\">\n<li>Store solifenacin succinate tablets between 59°F to 86°F (15°C to 30°C). Keep the bottle closed.</li>\n<li>Safely throw away medicine that is out of date or no longer needed.</li>\n</ul>\n<span class=\"Bold\">Keep solifenacin succinate tablets and all medicines out of the reach of children.</span>\n<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td align=\"justify\" class=\"Lrule Rrule\" valign=\"top\"><span class=\"Bold\">General information about the safe and effective use of solifenacin succinate tablets</span>\n<br/>Medicines are sometimes prescribed for purposes other than those listed in Patient Information leaflets. Do not use solifenacin succinate tablets for a condition for which it was not prescribed. Do not give solifenacin succinate tablets to other people, even if they have the same symptoms you have. It may harm them.<br/>This leaflet summarizes the most important information about solifenacin succinate tablets. If you would like more information, talk with your doctor. You can ask your doctor or pharmacist for information about solifenacin succinate that is written for health professionals.<br/>\n</td>\n</tr>\n<tr class=\"Botrule\">\n<td align=\"justify\" class=\"Lrule Rrule\" valign=\"top\"><span class=\"Bold\">What are the ingredients in solifenacin succinate tablets?</span>\n<br/>\n<span class=\"Bold\">Active ingredient: </span>solifenacin succinate<br/>\n<span class=\"Bold\">Inactive ingredients: </span>lactose monohydrate, corn starch, hypromellose 2910, magnesium stearate. The coating material contains hypromellose 2910, talc, polyethylene glycol 8000 and titanium dioxide with yellow ferric oxide (5 mg solifenacin succinate tablet) or red ferric oxide (10 mg solifenacin succinate tablet).<br/>\n</td>\n</tr>\n<tr class=\"Last\">\n<td align=\"justify\" class=\"Lrule Rrule\" valign=\"top\"><span class=\"Bold\">What is overactive bladder?</span>\n<br/>Overactive bladder occurs when you cannot control your bladder contractions. When these muscle contractions happen too often or cannot be controlled you can get symptoms of overactive bladder, which are urinary frequency, urinary urgency, and urinary incontinence (leakage).<br/>\n<br/>\n<span class=\"Bold\">Manufactured by</span>:<br/>Alkem Laboratories Ltd.,<br/> INDIA.<br/>\n<br/>\n<span class=\"Bold\">Distributed by:</span>\n<br/>Ascend Laboratories, LLC<br/>Parsippany, NJ 07054<br/>For more information call [1-877-ASCRX01 (877-272-7901)]<br/>\n</td>\n</tr>\n</tbody>\n</table></div>" }

        This Patient Information has been approved by the U.S. Food and Drug Administration.                          Revised: November, 2021

{ "type": "p", "children": [], "text": "        This Patient Information has been approved by the U.S. Food and Drug Administration.                          Revised: November, 2021" }

PT2777-04

{ "type": "p", "children": [], "text": "PT2777-04" }

Solifenacin Succinate 5 mg Tablet #30

{ "type": "p", "children": [], "text": "Solifenacin Succinate 5 mg Tablet #30" }