Emfenacin
Emfenacin Uses, Dosage, Side Effects, Food Interaction and all others data.
Emfenacin is a competitive muscarinic (acetylcholine) receptor antagonist. The binding of acetylcholine to these receptors, particularly the M3 receptor subtype, plays a critical role in the contraction of smooth muscle. By preventing the binding of acetylcholine to these receptors, solifenacin reduces smooth muscle tone in the bladder, allowing the bladder to retain larger volumes of urine and reducing the number of incontinence episodes.
Emfenacin antagonizes the M2 and M3 muscarinic receptors in the bladder to treat an overactive bladder. It has a long duration of action as it is usually taken once daily. Patients taking solifenacin should be aware of the risks of angioedema and anaphylaxis.
Trade Name | Emfenacin |
Availability | Prescription only |
Generic | Solifenacin |
Solifenacin Other Names | Solifenacin, Solifenacina |
Related Drugs | oxybutynin, Myrbetriq, tolterodine, mirabegron, Ditropan, Detrol, Botox, VESIcare, trospium, Gemtesa |
Type | Tablet |
Formula | C23H26N2O2 |
Weight | Average: 362.473 Monoisotopic: 362.199428085 |
Protein binding | Solifenacin is 93-96% protein bound in plasma, mainly to alpha-1-acid glycoprotein. |
Groups | Approved |
Therapeutic Class | Anticholinergics (antimuscarinics)/ Anti-spasmodics, BPH/ Urinary retention/ Urinary incontinence |
Manufacturer | Emcure Pharmaceuticals Ltd |
Available Country | India |
Last Updated: | September 19, 2023 at 7:00 am |
Uses
Symptomatic treatment of urge incontinence and/or increased urinary frequency and urgency as may occur in patients with overactive bladder syndrome.
Emfenacin is also used to associated treatment for these conditions: Benign Prostatic Hyperplasia (BPH), Urinary Bladder, Overactive
How Emfenacin works
Emfenacin is a competitive muscarinic receptor antagonist. It has the highest affinity for M3, M1, and M2 muscarinic receptors. 80% of the muscarinic receptors in the bladder are M2, while 20% are M3. Emfenacin's antagonism of the M3 receptor prevents contraction of the detrusor muscle, while antagonism of the M2 receptor may prevent contraction of smooth muscle in the bladder.
Dosage
Emfenacin dosage
Adults, including the elderly: The recommended dose is Emfenacin Succinate 5 mg once daily. If needed, the dose may be increased to Emfenacin Succinate 10 mg once daily.
Children and adolescents: Safety and effectiveness in children have not yet been established. Therefore, Emfenacin Succinate should not be used in children.
Side Effects
The most common side effects are blurred vision, dry mouth, constipation & heat prostration. Other side effects include dizziness, fatigue, edema, palpitation and skin reactions. Disorientation, hallucination and convulsion may occur.
Toxicity
The LD50 of Emfenacin has yet to be determined.
Signs of overdose include severe anticholinergic effects, mental status changes, and decreased consciousness. In case of overdose, treat patients with gastric lavage and supportive measures. Monitor patients with an ECG.
Precaution
Other causes of frequent urination (heart failure or renal disease) should be assessed before treatment with Emfenacin. If urinary tract infection is present, an appropriate antibacterial therapy should be started. Emfenacin Succinate should be used with caution in patients with clinically significant bladder outflow obstruction at risk of urinary retention, gastrointestinal obstructive disorders, risk of decreased gastrointestinal motility, severe renal impairment (creatinine clearance 30 ml/min), moderate hepatic impairment, concomitant use of a strong CYP3A4 inhibitor, e.g. ketoconazole
Interaction
Concomitant medication with other drugs with anticholinergic properties may result in more pronounced therapeutic effects and side effects. The therapeutic effect of solifenacin may be reduced by concomitant administration of cholinergic receptor agonists. Emfenacin can reduce the effect of drugs that stimulate the motility of the gastro-intestinal tract, such as metoclopramide and cisapride. Ketoconazole & other CYP3A4 inhibitors increase the plasma concentration of solifenacin.
Food Interaction
- Take with or without food.
Emfenacin Drug Interaction
Moderate: diphenhydramine, mirabegron, budesonide / formoterolMinor: acetaminophen, acetaminophenUnknown: aspirin, ubiquinone, duloxetine, apixaban, omega-3 polyunsaturated fatty acids, pregabalin, metoprolol, metoprolol, levothyroxine, cyanocobalamin, ascorbic acid, ergocalciferol, cholecalciferol, rivaroxaban, cetirizine
Emfenacin Disease Interaction
Major: GI motility, kidney impairment, liver impairment, narrow-angle glaucoma, urinary obstructionModerate: CNS, QT prolongation
Volume of Distribution
The volume of distribution of solifenacin is 600L.
Elimination Route
Emfenacin is well absorbed in the duodenum, jejunum, and ileum but not the stomach. Absorption occurs via passive diffusion and so no transporters are involved. The mean oral bioavailability of solifenacin is 88%. The Tmax of solifenacin is 3-8 hours with a Css of 32.3ng/mL for a 5mg oral dose and 62.9ng/mL for a 10mg oral dose.
Half Life
The elimination half life of solifenacin ranges from 33-85 hours.
Clearance
The clearance of solifenacin is 7-14L/h and a renal clearance of 0.67-1.51L/h.
Elimination Route
69.2±7.8% of a radiolabelled dose is recovered in the urine, 22.5±3.3% was recovered in feces, and 0.4±7.8% was recovered in exhaled air. 18% of solifenacin is eliminated as the N-oxide metabolite, 9% is eliminated as the 4R-hydroxy N-oxide metabolite, and 8% is eliminated as the 4R-hydroxy metabolite.
Pregnancy & Breastfeeding use
Use in pregnancy: There are no adequate data from the use of solifenacin succinate in pregnant women. Caution should be exercised while prescribing solifenacin to pregnant women.
Use in lactating mother: No data concerning the excretion of solifenacin into breast milk are available. The use of Emfenacin is avoided in lactating mother.
Contraindication
Emfenacin is contraindicated in patients with hypersensitivity to solifenacin or to any of the excipients. It is also contraindicated in myasthenia gravis, urinary retention, uncontrolled narrow angle glaucoma, severe gastro-intestinal condition (including toxic megacolon), patients undergoing haemodialysis, patients with severe hepatic impairment, patients with severe renal impairment or moderate hepatic impairment and on treatment with a strong CYP3A4 inhibitor, e.g. ketoconazole.
Special Warning
Patients with renal impairment: No dosage adjustment is necessary for patients with mild to moderate renal impairment (creatinine clearance > 30 ml/min). Patients with severe renal impairment (creatinine clearance 30 ml/min) should be treated with caution and receive no more than 5 mg Emfenacin SuccinateTablet once daily.
Patients with hepatic impairment: No dosage adjustment is necessary for patients with mild hepatic impairment. Patients with moderate hepatic impairment should be treated with caution and receive no more than 5 mg Emfenacin SuccinateTablet once daily.
Patients taking CYP3A4 inhibitors concomitantly: The maximum dose of Emfenacin Succinateshould be limited to 5 mg when treated simultaneously with ketoconazole or other potent CYP3A4 inhibitors e.g. ritonavir, nelfinavir or itraconazole.
Use in children: Safety and efficacy of solifenacin in children have not been established.
Innovators Monograph
You find simplified version here Emfenacin
Emfenacin contains Solifenacin see full prescribing information from innovator Emfenacin Monograph, Emfenacin MSDS, Emfenacin FDA label
FAQ
What is Emfenacin used for?
Emfenacin used to treat symptoms of an overactive bladder.
How safe is Emfenacin?
Taking 1 extra dose of Emfenacin is unlikely to harm you. However, you may get more side effects, such as a dry mouth or headache. The amount of Emfenacin that can lead to an overdose varies from person to person, and too much Emfenacin can be dangerous.
How does Emfenacin work?
Emfenacin works by relaxing the muscle that is found in the wall of the bladder. This helps to increase the volume of pee your bladder can hold and control the release of pee.
What are the common side effects of Emfenacin?
Common side effects of Emfenacin are include:
- dry mouth
- constipation
- stomach pain
- upset stomach
- vomiting
- heartburn
- dry eyes
- blurred vision
- dry skin
Is Emfenacin safe during pregnancy?
Emfenacin should be used during pregnancy only if the possible benefit outweighs the possible risk to the unborn baby.
Is Emfenacin safe during breastfeeding?
There is no published experience with Emfenacin during breastfeeding.
Can I drink alcohol with Emfenacin?
Limit drinking alcohol while your are taking Emfenacin. Alcohol can increase the risk of side effects.
Can I drive after taking Emfenacin?
You should know that Emfenacin may make you dizzy or drowsy or cause blurred vision. Do not drive a car or operate machinery until you know how this medication affects you.
When is the best time to take Emfenacin?
Try to take the tablet at the same time of day each day, as this will help you to remember to take your doses regularly. You can take Emfenacin either before or after meals.
How long does it take for Emfenacin to start working?
Most people start to notice improvement in symptoms about 4 weeks after starting Emfenacin. It can take up to 12 weeks to see the full effects.
Should Emfenacin be taken at night?
Night time dosing with Emfenacin would more effectively improve night time symptoms such as nocturia.
Does Emfenacin work immediately?
You will usually take this medicine long term to help keep your symptoms under control.Emfenacin starts to work within 3 to 8 hours, but it can take up to 4 weeks to reach its full effect.
How long does Emfenacin stay in my system?
Emfenacin has 90% bioavailability and a long half-life of 45–68 hours.
What happens if I stop taking Emfenacin?
If you stop taking the drug or don't take it at all symptoms will likely not improve.
Does Emfenacin lower blood pressure?
Therapeutically effective doses of Emfenacin did not increase heart rate or blood pressure.
Does Emfenacin cause constipation?
Emfenacin may cause constipation. Call your doctor if you get severe stomach pain or become constipated for 3 or more days. This medicine may cause dry mouth.
Can Emfenacin cause dementia?
Emfenacin can causes denimia also with other side effects.
Who should not take Emfenacin?
It shouldn't be used in children younger than 18 years.
You should not use Emfenacin if you have untreated or uncontrolled narrow-angle glaucoma, a blockage in your digestive tract, or if you are unable to urinate.
What happens if I miss a dose?
Skip the missed dose and use your next dose at the regular time. Do not take 2 doses on the same day.
Oral suspension: Take Emfenacin as soon as you can, but skip the missed dose if you are more than 12 hours late for the dose. Do not take two doses at one time.