Drug interactions
Physostigmine + Solifenacin
Severity: Moderate
Physostigmine and Solifenacin: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Physostigmine increases cholinergic activity by inhibiting acetylcholinesterase, while solifenacin blocks muscarinic receptors, so each opposes the other. Physostigmine is used to reverse anticholinergic toxicity, including from antimuscarinic overdose.
What this interaction means in plain words
Physostigmine and Solifenacin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Pharmacodynamic antagonism between cholinesterase inhibition and muscarinic receptor blockade.
What to do
Expect reduced solifenacin effect if given together; when physostigmine is used for antimuscarinic toxicity, monitor for bradycardia, bronchospasm, seizures, and excessive cholinergic effects with atropine available.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Solifenacin
Frequently asked questions
Can I take Physostigmine with Solifenacin?
MediHelp rates the interaction as moderate. Physostigmine and Solifenacin can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Physostigmine increases cholinergic activity by inhibiting acetylcholinesterase, while solifenacin blocks muscarinic receptors, so each opposes the other. Physostigmine is used to reverse anticholinergic toxicity, including from antimuscarinic overdose.
How serious is the interaction between Physostigmine and Solifenacin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Expect reduced solifenacin effect if given together; when physostigmine is used for antimuscarinic toxicity, monitor for bradycardia, bronchospasm, seizures, and excessive cholinergic effects with atropine available.
What other medicines interact with Solifenacin?
MediHelp also lists interactions of Solifenacin with, for example, Adagrasib, Amiodarone, Amisulpride. The full list is on the Solifenacin page.
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