Symptoms: Over dosage with solifenacin succinate can potentially result in severe anticholinergic effects. The highest dose of solifenacin succinate accidentally given to a single patient was 280 mg in a 5-hour period, resulting in mental status changes not requiring hospitalization.
Treatment: In the event of overdose with solifenacin succinate the patient should be treated with activated charcoal. Gastric lavage is useful if performed within 1 hour, but vomiting should not be induced.
As for other anticholinergics, symptoms can be treated as follows: Severe central anticholinergic effects such as hallucinations or pronounced excitation: treat with physostigmine or carbachol.
Convulsions or pronounced excitation: treat with benzodiazepines.
Respiratory insufficiency: treat with artificial respiration.
Tachycardia: treat with beta-blockers.
Urinary retention: treat with catheterization.
Mydriasis: treat with pilocarpine eye drops and/or place patient in dark room.
As with other antimuscarinics, in case of overdosing, specific attention should be paid to patients with known risk for QT prolongation (i.e. hypokalemia, bradycardia and concurrent administration of medicinal products known to prolong QT interval) and relevant preexisting cardiac diseases (i.e. myocardial ischemia, arrhythmia, congestive heart failure).
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