increased risk for potentially fatal adverse events.Serious - Use Alternative (1)itraconazole and solifenacin both increase QTc interval. Avoid or Use Alternate Drug.ivosidenibSerious - Use Alternative (2)ivosidenib and solifenacin both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation. ivosidenib will decrease the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP3A4 substrates with ivosidenib or replace with alternative therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.ketoconazoleSerious - Use Alternative (1)ketoconazole will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Do not exceed a 5 mg/day dosage of solifenacin when concomitantly used with strong CYP3A4 inhibitors.lapatinibMonitor Closely (2)lapatinib will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. solifenacin and lapatinib both increase QTc interval. Use Caution/Monitor.larotrectinibMinor (1)larotrectinib will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.lefamulinContraindicated (1)lefamulin will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Lefamulin is contraindicated with CYP3A substrates know to prolong the QT interval.Serious - Use Alternative (1)solifenacin and lefamulin both increase QTc interval. Avoid or Use Alternate Drug.lenacapavirMonitor Closely (1)lenacapavir will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lencapavir may increase CYP3A4 substrates initiated within 9 months after last SC dose of lenacapavir, which may increase potential risk of adverse reactions of CYP3A4 substrates.lenvatinibSerious - Use Alternative (1)solifenacin and lenvatinib both increase QTc interval. Avoid or Use Alternate Drug.letermovirMonitor Closely (1)letermovir increases levels of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.leuprolideMonitor Closely (1)solifenacin and leuprolide both increase QTc interval. Use Caution/Monitor.levodopaMinor (1)solifenacin, levodopa. Other (see comment). Minor/Significance Unknown. Comment: Anticholinergic agents may enhance the therapeutic effects of levodopa; however, anticholinergic agents can exacerbate tardive dyskinesia. In high dosage, anticholinergics may decrease the effects of levodopa by delaying its GI absorption. .levoketoconazoleSerious - Use Alternative (1)levoketoconazole will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Do not exceed a 5 mg/day dosage of solifenacin when concomitantly used with strong CYP3A4 inhibitors.lithiumMonitor Closely (1)lithium and solifenacin both increase QTc interval. Use Caution/Monitor.lofepramineMonitor Closely (1)solifenacin and lofepramine both decrease cholinergic effects/transmission. Use Caution/Monitor.lofexidineMonitor Closely (1)solifenacin and lofexidine both increase QTc interval. Use Caution/Monitor.lonafarnibSerious - Use Alternative (1)lonafarnib will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. Avoid coadministration with sensitive CYP3A substrates. If coadministration unavoidable, monitor for adverse reactions and reduce CYP3A substrate dose in accordance with product labeling.loperamideMonitor Closely (1)solifenacin and loperamide both increase QTc interval. Use Caution/Monitor.lopinavirSerious - Use Alternative (2)lopinavir will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. solifenacin and lopinavir both increase QTc interval. Avoid or Use Alternate Drug.lorlatinibMonitor Closely (1)lorlatinib will decrease the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.loxapineMonitor Closely (3)solifenacin decreases levels of loxapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. solifenacin decreases levels of loxapine by pharmacodynamic antagonism. Use Caution/Monitor. loxapine increases effects of solifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.loxapine inhaledMonitor Closely (2)loxapine inhaled increases effects of solifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. solifenacin decreases levels of loxapine inhaled by pharmacodynamic antagonism. Use Caution/Monitor.lumefantrineMonitor Closely (1)lumefantrine will decrease the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.macimorelinSerious - Use Alternative (1)macimorelin and solifenacin both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.maprotilineMonitor Closely (1)solifenacin and maprotiline both decrease cholinergic effects/transmission. Use Caution/Monitor.Serious - Use Alternative (1)solifenacin and maprotiline both increase QTc interval. Avoid or Use Alternate Drug.marijuanaMonitor Closely (1)marijuana will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.meclizineMonitor Closely (1)meclizine and solifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.mefloquineSerious - Use Alternative (1)mefloquine increases toxicity of solifenacin by QTc interval. Avoid or Use Alternate Drug. Mefloquine may enhance the QTc prolonging effect of high risk QTc prolonging agents.methadoneSerious - Use Alternative (1)solifenacin and methadone both increase QTc interval. Avoid or Use Alternate Drug.methscopolamineMonitor Closely (1)methscopolamine and solifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.methylprednisoloneMonitor Closely (1)methylprednisolone will decrease the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.metronidazoleMonitor Closely (1)metronidazole will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.miconazole vaginalMonitor Closely (1)miconazole vaginal will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.midostaurinSerious - Use Alternative (1)solifenacin and midostaurin both increase QTc interval. Avoid or Use Alternate Drug.mifepristoneMonitor Closely (2)mifepristone will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. mifepristone, solifenacin. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.mirabegronMonitor Closely (1)mirabegron increases toxicity of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor patients for signs/symptoms of urinary retention.mirtazapineMonitor Closely (1)mirtazapine and solifenacin both increase QTc interval. Use Caution/Monitor.mitotaneMonitor Closely (1)mitotane decreases levels of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Mitotane is a strong inducer of cytochrome P-4503A4; monitor when coadministered with CYP3A4 substrates for possible dosage adjustments.mobocertinibSerious - Use Alternative (1)mobocertinib and solifenacin both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.nafcillinMonitor Closely (1)nafcillin will decrease the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nefazodoneSerious - Use Alternative (1)nefazodone will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.nelfinavirMonitor Closely (1)nelfinavir will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.neostigmineMonitor Closely (1)neostigmine increases and solifenacin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.nevirapineMonitor Closely (1)nevirapine will decrease the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nifedipineMonitor Closely (1)nifedipine will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nilotinibMonitor Closely (1)nilotinib will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.nortriptylineMonitor Closely (2)solifenacin and nortriptyline both increase QTc interval. Use Caution/Monitor. solifenacin and nortriptyline both decrease cholinergic effects/transmission. Use Caution/Monitor.octreotideMonitor Closely (1)solifenacin and octreotide both increase QTc interval. Use Caution/Monitor.ofloxacinMonitor Closely (1)solifenacin and ofloxacin both increase QTc interval. Use Caution/Monitor.olanzapineMonitor Closely (4)solifenacin decreases levels of olanzapine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. solifenacin decreases levels of olanzapine by pharmacodynamic antagonism. Use Caution/Monitor. olanzapine increases effects of solifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. olanzapine and solifenacin both increase QTc interval. Use Caution/Monitor.oliceridineMonitor Closely (1)solifenacin increases toxicity of oliceridine by Other (see comment). Use Caution/Monitor. Comment: Anticholinergic drugs may increase risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. Monitor for signs of urinary retention or reduced gastric motility if oliceridine is coadministered with anticholinergics.onabotulinumtoxinAMonitor Closely (1)onabotulinumtoxinA and solifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.ondansetronSerious - Use Alternative (1)ondansetron and solifenacin both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.orphenadrineMonitor Closely (1)solifenacin and orphenadrine both decrease cholinergic effects/transmission. Use Caution/Monitor.osilodrostatMonitor Closely (1)osilodrostat and solifenacin both increase QTc interval. Use Caution/Monitor.osimertinibMonitor Closely (1)osimertinib and solifenacin both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.oxaliplatinSerious - Use Alternative (1)oxaliplatin and solifenacin both increase QTc interval. Avoid or Use Alternate Drug.oxcarbazepineMonitor Closely (1)oxcarbazepine will decrease the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.oxybutyninMonitor Closely (1)oxybutynin and solifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.oxybutynin topicalMonitor Closely (1)oxybutynin topical and solifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.oxybutynin transdermalMonitor Closely (1)oxybutynin transdermal and solifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.ozanimodMonitor Closely (1)ozanimod and solifenacin both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.paliperidoneMonitor Closely (3)solifenacin decreases levels of paliperidone by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. solifenacin decreases levels of paliperidone by pharmacodynamic antagonism. Use Caution/Monitor. paliperidone increases effects of solifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.Serious - Use Alternative (1)solifenacin and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.pancuroniumMonitor Closely (1)pancuronium and solifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.panobinostatSerious - Use Alternative (1)solifenacin and panobinostat both increase QTc interval. Avoid or Use Alternate Drug.pasireotideMonitor Closely (1)solifenacin and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.pazopanibMonitor Closely (1)solifenacin and pazopanib both increase QTc interval. Use Caution/Monitor.pentamidineSerious - Use Alternative (1)solifenacin and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.pentobarbitalMonitor Closely (1)pentobarbital will decrease the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.perphenazineMonitor Closely (4)solifenacin decreases levels of perphenazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. solifenacin decreases levels of perphenazine by pharmacodynamic antagonism. Use Caution/Monitor. perphenazine increases effects of solifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. solifenacin and perphenazine both increase QTc interval. Use Caution/Monitor.phenobarbitalMonitor Closely (1)phenobarbital will decrease the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.phenytoinMonitor Closely (1)phenytoin will decrease the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.physostigmineMonitor Closely (1)physostigmine increases and solifenacin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.pilocarpineMonitor Closely (1)pilocarpine increases and solifenacin decreases cholinergic effects/transmission. Effect of interaction is not clear, use caution. Use Caution/Monitor.pimavanserinSerious - Use Alternative (1)solifenacin and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.pimozideMonitor Closely (3)solifenacin decreases levels of pimozide by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. solifenacin decreases levels of pimozide by pharmacodynamic antagonism. Use Caution/Monitor. pimozide increases effects of solifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia.Serious - Use Alternative (1)solifenacin and pimozide both increase QTc interval. Contraindicated.pitolisantSerious - Use Alternative (1)solifenacin and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.ponesimodSerious - Use Alternative (1)solifenacin and ponesimod both increase QTc interval. Avoid or Use Alternate Drug.posaconazoleMonitor Closely (1)posaconazole will increase the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.Serious - Use Alternative (1)solifenacin and posaconazole both increase QTc interval. Contraindicated.prabotulinumtoxinAMonitor Closely (1)solifenacin, prabotulinumtoxinA. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Use of anticholinergic drugs after administration of botulinum toxin-containing products may potentiate systemic anticholinergic effects.pralidoximeMonitor Closely (1)pralidoxime and solifenacin both decrease cholinergic effects/transmission. Use Caution/Monitor.pramlintideSerious - Use Alternative (1)pramlintide, solifenacin. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.prednisoneMonitor Closely (1)prednisone will decrease the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.primaquineMonitor Closely (1)primaquine and solifenacin both increase QTc interval. Use Caution/Monitor.primidoneMonitor Closely (1)primidone will decrease the level or effect of solifenacin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.procainamideMonitor Closely (1)solifenacin and procainamide both increase QTc interval. Use Caution/Monitor.prochlorperazineMonitor Closely (4)solifenacin decreases levels of prochlorperazine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. solifenacin decreases levels of prochlorperazine by pharmacodynamic antagonism. Use Caution/Monitor. prochlorperazine increases effects of solifenacin by pharmacodynamic synergism. Use Caution/Monitor. Additive anticholinergic effects, possible hypoglycemia. solifenacin and prochlorperazine both decrease QTc interval. Use Caution/Monitor.promethazineMonitor Closely (4)solifenacin decreases levels of promethazine by inhibition of GI absorption. Applies only to oral