Mirabegron Brand Name– Myrbetriq
What is Mirabegron
Mirabegron is a beta-3 adrenergic receptor (beta-3 AR) agonist indicated for the treatment of patients with overactive bladder (OAB) with symptoms of urge urinary incontinence, urgency, and urinary frequency.
Mirabegron was the first in this class of agents with a novel mechanism for improving the symptoms of OAB. By relaxing the detrusor muscle via beta-3 AR activation, bladder capacity is increased during the urine storage phase.
In monotherapy clinical studies for OAB, mirabegron was associated with a reduction in urinary frequency and incontinence during a 24-hour period. At the 50 mg/day dose, patients also expelled a greater volume of urine, demonstrating effectiveness at improving bladder capacity.
Mirabegron is usually well-tolerated by patients. Other oral agents approved for OAB treatment exert their effect through muscarinic receptor antagonism, a mechanism that can lead to anticholinergic-based side effects; mirabegron provides an alternative for patients experiencing intolerance to these agents.
However, mirabegron has also been shown to be effective when used with muscarinic antagonists.
Trials with the combined therapy of solifenacin plus mirabegron provided improvement in the number of incontinent episodes versus solifenacin alone, and with similar tolerability; dry mouth and constipation were the primary side effects in both treatment groups. Of note, because of mirabegron’s potential for increasing blood pressure, its use is not recommended for those patients with uncontrolled hypertension (SBP greater than or equal to 180 mmHg or DBP greater than or equal to 110 mmHg).
Mirabegron was first FDA-approved in 2012.
The drug is approved for use in adults with OAB as monotherapy and as combination therapy with solifenacin, a muscarinic antagonist
Indications
- overactive bladder (OAB)
- urinary incontinence
For the treatment of overactive bladder (OAB) with symptoms of urge urinary incontinence, urgency, and urinary frequency
Side Effects
- abdominal pain
- angioedema
- anxiety
- arthralgia
- atrial fibrillation
- back pain
- bladder discomfort
- blurred vision
- confusion
- constipation
- cystitis
- diarrhea
- dizziness
- dyspepsia
- elevated hepatic enzymes
- fatigue
- gastritis
- hallucinations
- headache
- hypertension
- infection
- influenza
- insomnia
- nausea
- nephrolithiasis
- new primary malignancy
- ocular hypertension
- palpitations
- pharyngitis
- pruritus
- purpura
- rash
- rhinitis
- sinus tachycardia
- sinusitis
- Stevens-Johnson syndrome
- stroke
- urinary retention
- urticaria
- vaginal irritation
- vaginitis
- vasculitis
- xerophthalmia
- xerostomia
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- anticholinergic medications
- bladder obstruction
- breast-feeding
- children
- dialysis
- geriatric
- hepatic disease
- history of angioedema
- hypertension
- infants
- pregnancy
- renal failure
- renal impairment
- urinary retention
- urinary tract obstruction
Interactions
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
- Acetaminophen; Dextromethorphan; Phenylephrine
- Acetaminophen; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Diphenhydramine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Tramadol
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amoxapine
- Aripiprazole
- Asenapine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atazanavir; Cobicistat
- Atomoxetine
- Brimonidine; Timolol
- Brompheniramine; Dextromethorphan; Guaifenesin
- Brompheniramine; Dextromethorphan; Phenylephrine
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Carbetapentane; Chlorpheniramine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carvedilol
- Cevimeline
- Chlorpheniramine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Chlorpromazine
- Cinacalcet
- Clomipramine
- Clozapine
- Cobicistat
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Darifenacin
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Delavirdine
- Desipramine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dextromethorphan
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Guaifenesin
- Dextromethorphan; Guaifenesin; Phenylephrine
- Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate
- Dextromethorphan; Guaifenesin; Pseudoephedrine
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Digoxin
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Diphenhydramine; Phenylephrine
- Dolasetron
- Donepezil
- Donepezil; Memantine
- Dorzolamide; Timolol
- Doxepin
- Doxorubicin
- Duloxetine
- Dutasteride; Tamsulosin
- Eliglustat
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Encainide
- Fesoterodine
- Flecainide
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluphenazine
- Fluticasone; Umeclidinium; Vilanterol
- Fluvoxamine
- Fosamprenavir
- Gefitinib
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Haloperidol
- Homatropine; Hydrocodone
- Hydrochlorothiazide, HCTZ; Metoprolol
- Hydrochlorothiazide, HCTZ; Propranolol
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Ibuprofen; Oxycodone
- Iloperidone
- Imipramine
- Indacaterol
- Indacaterol; Glycopyrrolate
- Isocarboxazid
- Ivermectin
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Maprotiline
- Meclizine
- Meperidine; Promethazine
- Methadone
- Metoprolol
- Mexiletine
- Mirtazapine
- Monoamine oxidase inhibitors
- Nebivolol
- Nebivolol; Valsartan
- Netupitant, Fosnetupitant; Palonosetron
- Nortriptyline
- Olanzapine
- Ombitasvir; Paritaprevir; Ritonavir
- Ondansetron
- Oxybutynin
- Oxycodone
- Palonosetron
- Paroxetine
- Pentamidine
- Perphenazine
- Perphenazine; Amitriptyline
- Phenelzine
- Phenylephrine; Promethazine
- Pimozide
- Pirfenidone
- Promethazine
- Propafenone
- Propranolol
- Protriptyline
- Quinine
- Ranolazine
- Ritonavir
- Sertraline
- Solifenacin
- Tamsulosin
- Tetrabenazine
- Thioridazine
- Timolol
- Tolterodine
- Tramadol
- Tranylcypromine
- Tricyclic antidepressants
- Trimipramine
- Umeclidinium
- Umeclidinium; Vilanterol
- Venlafaxine
- Vilazodone
- Warfarin
- Yohimbine
