Mirabegron is a selective β3 adrenergic receptor agonist primarily used to treat symptoms caused by overactive bladder (OAB). This medication works by selectively stimulating β3 receptors on the bladder smooth muscle, relaxing overactive detrusor muscles, and improving symptoms such as urgency incontinence, frequency, and urinary urgency. Unlike traditional anticholinergic drugs, Mirabegron directly acts on the bladder muscle, offering an alternative treatment option.
Clinical trials have shown that this drug can significantly reduce the number of daily urinations and extend the interval between urinations. Its mechanism of action is unique, with less impact on β receptors outside the bladder (such as β1 and β2 receptors in the heart), thus reducing cardiovascular side effects.
The generic name of this drug is Mirabegron, with the main brand name being Myrbetriq. Different countries may have other trade names, but the generic drug has been marketed in most regions. Patients should verify that the active ingredient on the medication packaging is Mirabegron and follow their physician’s prescription.
Mirabegron is classified as a selective β3 adrenergic receptor agonist, belonging to a novel class of drugs for overactive bladder treatment. This category of drugs has a different mechanism from anticholinergic agents (such as Solifenacin), mainly targeting neural regulation of the bladder muscle, providing a multifaceted treatment approach.
This medication is approved for use in adult patients with symptoms caused by overactive bladder, including:
It is suitable for patients with acute and neurogenic overactive bladder, but should be used in conjunction with a physician’s assessment of other potential causes.
Mild side effects include:
Serious side effects, though rare, include:
Contraindications:
Pregnancy is classified as Category C; women who are pregnant or planning pregnancy should evaluate risks and benefits. Use during breastfeeding may lead to secretion into breast milk; weigh the pros and cons before use. Patients with hepatic or renal impairment should have dosage adjustments.
Concomitant use with CYP2D6 inhibitors (such as Paroxetine, Fluoxetine) may increase blood concentrations, requiring dose adjustments. Avoid combining with strong CYP2D6 inducers (such as Carbamazepine), which may reduce efficacy.
Using with other antihypertensive agents (such as norepinephrine) may enhance blood pressure elevation. Patients should inform their healthcare provider of all prescription drugs, over-the-counter medications, and herbal supplements they are taking.
The initial dose is usually 50 mg once daily, which can be adjusted to 100 mg based on efficacy and tolerability. It should be taken as a whole tablet, unaffected by meals, but taking it at a fixed time each day is recommended to maintain stable drug levels.
Patients with severe hepatic impairment (Child-Pugh Class C) should reduce the dose to 50 mg once daily. Patients with renal impairment should adjust the dose according to creatinine clearance to avoid accumulation and toxicity.
If a dose is missed and more than 6 hours remain before the next scheduled dose, take it as soon as possible. If it is close to the next dose time, skip the missed dose and take the next dose at the scheduled time. Do not double doses to make up for missed ones.
Overdose may cause palpitations, dizziness, increased blood pressure, or decreased urine output. If these symptoms occur, seek medical attention immediately; do not attempt to treat at home. Emergency treatment may include the use of β-blockers or hemodialysis, but non-selective β-blockers should be avoided.
Mirabegron can be taken with or without food; the timing is not affected by meals. However, to reduce gastrointestinal discomfort, it is recommended to take it at a consistent time each day and maintain regular eating habits. Avoid excessive alcohol intake, as it may enhance the drug’s effect on blood pressure.
How to manage potential side effects like dry mouth or constipation during long-term use of Mirabegron?Dry mouth can be alleviated by increasing fluid intake or using sugar-free lozenges; constipation can be managed by increasing fiber intake, exercising regularly, and, if severe, consulting a doctor for dose adjustment or laxatives. If symptoms persist or worsen, seek medical evaluation promptly.
What drug interactions should be considered when combining Mirabegron with other antihypertensive medications?Combining Mirabegron with diuretics or β-blockers may enhance blood pressure lowering effects, potentially causing orthostatic hypotension. Physicians will adjust doses based on blood pressure, and patients should monitor their blood pressure regularly, avoiding sudden standing or prolonged standing.
Do I need to restrict fluid intake or adjust urination habits while using Mirabegron?There is no need to deliberately limit water intake, but avoid drinking large amounts of water in a short period to reduce the sensation of frequent urination. Urination habits should follow natural needs. If difficulty urinating or urinary retention occurs, stop the medication immediately and seek medical attention, as these may be contraindications.
Is gradual dose reduction necessary when discontinuing Mirabegron to prevent withdrawal reactions?There is no clear evidence that gradual tapering is required, but discontinuation should be decided by a healthcare provider. If symptoms worsen after sudden cessation (such as bladder discomfort or urinary retention), return to the clinic for dose adjustment, and avoid self-modification of the medication plan.
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