Mirabegron (Myrbetriq) is a prescription beta-3 adrenergic agonist that relaxes the bladder muscle, used to treat overactive bladder symptoms such as urinary urgency, frequency, and urge incontinence.
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Dr. Steve Malen, PharmD
Dr. Steven Blikstein, PharmD
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Mirabegron (Myrbetriq) is a beta-3 adrenergic receptor agonist that relaxes the detrusor smooth muscle of the bladder during the storage phase, increasing bladder capacity and reducing symptoms of overactive bladder, including urinary urgency, increased frequency, and urge incontinence. It is available as an extended-release tablet taken once daily, with or without food, and should be swallowed whole without crushing or chewing. The usual starting dose is 25 mg once daily, which may be increased to 50 mg once daily based on individual response and tolerability; a lower starting dose may be considered in patients with severe kidney or moderate liver impairment. Common side effects include increased blood pressure, headache, urinary tract infection, and nasopharyngitis. Mirabegron can raise blood pressure, so blood pressure should be monitored periodically, especially in patients with pre-existing hypertension; it is not recommended for patients with severe uncontrolled hypertension. It can also cause urinary retention in patients with bladder outlet obstruction or who are taking antimuscarinic medications for overactive bladder, so patients should be monitored for difficulty urinating. Mirabegron may increase levels of certain other medications (such as digoxin and some antidepressants) by inhibiting a liver enzyme (CYP2D6), so dose adjustments of those medications may be needed. Angioedema of the face, lips, tongue, and/or larynx has been reported and requires immediate discontinuation and medical attention.
Mirabegron relaxes the bladder muscle to treat overactive bladder symptoms like urgency, frequency, and urge incontinence. Common side effects include increased blood pressure, headache, urinary tract infection, and nasopharyngitis (cold-like symptoms).
Blood pressure: Mirabegron can raise blood pressure and is not recommended for patients with severe uncontrolled hypertension. Blood pressure should be checked periodically during treatment, particularly in patients with pre-existing high blood pressure.
Urinary retention: Mirabegron may cause urinary retention in patients with bladder outlet obstruction or in those taking other overactive bladder medications (antimuscarinics); patients should be monitored for difficulty urinating.
Drug interactions: Mirabegron inhibits a liver enzyme (CYP2D6) and can raise blood levels of certain other drugs, including digoxin and some antidepressants and antipsychotics; dose adjustments of those medications may be needed.
Angioedema: Swelling of the face, lips, tongue, or throat has been reported; patients should stop the medication and seek immediate medical attention if this occurs.