Mirabegron
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Mirabegron
Myrbetriq
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Summary
Common uses
Overactive bladder (urgency, frequency, urge incontinence)0, Neurogenic detrusor overactivity0
Pharmacy
Starting dose
25 mg PO once daily; titrate to 50 mg after 4-8 weeks if needed
Preparations
25, 50 mg ER tablets; 8 mg/mL granules for oral suspension (Myrbetriq Granules, pediatric)
US FDA Max
50 mg/d
Pharmacology
Routes
Oral
Onset
Symptom improvement within weeks
Duration
24 hours
Half-life
~50 hours[1]
Bioavailability
25 mg: ~29%; 50 mg: ~35%; food reduces absorption[1]
Pregnancy
Limited data.[citation needed]
Legal status
Rx-only in US
Purported mechanism
Mirabegron selectively activates β3 adrenergic receptors on detrusor smooth muscle, relaxing the bladder during filling and increasing functional bladder capacity without the anticholinergic burden of muscarinic-antagonist therapy.0 The mechanistically distinct profile makes it the preferred OAB agent in older adults at risk from cumulative anticholinergic exposure. Modest BP elevation (especially in untreated hypertension) and atrial fibrillation signals limit use in some patients. CYP2D6 substrate AND moderate inhibitor — clinically relevant interaction with metoprolol and other CYP2D6 substrates[1].
References
edit- ↑ 1.0 1.1 1.2 FDA Prescribing Information, Myrbetriq (mirabegron), Astellas, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/202611s015lbl.pdf