Medication for overactive bladder
Pharmaceutical compound
Mirabegron Clinical data Trade names Myrbetriq, Betanis, Betmiga, others Other names YM-178 AHFS /Drugs.com Monograph MedlinePlus a612038 License data Pregnancy Routes of By mouth ATC code Legal status Legal status Pharmacokinetic dataBioavailability 29–35%[ 4] Protein binding 71%[ 4] Metabolism Liver via (direct) glucuronidation, amide hydrolysis, and minimal oxidative metabolismin vivo byCYP2D6 andCYP3A4 . Some involvement of butylcholinesterase[ 4] Eliminationhalf-life 50 hours[ 4] Excretion Urine (55%), faeces (34%)[ 4] Identifiers CAS Number PubChem CID DrugBank ChemSpider UNII KEGG ChEBI ChEMBL CompTox Dashboard (EPA) ECHA InfoCard 100.226.392 Chemical and physical data Formula C 21 H 24 N 4 O 2 S Molar mass −1 3D model (JSmol ) InChI=1S/C21H24N4O2S/c22-21-25-18(14-28-21)12-20(27)24-17-8-6-15(7-9-17)10-11-23-13-19(26)16-4-2-1-3-5-16/h1-9,14,19,23,26H,10-13H2,(H2,22,25)(H,24,27)/t19-/m0/s1
Key:PBAPPPCECJKMCM-IBGZPJMESA-N
Mirabegron , sold under the brand nameMyrbetriq among others, is amedication used to treatoveractive bladder .[ 5] antimuscarinic medication such assolifenacin ortolterodine .[ 6] [ 5]
Common side effects includehigh blood pressure , headaches, andurinary tract infections .[ 5] urinary retention ,irregular heart rate , andangioedema .[ 5] [ 7] β3 adrenergic receptor in thebladder , resulting in its relaxation.[ 5] [ 7]
Mirabegron is the first clinically availablebeta-3 agonist with approval for use in adults withoveractive bladder . Mirabegron was approved for medical use in the United States and in the European Union in 2012.[ 8] [ 9] [ 3] million prescriptions.[ 10] [ 11] generic medication .[ 12]
Mirabegron is used is in the treatment ofoveractive bladder .[ 13] [ 4] [ 2] [ 1] antimuscarinic medication such assolifenacin ortolterodine .[ 6] [ 3] [ 7]
Mirabegron is also indicated to treat neurogenic detrusor overactivity (NDO), a bladder dysfunction related to neurological impairment, in children ages three years and older.[ 13]
Adverse effects by incidence: [ 4] [ 2] [ 1]
Very common (>10% incidence) adverse effects include:
Common (1–10% incidence) adverse effects include:
Rare (<1% incidence) adverse effects include:
Palpitations Blurred vision Glaucoma Indigestion Gastritis Abdominal distension Rhinitis Elevations in liver enzymes (GGTP ,AST ,ALT andLDH ) Renal and urinary disorders (e.g.,nephrolithiasis , bladder pain) Reproductive system disorders (e.g., vulvovaginal pruritus, vaginal infection) Skin and subcutaneous tissue disorders (e.g., urticaria, leukocytoclastic vasculitis, rash, pruritus, purpura, lip edema) Stevens–Johnson syndrome associated with increased serum ALT, AST and bilirubinUrinary retention As a selective beta-3adrenergic agonist , mirabegron does not cause the cardiovascular adverse effects of other adrenergic agonists that are active at thebeta-1 andbeta-2 adrenergic receptors . Beta-3 adrenergic agonists activatebrown adipose tissue (BAT) and increaseenergy expenditure , leading to research interest in their development asweight loss drugs .[ 14] metformin was studied in mice and caused greater weight loss than either drug alone.[ 15] insulin sensitivity but no significant weight change, which was hypothesized to be due to low levels of BAT in obese humans and/or the low dose of mirabegron used in the study.[ 16]
^a b c "Betmiga 25mg & 50mg prolonged-release tablets" .electronic Medicines Compendium . Astellas Pharma Ltd. 22 February 2013. Archived fromthe original on 2 April 2015. Retrieved17 November 2013 .^a b c "Myrbetriq- mirabegron tablet, film coated, extended release" .DailyMed . Retrieved27 March 2021 .^a b c "Betmiga EPAR" .European Medicines Agency . Retrieved28 April 2020 .^a b c d e f g "mirabegron (Rx) - Myrbetriq" .Medscape Reference . WebMD. Retrieved17 November 2013 .^a b c d e "Mirabegron Monograph for Professionals" .Drugs.com . American Society of Health-System Pharmacists. Retrieved18 March 2019 .^a b "[93] Are claims for newer drugs for overactive bladder warranted?" .Therapeutics Initiative . 22 April 2015. Retrieved17 March 2019 .^a b c British national formulary : BNF 76 (76 ed.). Pharmaceutical Press. 2018. p. 763.ISBN 9780857113382 ^ "Drug Approval Package: Myrbetriq (mirabegron) Extended Release Tablets NDA #202611" .U.S.Food and Drug Administration (FDA) . 10 August 2012. Retrieved28 April 2020 .^ Sacco E, Bientinesi R, Tienforti D, Racioppi M, Gulino G, D'Agostino D, et al. (April 2014). "Discovery history and clinical development of mirabegron for the treatment of overactive bladder and urinary incontinence".Expert Opinion on Drug Discovery .9 (4):433– 448.doi :10.1517/17460441.2014.892923 .PMID 24559030 .S2CID 26424400 . ^ "The Top 300 of 2023" .ClinCalc .Archived from the original on 12 August 2025. Retrieved12 August 2025 .^ "Mirabegron Drug Usage Statistics, United States, 2013 - 2023" .ClinCalc . Retrieved20 August 2025 .^ "2022 First Generic Drug Approvals" .U.S.Food and Drug Administration (FDA) . 3 March 2023. Archived fromthe original on 30 June 2023. Retrieved30 June 2023 .^a b "FDA Approves New indication for Drug to Treat Neurogenic Detrusor Overactivity in Pediatric Patients" .U.S.Food and Drug Administration (FDA) (Press release). 25 March 2021. Archived fromthe original on 25 March 2021. Retrieved26 March 2021 .public domain .^ Hainer V (November 2016). "Beta3-adrenoreceptor agonist mirabegron - a potential antiobesity drug?".Expert Opinion on Pharmacotherapy .17 (16):2125– 2127.doi :10.1080/14656566.2016.1233177 .PMID 27600952 .S2CID 1308773 . ^ Zhao XY, Liu Y, Zhang X, Zhao BC, Burley G, Yang ZC, et al. (April 2023)."The combined effect of metformin and mirabegron on diet-induced obesity" .MedComm .4 (2): e207.doi :10.1002/mco2.207 .PMC 9928947 PMID 36818016 . ^ Dehvari N, Sato M, Bokhari MH, Kalinovich A, Ham S, Gao J, et al. (October 2020)."The metabolic effects of mirabegron are mediated primarily by β3 -adrenoceptors" .Pharmacology Research & Perspectives .8 (5): e00643.doi :10.1002/prp2.643 .PMC 7437350 PMID 32813332 .
α1
Agonists Antagonists Abanoquil ADRIANA Ajmalicine Alfuzosin Anisodamine Anisodine Atiprosin Atypical antipsychotics (e.g.,brexpiprazole ,clozapine ,olanzapine ,quetiapine ,risperidone )Benoxathian Beta blockers (e.g.,adimolol ,amosulalol ,arotinolol ,carvedilol ,eugenodilol ,labetalol )Buflomedil Bunazosin Butanserin Corynanthine Dapiprazole Domesticine Doxazosin Ergolines (e.g.,acetergamine ,ergotamine ,dihydroergotamine ,lisuride ,nicergoline ,terguride )Etoperidone Fenspiride Hydroxyzine Indoramin Ketanserin L-765,314 mCPP Mepiprazole Metazosin Monatepil Moxisylyte MT-1207 Naftopidil Nantenine Neldazosin Niaprazine Niguldipine Pardoprunox Pelanserin Perlapine Phendioxan Phenoxybenzamine Phentolamine Phenylpiperazine antidepressants (e.g.,hydroxynefazodone ,nefazodone ,trazodone ,triazoledione )Piperoxan Prazosin Quinazosin Quinidine Silodosin Spegatrine Spiperone Talipexole Tamsulosin Terazosin Tiodazosin Tolazoline Tetracyclic antidepressants (e.g.,amoxapine ,maprotiline ,mianserin )Tricyclic antidepressants (e.g.,amitriptyline ,clomipramine ,doxepin ,imipramine ,trimipramine )Trimazosin Typical antipsychotics (e.g.,chlorpromazine ,fluphenazine ,loxapine ,thioridazine )Urapidil WB-4101 Zolertine
α2
Agonists Antagonists 1-PP Adimolol Amesergide Aptazapine Atipamezole Atypical antipsychotics (e.g.,asenapine ,brexpiprazole ,clozapine ,lurasidone ,olanzapine ,paliperidone ,quetiapine ,risperidone ,zotepine )Azapirones (e.g.,buspirone ,gepirone ,ipsapirone ,tandospirone )BRL-44408 Buflomedil Cirazoline Efaroxan Esmirtazapine Fenmetozole Fipamezole Fluparoxan Idazoxan Ketanserin Lisuride mCPP Mianserin Mirtazapine NAN-190 Pardoprunox Phentolamine Phenoxybenzamine Piperoxan Piribedil Rauwolscine Rotigotine Setiptiline Spegatrine Spiroxatrine Sunepitron Terguride Tolazoline Typical antipsychotics (e.g.,chlorpromazine ,fluphenazine ,loxapine ,thioridazine )Yohimbine
β
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