From the Guidelines
Mirabegron is recommended as a first-line treatment for overactive bladder, with an initial dose of 25 mg once daily, which can be increased to 50 mg once daily based on individual response and tolerability, as supported by the AUA/SUFU guideline on the diagnosis and treatment of idiopathic overactive bladder 1. The medication should be taken with water and can be administered with or without food. Patients should swallow the extended-release tablet whole without crushing or chewing it. Some key points to consider when prescribing mirabegron include:
- Clinical improvement is usually observed within 8 weeks of starting treatment
- Dose adjustments are necessary for patients with severe renal impairment (GFR 15-29 mL/min/1.73 m²) or moderate hepatic impairment, limiting the maximum dose to 25 mg daily
- Mirabegron works by activating beta-3 adrenergic receptors in the bladder detrusor muscle, promoting relaxation during the storage phase and increasing bladder capacity
- This mechanism differs from anticholinergics, potentially offering fewer side effects like dry mouth and constipation
- Common side effects include hypertension, nasopharyngitis, urinary tract infections, and headache
- Blood pressure should be monitored regularly, especially in hypertensive patients, as mirabegron can cause blood pressure elevation, as noted in the guideline 1 and other studies 1. It's also important to consider the patient's quality of life and individual needs when selecting a treatment option, as emphasized in the AUA/SUFU guideline 1.
From the FDA Drug Label
The recommended starting dose of mirabegron extended-release tablets is 25 mg orally once daily. After 4 to 8 weeks, the mirabegron extended-release tablets dose may be increased to 50 mg orally once daily.
The recommended treatment regimen for overactive bladder using Mirabegron is to start with a dose of 25 mg orally once daily. After 4 to 8 weeks, the dose may be increased to 50 mg orally once daily 2. Key points to consider:
- The dose may be adjusted based on the patient's response to the medication.
- It is essential to follow the recommended dosage and administration instructions to ensure safe and effective use of Mirabegron.
From the Research
Treatment Regimen for Overactive Bladder using Mirabegron
The recommended treatment regimen for overactive bladder using Mirabegron, a beta-3 adrenergic agonist, is as follows:
- The established dose of Mirabegron for the treatment of overactive bladder is 50mg once daily 3, 4, 5.
- Mirabegron has been shown to be effective in treating the symptoms of overactive bladder, including micturition frequency, urgency incontinence, and urgency 4, 5.
- The efficacy of Mirabegron is comparable to that of antimuscarinic agents, but with a more favorable tolerability profile, particularly with regards to dry mouth, constipation, and urinary retention 3, 4, 6.
- Mirabegron has been shown to be well tolerated in clinical trials of up to 12 months, with the most common adverse events being hypertension, nasopharyngitis, and urinary tract infection 4, 5.
Patient Populations
Mirabegron has been studied in various patient populations, including:
- Men and women with overactive bladder 3, 4, 6.
- Elderly patients with overactive bladder 4, 7.
- Patients who have previously discontinued antimuscarinic therapy due to poor tolerability 4, 6.
- Patients from different geographic areas, including Asia 7.
Combination Therapy
Combination therapy with Mirabegron and antimuscarinic agents, such as solifenacin, has been shown to be effective in treating overactive bladder symptoms, but may be associated with a higher incidence of anticholinergic side effects 3, 6.
Tolerability and Safety
The tolerability and safety of Mirabegron have been evaluated in several studies, with results indicating that it is well tolerated and has a favorable safety profile compared to antimuscarinic agents 3, 4, 5, 6.