From the Guidelines
Geriatric patients taking Gemtesa (vibegron) for overactive bladder should be closely monitored for fall risk, as the medication may contribute to falls due to its side effects, although it has a lower risk profile compared to anticholinergic alternatives 1. When considering the use of Gemtesa in elderly patients, it is essential to weigh the benefits of the medication against the potential risks of falls. The medication's side effects, such as dizziness, headache, and dry mouth, can increase the risk of falls, especially in older adults. However, unlike anticholinergic medications, Gemtesa works as a beta-3 adrenergic receptor agonist and does not cause cognitive impairment or significant blood pressure changes, which is beneficial for fall prevention in older adults.
Some key considerations for healthcare providers prescribing Gemtesa to geriatric patients include:
- Assessing baseline fall risk before prescribing the medication
- Regularly monitoring patients for signs of increased fall risk, such as dizziness or mobility issues
- Encouraging patients to take standard fall precautions, including using nightlights, removing tripping hazards, wearing proper footwear, and considering assistive devices if needed
- Being aware of the potential for increased nighttime bathroom trips, which can create opportunities for falls
It is crucial to note that falls are a significant problem in community-dwelling older persons, with one-third of older persons living at home experiencing a fall annually 1. Therefore, healthcare providers should prioritize fall prevention strategies when prescribing Gemtesa to geriatric patients, taking into account the individual patient's fall-risk profile and implementing tailored interventions to minimize the risk of falls.
From the Research
Risks of Falls in Geriatric Patients Taking Gemtesa (Vibegron)
- The risk of falls in geriatric patients taking Gemtesa (vibegron) for overactive bladder is not directly addressed in the provided studies.
- However, studies suggest that overactive bladder (OAB) is associated with an increased risk of falls and fractures in older patients 2.
- Antimuscarinic agents, which are commonly used to treat OAB, may have systemic side effects that can contribute to the risk of falls, particularly in older adults 2, 3.
- Vibegron, a beta-3 adrenergic receptor agonist, has been shown to be effective in reducing symptoms of OAB with a favorable side effect profile, including a lower risk of cognitive impairment compared to antimuscarinic agents 4.
- A study on the risk of dementia associated with anticholinergic drugs for OAB found that certain antimuscarinic agents, such as oxybutynin hydrochloride, solifenacin succinate, and tolterodine tartrate, were associated with an increased risk of dementia in older adults 5.
- While vibegron is not an antimuscarinic agent, its safety profile in older adults suggests that it may be a suitable alternative for treating OAB in this population, potentially reducing the risk of falls and other adverse events 4, 3.
Considerations for Geriatric Patients
- Geriatric patients with OAB should be carefully evaluated for their risk of falls and fractures, and treatment should be tailored to minimize this risk 2, 6.
- Healthcare providers should consider the potential benefits and risks of different treatment options, including Gemtesa (vibegron), when managing OAB in older adults 4, 5.
- Non-pharmacologic and pharmacologic therapies should be used in combination to maximize treatment outcomes and minimize adverse effects in geriatric patients with OAB 6.