Gemtesa (Vibegron) Elimination Time
Gemtesa (vibegron) takes approximately 5-6 days to be substantially eliminated from the body, based on its effective half-life of 30.8 hours, meaning that after stopping the medication, over 95% will be cleared within this timeframe. 1
Pharmacokinetic Profile
Vibegron has an effective half-life of 30.8 hours across all populations. 1 Using standard pharmacokinetic principles, a drug is considered essentially eliminated after 5 half-lives (when approximately 97% has been cleared from the body):
- After 1 half-life (31 hours): ~50% remains 1
- After 2 half-lives (62 hours): ~25% remains 1
- After 3 half-lives (93 hours): ~12.5% remains 1
- After 4 half-lives (124 hours): ~6% remains 1
- After 5 half-lives (154 hours/6.4 days): ~3% remains 1
Excretion Pathways
The drug is eliminated through both renal and fecal routes: 1
- 59% recovered in feces (54% as unchanged drug) 1
- 20% recovered in urine (19% as unchanged drug) 1
- Metabolism plays only a minor role in elimination, with CYP3A4 being the predominant enzyme responsible 1
Special Population Considerations
No clinically significant differences in vibegron elimination occur based on: 1
- Age (18-93 years) 1
- Sex 1
- Mild to moderate renal impairment (eGFR 30-89 mL/min/1.73 m²) 1
- Severe renal impairment (eGFR 15-29 mL/min/1.73 m²) 1
- Moderate hepatic impairment (Child-Pugh B) 1
Important caveat: The effect of end-stage renal disease requiring hemodialysis (eGFR <15 mL/min/1.73 m²) or severe hepatic impairment (Child-Pugh C) on vibegron elimination was not studied, so elimination may be prolonged in these populations. 1
Clinical Implications
Steady-state concentrations are achieved within 7 days of once-daily dosing, with a mean accumulation ratio of 1.7 for peak concentration and 2.4 for overall exposure. 1 This means the drug accumulates moderately with repeated dosing, which is consistent with its 30.8-hour half-life. 1
For practical purposes, patients can expect the medication to be largely out of their system within approximately one week after discontinuation, though trace amounts may persist slightly longer. 1