Timing of Mirabegron Administration
Mirabegron can be taken at any time of day—morning or evening—as the timing does not affect its efficacy or safety profile. 1
FDA-Approved Administration Guidelines
The FDA label for mirabegron explicitly states that adults can take mirabegron extended-release tablets with or without food at any time of day. 1 The label provides no specific recommendation favoring morning versus evening administration, indicating that timing flexibility is built into the drug's design. 1
- Once-daily dosing is standard: one tablet taken at the same time each day maintains therapeutic levels. 1
- The extended-release formulation provides 24-hour coverage regardless of when it is administered. 1
- Tablets must be swallowed whole with water and should not be chewed, divided, or crushed. 1
Clinical Considerations for Timing Selection
Patient-Specific Factors
While the drug can be taken at any time, practical considerations may guide individual timing preferences:
- For patients concerned about adherence: Choose the time of day that best fits into their daily routine to maximize compliance. 1
- For patients on multiple medications: Coordinate timing with other daily medications to simplify the regimen. 1
- For patients with sleep concerns: Although mirabegron does not have sedating or activating properties like some other medications, some research suggests it may improve sleep quality by reducing nocturia (nighttime urination). 2
Evidence on Sleep and Nocturia
A prospective trial demonstrated that mirabegron significantly improved sleep disturbance scores and reduced nighttime voids by 0.8 episodes per night in patients with urinary symptoms and disordered sleep. 2 This suggests that for patients with significant nocturia disrupting sleep, the timing may be less important than the therapeutic effect itself, which reduces nighttime awakenings regardless of when the dose is taken. 2
Missed Dose Instructions
If a dose is missed, take it as soon as remembered unless more than 12 hours have passed since the scheduled time. 1 If more than 12 hours have elapsed, skip the missed dose and resume the regular schedule with the next dose. 1 Never double up on doses. 1
Key Safety Monitoring (Regardless of Timing)
- Blood pressure monitoring is essential, especially in patients with hypertension, as mirabegron can increase blood pressure. 1
- Patients should report any difficulty emptying the bladder, particularly those with bladder outlet obstruction or taking antimuscarinic medications concurrently. 1
- Watch for signs of angioedema (swelling of face, lips, tongue, or throat), which requires immediate discontinuation and emergency care. 1
Practical Recommendation
Select either morning or evening based solely on patient convenience and medication adherence patterns. 1 The most important factor is consistency—taking the medication at the same time each day—rather than the specific time chosen. 1 For patients with bothersome nocturia, reassure them that mirabegron's therapeutic effect on reducing nighttime urination occurs regardless of administration timing. 2