Can Myrbetriq Cause Hearing Problems?
No, hearing loss is not a recognized adverse effect of Myrbetriq (mirabegron) based on current clinical evidence and FDA-approved labeling. Hearing problems are not listed among the documented side effects of this β3-adrenoceptor agonist used for overactive bladder treatment.
Known Adverse Effects of Mirabegron
The established side effect profile of mirabegron does not include auditory or vestibular toxicity. The documented adverse effects include:
- Hypertension (7.5-11.3% vs 7.6% placebo) - the most significant concern requiring monitoring 1, 2
- Nasopharyngitis (3.5-3.9% vs 2.5% placebo) 1, 2
- Urinary tract infections (2.9-4.2% vs 1.8% placebo) 1, 2
- Headache (2.1-3.2% vs 3.0% placebo) 1, 2
- Dry mouth (0.5-2.1% vs 1.5% placebo) - notably much lower than antimuscarinic medications 3
- Constipation (1.6% vs 1.4% placebo) 1
Contrast with Ototoxic Medications
Hearing problems are well-documented with certain other medication classes, but mirabegron is not among them:
- Aminoglycoside antibiotics (streptomycin, amikacin, tobramycin) cause vestibular/auditory toxicity including dizziness, vertigo, tinnitus, and hearing loss 4
- Macrolide antibiotics (erythromycin, clarithromycin, azithromycin) are associated with ototoxicity and decreased hearing 4
Real-World Safety Data
A comprehensive pharmacovigilance analysis of 18,763 adverse event reports from the FDA FAERS database (2012-2023) identified 80 significant adverse events associated with mirabegron, but hearing loss or auditory problems were not among them 5. The most common unexpected adverse events included cardiac arrhythmias, palpitations, and neurological effects, but not ototoxicity 5.
Clinical Recommendation
If a patient on mirabegron reports hearing problems, clinicians should investigate alternative causes rather than attributing symptoms to the medication. Consider evaluating for:
- Age-related hearing loss (presbycusis)
- Concurrent ototoxic medications (aminoglycosides, macrolides, loop diuretics)
- Underlying conditions causing hearing loss (Ménière's disease, vestibular schwannoma, autoimmune inner ear disease) 4
- Recent infections or inflammatory conditions 4
The well-established safety profile of mirabegron across multiple large trials and real-world data does not support a causal relationship with hearing impairment 1, 3, 5, 6.