From the Guidelines
Alternatives to Mirabegron (Myrbetriq) at a 50mg equivalent dose Mirabegron 50mg can be alternately treated with solifenacin 5mg or tolterodine as these have been shown to have similar efficacy in treating overactive bladder symptoms 1.
Key Alternatives
- Solifenacin 5mg: has been directly compared to mirabegron 50mg in the BESIDE trial, showing similar efficacy in reducing urinary incontinence episodes per 24 hours 1.
- Tolterodine: although not directly compared to mirabegron 50mg in the provided evidence, it has been shown to be effective in reducing overactive bladder symptoms in other studies, and may be considered as an alternative 1.
Additional Options
- Solifenacin 10mg: may also be considered as an alternative, although it has not been directly compared to mirabegron 50mg at the 50mg equivalent dose 1. It is essential to note that these alternatives may have different side effect profiles and dosing regimens, and therefore may require individualized dose adjustments to achieve optimal efficacy and tolerability 1.
From the Research
Alternatives to Mirabegron (Myrbetriq) at a 50mg Equivalent Dose
- Solifenacin 10mg: shown to be more efficacious than mirabegron 50mg for some outcomes, with a similar overall tolerability profile 2
- Solifenacin 5mg plus mirabegron 25 or 50mg: combination treatment appears to provide an efficacy benefit compared with mirabegron 50mg alone, but with more anticholinergic side effects 2, 3
- Fesoterodine 8mg: shown to be effective in reducing urgency incontinence episodes, but may have a higher incidence of dry mouth and constipation compared to mirabegron 4
- Vibegron: shown to have a similar safety profile to mirabegron, with a lower incidence of dry mouth and constipation 4
- ER-oxybutynin 10mg: shown to have a similar safety profile to mirabegron, with a lower incidence of dry mouth and constipation 4
Tolerability Profile
- Mirabegron 50mg: has a favorable tolerability profile, with a lower incidence of dry mouth, constipation, and urinary retention compared to antimuscarinics 2, 5
- Antimuscarinics (e.g. solifenacin, fesoterodine): may be associated with a higher incidence of dry mouth, constipation, and urinary retention compared to mirabegron 2, 5, 4
Efficacy
- Mirabegron 50mg: has been shown to be effective in reducing symptoms of overactive bladder, with a similar efficacy profile to antimuscarinics 2, 6
- Combination therapy with solifenacin and mirabegron: may provide an efficacy benefit compared with mirabegron 50mg alone, with a similar safety profile to monotherapy or placebo 3