What is Myrbetriq Uses, warnings & interactions
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Myrbetriq (mirabegron) is a prescription adrenergic agonist that is manufactured by Astellas Pharma US, Inc. It was approved by the U.S. Food and Drug Administration (FDA) to treat overactive bladder in adults in 2012. Myrbetriq is available as extended-release tablets and granules. Myrbetriq tablets and Myrbetriq granules are two different products and cannot be substituted on a milligram-per-milligram basis.
What is Myrbetriq used for?
Myrbetriq (mirabegron) is a beta-3 receptor agonist that is used to relieve symptoms of overactive bladder such as frequent or urgent urination and urinary incontinence. Myrbetriq is approved by the U.S. Food and Drug Administration (FDA) to treat the following conditions:
- Overactive bladder (OAB) in adults with symptoms such as urinary incontinence, urgency, and urinary frequency. Myrbetriq can be used alone or along with the antimuscarinic medication Vesicare (solifenacin).
- Neurogenic detrusor overactivity (NDO) in pediatric patients 3 years of age and older and weighing at least 35 kg.
How does Myrbetriq work?
The detrusor muscle in your bladder wall relaxes to let your bladder fill with urine and then contracts to squeeze the bladder and release the urine. With an overactive bladder, the bladder muscle contracts more frequently or uncontrollably. This decreases the amount of urine your bladder can hold and makes you feel like you need to urinate frequently. It can also cause urine leakage (incontinence).
Myrbetriq works by binding to beta-3 receptors on detrusor muscle cells. This causes the muscle to relax and allows more urine to be stored by the bladder. This helps decrease how often you urinate as well as prevents incontinence.
What are the most commonly prescribed doses of Myrbetriq?
- 25mg extended-release tablet
- 50mg extended-release tablet
Before taking Myrbetriq
Before starting Myrbetriq, tell your healthcare provider if you have any of the following medical conditions:
- Liver problems or impairment
- Kidney problems or impairment
- Uncontrolled high blood pressure
- Are pregnant, plan on becoming pregnant, or are breastfeeding
How to take Myrbetriq
- Read the Full Prescribing Information including the Black Boxed Warning, Instructions for Use, and Medication Guide that comes with Myrbetriq.
- Take Myrbetriq exactly as your healthcare professional prescribes it to you. Do not change your dose or stop taking Myrbetriq without discussing it with them.
- Myrbetriq tablets are usually taken once a day. If you are taking Vesicare (solifenacin) with Myrbetriq, you should take them once a day at the same time.
- You should swallow Myrbetriq tablets whole with water. You should not break, crush, or chew the tablet. Adult patients can take Myrbetriq with or without food. Pediatric patients should take Myrbetriq with food.
- If you miss a dose of Myrbetriq, take it immediately. If it has been more than 12 hours since taking your last dose of Myrbetriq, skip the missed dose and take the next dose at its regular time.
- Store Myrbetriq tablets in the original bottle at room temperature between 15°C-30°C (59°F-86°F).
Myrbetriq is contraindicated in patients who have any of the following medical conditions:
- Allergic reaction to Myrbetriq or any of its inactive ingredients.
- Myrbetriq can cause increases in blood pressure. Patients with hypertension should have their blood pressure periodically monitored. It is not recommended in patients with uncontrolled high blood pressure.
- Increased risk of urinary retention in patients with a bladder outlet obstruction (blockage) and those taking anticholinergic medications such as Vesicare (solifenacin).
- Angioedema (swelling of the face, lips, throat, or tongue) has been reported with Myrbetriq.
Common side effects of Myrbetriq
The most common adverse effects of Myrbetriq include:
- High blood pressure (hypertension)
- Nasopharyngitis (common cold symptoms)
- Urinary tract infection (UTI)
- Dry mouth
- Increased heart rate (tachycardia)
- Back pain
Myrbetriq can cause serious side effects including:
- Hypersensitivity reactions including hives, angioedema, and trouble breathing
Contact your healthcare provider for medical advice about any side effects you experience while taking Myrbetriq. You can report your side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Myrbetriq drug interactions
When Myrbetriq is taken with other drugs, it may change the way the other drugs work. The other drugs may also change how Myrbetriq works. They may increase the frequency and severity of side effects as well. Make sure your doctor is aware of all prescription drugs, over-the-counter medications, vitamins, and herbal supplements you take. Some major drug interactions with Myrbetriq include:
- Medications metabolized by CYP2D6 including Rythmol (propafenone), Mellaril (thioridazine), Tambocor (flecainide), Norpramin (desipramine), and Lopressor (metoprolol)
- Lanoxin (digoxin)
- Coumadin (warfarin)
There are other overactive bladder medications that your healthcare provider can prescribe if Myrbetriq is not the right medication for you. Some alternative FDA-approved treatment options include:
- Ditropan XL (oxybutynin)
- Detrol LA (tolterodine)
- Gemtesa (vibegron)
- Urispas (flavoxate)
How does Myrbetriq compare with Gemtesa (vibegron)?
Myrbetriq and Gemtesa are both indicated to treat overactive bladder in adults. They share most of the same side effects, although Myrbetriq can also cause high blood pressure and dizziness. Myrbetriq has more drug interactions than Gemtesa. Both medications are typically taken once daily with water. They both can be taken with or without food.
Myrbetriq and Gemtesa have not been directly compared in head-to-head trials. There is a literature review that looked at phase 3, double-blind, controlled trials to indirectly compare these 2 medications. It showed that Gemtesa had significant improvements in episodes of incontinence as well as urine volume versus Myrbetriq. They both had similar incidences of adverse effects.
There is currently no generic alternative available for either medication. Myrbetriq has an average cost of around $500 for #30, 50mg tablets while Gemtesa costs approximately $550 for #30, 75mg tablets.
How long does Myrbetriq stay in your system?
Myrbetriq has a half-life of approximately 50 hours, so it will stay in your bloodstream for around 10.5 days after the last dose.
How do I store Myrbetriq?
Store Myrbetriq tablets in the original bottle at room temperature between 15°C-30°C (59°F-86°F). Always keep all medications out of the reach of children.
How long does it take for Myrbetriq to start working?
Myrbetriq will start to work right after you take the first dose. You may notice an improvement in urinary symptoms in the first week but it can take 4 to 8 weeks to see its full benefit.
Can you take Myrbetriq while you are pregnant or breastfeeding?
There is no clinical data on the use of Myrbetriq in pregnant women to know if there is a risk for birth defects or miscarriage. There is also no data on whether Myrbetriq is found in breast milk or the effects it may have on the infant. It was found in rat milk during animal studies. You should always discuss the risks and benefits of any medication with your healthcare provider if you are pregnant, plan on becoming pregnant, or are breastfeeding.
Do I need to take Myrbetriq every day?
Yes, even if you are not having symptoms, you should continue to take Myrbetriq. You should not wait until your symptoms are bothersome to take this medication.
Is there a generic for Myrbetriq?
Currently, there is no generic for Myrbetriq available on the market. However, you can still save on brand-name drugs like Myrbetriq through NiceRx if eligible for assistance.