Mirabegron

Mirabegron, sold under the brand name Myrbetriq among others, is a medication used to treat overactive bladder.[2] Its benefits are similar to other antimuscarinic medication such as solifenacin or tolterodine.[3] In the United Kingdom it is less preferred to antimuscarinic medication such as oxybutynin.[4] It is taken by mouth.[2]

Mirabegron
Clinical data
Trade namesMyrbetriq, Betanis, Betmiga, others
Other namesYM-178
AHFS/Drugs.comMonograph
License data
Pregnancy
category
  • AU: B3
  • US: C (Risk not ruled out)
    Routes of
    administration
    By mouth (tablets)
    ATC code
    Legal status
    Legal status
    • AU: S4 (Prescription only)
    • UK: POM (Prescription only)
    • US: ℞-only
    • In general: ℞ (Prescription only)
    Pharmacokinetic data
    Bioavailability29–35%[1]
    Protein binding71%[1]
    MetabolismHepatic via (direct) glucuronidation, amide hydrolysis, and minimal oxidative metabolism in vivo by CYP2D6 and CYP3A4. Some involvement of butylcholinesterase[1]
    Elimination half-life50 hours[1]
    ExcretionUrine (55%), faeces (34%)[1]
    Identifiers
    CAS Number
    PubChem CID
    ChemSpider
    ECHA InfoCard100.226.392
    Chemical and physical data
    FormulaC21H24N4O2S
    Molar mass396.506 g/mol g·mol−1
    3D model (JSmol)

    Common side effects include high blood pressure, headaches, and urinary tract infections.[2] Other significant side effects include urinary retention, irregular heart rate, and angioedema.[2][4] It works by activating the β3 adrenergic receptor in the bladder, resulting in its relaxation.[4][2]

    Mirabegron was approved for medical use in the United States in 2012.[5][2] A month supply in the United Kingdom costs the NHS about £29 as of 2019.[4] In the United States the wholesale cost of this amount is about 369 USD.[6] In 2016 it was the 263rd most prescribed medication in the United States with more than a million prescriptions.[7]

    Medical uses

    Myrbetriq 50 mg both sides

    Its used is in the treatment of overactive bladder.[1][8][9] It works equally well to antimuscarinic medication such as solifenacin or tolterodine.[3] In the United Kingdom it is less preferred to these agents.[4]

    Adverse effects

    Adverse effects by incidence:[1][8][9]

    Very common (>10% incidence) adverse effects include:

    Common (1–10% incidence) adverse effects include:

    Rare (<1% incidence) adverse effects include:

    Pronunciation

    Myrbetriq is pronounced /mɪərˈbɛtrɪk/ meer-BET-rik.

    References

    1. "mirabegron (Rx) - Myrbetriq". Medscape Reference. WebMD. Retrieved 17 November 2013.
    2. "Mirabegron Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Retrieved 18 March 2019.
    3. "[93] Are claims for newer drugs for overactive bladder warranted?". Therapeutics Initiative. 22 April 2015. Retrieved 17 March 2019.
    4. British national formulary : BNF 76 (76 ed.). Pharmaceutical Press. 2018. p. 763. ISBN 9780857113382.
    5. Sacco, E; Bientinesi, R; et al. (Apr 2014). "Discovery history and clinical development of mirabegron for the treatment of overactive bladder and urinary incontinence". Expert Opin Drug Discov. 9 (4): 433–48. doi:10.1517/17460441.2014.892923. PMID 24559030.
    6. "NADAC as of 2019-02-27". Centers for Medicare and Medicaid Services. Retrieved 3 March 2019.
    7. "The Top 300 of 2019". clincalc.com. Retrieved 22 December 2018.
    8. "MYRBETRIQ (mirabegron) tablet, film coated, extended release [Astellas Pharma US, Inc.]". DailyMed. Astellas Pharma US, Inc. September 2012. Retrieved 17 November 2013.
    9. "Betmiga 25mg & 50mg prolonged-release tablets". electronic Medicines Compendium. Astellas Pharma Ltd. 22 February 2013. Retrieved 17 November 2013.
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