Mirabegron

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Generic Name of Mirabegron - Learn More

Mirabegron

Mirabegron Precaution - What You Need to Know

Before starting treatment with Mirabegron, it is crucial to consult a healthcare provider, particularly in the presence of the following conditions:

- Hypertension: Mirabegron can increase blood pressure due to its action on beta-3 adrenergic receptors in the bladder. Patients with pre-existing hypertension should have their blood pressure monitored regularly during treatment, and adjustments in antihypertensive therapy may be required.
- Severe Renal Impairment: Mirabegron is primarily excreted via the kidneys. In patients with severe renal impairment (CrCl < 15 mL/min), the dosage of Mirabegron should be reduced, and careful monitoring is necessary to avoid accumulation of the drug.
- Severe Hepatic Impairment: Patients with severe liver dysfunction should avoid Mirabegron or use it with extreme caution, as liver metabolism plays a significant role in the clearance of the drug.
- Bladder Outlet Obstruction: Patients with significant bladder outlet obstruction or other conditions that could affect urinary retention should be cautious when using Mirabegron, as the drug could worsen these conditions.
- QT Prolongation: Mirabegron can cause QT interval prolongation in some patients, especially those with underlying cardiac conditions or when combined with other medications that also prolong the QT interval. This should be carefully monitored.

Mirabegron Indication - Uses and Benefits

Mirabegron is primarily indicated for:

- Overactive Bladder (OAB): Mirabegron is used to treat overactive bladder, characterized by symptoms such as urinary urgency, frequency, and incontinence. It works by relaxing the bladder muscle, increasing the bladder’s capacity to store urine.
- Urinary Incontinence: It is specifically effective in managing urge incontinence, where patients experience involuntary loss of urine due to an overactive bladder.
- Improvement of OAB Symptoms: It can help reduce symptoms such as nighttime urination (nocturia), urgency, and increased urinary frequency.

Mirabegron Contraindications - Important Warnings

Mirabegron should not be used in the following circumstances:

- Hypersensitivity: Patients who are allergic to Mirabegron or any of its components should avoid its use to prevent an allergic reaction.
- Uncontrolled Hypertension: Due to the potential for blood pressure elevation, Mirabegron is contraindicated in patients with severely uncontrolled hypertension (e.g., systolic BP > 180 mmHg or diastolic BP > 110 mmHg).
- Severe Renal Impairment: Patients with severe renal impairment (creatinine clearance <15 mL/min) should not take Mirabegron as it may accumulate in the body, leading to increased risk of adverse effects.
- Severe Hepatic Impairment: Mirabegron should be avoided in patients with severe liver dysfunction due to impaired metabolism and excretion.

Mirabegron Side Effects - What to Expect

Common side effects of Mirabegron include:

- Hypertension: A rise in blood pressure is a common side effect, especially in patients with pre-existing hypertension.
- Headache: Mirabegron may cause mild to moderate headaches in some patients.
- Dry Mouth: Some individuals may experience dry mouth, which can be bothersome but is typically mild.
- Urinary Tract Infections (UTIs): In some cases, patients may experience urinary tract infections as a result of bladder changes.
- Constipation: Although less common, some patients may experience constipation or gastrointestinal discomfort.
- Dizziness or lightheadedness: This can occur, especially when standing up quickly (orthostatic hypotension).
- Serious Side Effects:
- Severe Hypertension: Rarely, Mirabegron can cause a significant increase in blood pressure, leading to hypertensive crisis or other cardiovascular complications.
- QT Interval Prolongation: There have been cases where Mirabegron prolonged the QT interval on an ECG, which can increase the risk of arrhythmias.
- Angioedema: Though rare, there have been reports of swelling of the face, lips, tongue, or throat, which may cause difficulty breathing.

Mirabegron Pregnancy Category ID - Safety Information

3

Mirabegron Mode of Action - How It Works

Mirabegron is a beta-3 adrenergic agonist, which works by selectively binding to and stimulating the beta-3 adrenergic receptors in the bladder. These receptors are located in the detrusor muscle (the muscle that contracts during urination). When stimulated, Mirabegron causes the detrusor muscle to relax, which leads to an increase in bladder capacity and a reduction in urgency and incontinence. This mechanism is distinct from anticholinergic drugs used for overactive bladder, which work by blocking the muscarinic receptors that control bladder contractions.

By relaxing the bladder muscle, Mirabegron helps to reduce the sensation of urgency and the frequency of involuntary contractions, making it easier for patients to retain urine and reduce episodes of incontinence.

Mirabegron Drug Interactions - What to Avoid

Mirabegron can interact with several other drugs, including:

- Strong CYP3A4 Inhibitors: Drugs like ketoconazole, itraconazole, and clarithromycin can increase the blood concentration of Mirabegron by inhibiting its metabolism via the CYP3A4 enzyme. This can lead to increased side effects, including elevated blood pressure.
- CYP3A4 Inducers: Medications like rifampin, phenytoin, and carbamazepine may decrease the effectiveness of Mirabegron by increasing its metabolism.
- Antihypertensive Agents: Combining Mirabegron with antihypertensive drugs requires caution, as Mirabegron can elevate blood pressure. Adjustments to the antihypertensive regimen may be necessary.
- Beta-blockers: While beta-blockers (such as metoprolol) can antagonize the effect of Mirabegron on bladder relaxation, no significant interaction has been noted. Still, monitoring is recommended in patients on both drugs.
- Digoxin: Concurrent use of digoxin with Mirabegron may increase the serum concentration of digoxin, requiring closer monitoring for digoxin toxicity.

Mirabegron Adult Dose - Recommended Dosage

The typical adult dosage for Mirabegron is:

- Initial Dose: 25 mg once daily, regardless of food intake.
- Maintenance Dose: After 4-8 weeks, the dose may be increased to 50 mg once daily if needed for adequate symptom control.
- Maximum Dose: The maximum recommended dose is 50 mg daily.
- The dose may be reduced in patients with moderate renal impairment (CrCl 30-59 mL/min), starting at 25 mg daily.

Mirabegron Child Dose - Dosage for Children

Mirabegron is not recommended for use in pediatric patients under the age of 18, as its safety and efficacy in children have not been established.

Patients under the age of 18 should explore other treatment options for overactive bladder under the guidance of their healthcare provider.

Mirabegron Renal Dose - Dosage for Kidney Conditions

In patients with renal impairment, the dose of Mirabegron should be adjusted:

- Mild Renal Impairment (CrCl 60-89 mL/min): No dose adjustment is required.
- Moderate Renal Impairment (CrCl 30-59 mL/min): The starting dose should be 25 mg once daily. The maximum dose should be 50 mg daily.
- Severe Renal Impairment (CrCl < 30 mL/min): Mirabegron is contraindicated in patients with severe renal impairment due to the risk of drug accumulation and potential toxicity.