mirabegron at a glance
Medicine class
Selective beta-3 adrenoceptor agonist.
Main role
Relieves bladder urgency, increased urinary frequency and urgency incontinence.
Tablet type
Prolonged-release tablet that must be swallowed whole.
Important check
Mirabegron can increase blood pressure, so this should be checked before treatment and periodically afterwards.
What is mirabegron used for?
The selected UK product is licensed for:
Urgency, increased urinary frequency and urgency incontinence in adults with overactive bladder syndrome.
Neurogenic detrusor overactivity in children and adolescents aged 3 to under 18 years.
How does mirabegron work?
Mirabegron stimulates beta-3 adrenoceptors in the bladder muscle. This relaxes the bladder during filling, increases storage capacity and can reduce urgency and frequent urination.
mirabegron preparations and strengths
Modified-release tablet
Route: Oral
Strengths: 25 mg, 50 mg
How to take mirabegron
Follow the product label and prescriber's instructions.
Swallow the prolonged-release tablet whole with liquid; do not chew, divide or crush it.
Adults treated for overactive bladder may take the tablet with or without food.
For paediatric neurogenic detrusor overactivity, take the tablet with food.
mirabegron side effects
Common or expected effects
- Urinary tract infection
- Fast heartbeat
- Headache or dizziness
- Nausea
- Constipation
- Diarrhoea
Get urgent medical advice
- Severe increase in blood pressure or hypertensive crisis
- Atrial fibrillation or a persistent fast or irregular heartbeat
- Urinary retention or inability to pass urine
- Angioedema or a serious allergic reaction, including facial, tongue or throat swelling
mirabegron in pregnancy
Mirabegron is not usually recommended during pregnancy because human safety information is limited and reproductive toxicity occurred in animal studies. If pregnancy is planned or occurs, contact the prescriber to review treatment rather than stopping without advice.
mirabegron while breastfeeding
The product information says mirabegron should not be used while breastfeeding. UK specialist guidance considers cautious use possible with a full-term, healthy infant when clinically appropriate, but prefers a better-established alternative and advises monitoring feeding, weight gain, wet nappies, irritability and gastrointestinal symptoms. Seek specialist advice, particularly for premature or unwell infants.
mirabegron interactions
A medicine review is important because mirabegron can affect the exposure or safety of several medicines.
Digoxin
Mirabegron can increase digoxin exposure; serum digoxin concentrations should guide prescribing when used together.
CYP2D6 substrates with a narrow therapeutic index, including flecainide, propafenone, thioridazine and some tricyclic antidepressants
Mirabegron can inhibit their metabolism and increase exposure, requiring caution and clinical review.
Strong CYP3A/P-glycoprotein inhibitors, including clarithromycin, itraconazole, ketoconazole and ritonavir
These can increase mirabegron exposure; kidney and liver function may affect whether the combination is suitable.
Common questions about mirabegron
Answers are fully visible for fast scanning and source review.
Is mirabegron an antimuscarinic medicine?
No. It is a beta-3 adrenoceptor agonist and relaxes the bladder through a different receptor pathway.
Can mirabegron tablets be crushed or split?
No. They are prolonged-release tablets and should be swallowed whole with liquid.
Can mirabegron raise blood pressure?
Yes. Baseline and periodic checks are recommended. It must not be used in severe uncontrolled hypertension.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.