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Mirabegron

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Mirabegron
Clinical data
Trade namesMyrbetriq, Betanis, Betmiga, others
Other namesYM-178
AHFS/Drugs.comMonograph
MedlinePlusa612038
License data
Pregnancy
category
  • AU: B3
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
  • 2-(2-Amino-1,3-thiazol-4-yl)-N-[4-(2-{[(2R)-2-hydroxy-2-phenylethyl]amino}ethyl)phenyl]acetamide
CAS Number
PubChem CID
ChemSpider
UNII
CompTox Dashboard (EPA)
ECHA InfoCard100.226.392 Edit this at Wikidata
Chemical and physical data
FormulaC21H24N4O2S
Molar mass396.51 g·mol−1
3D model (JSmol)
  • O=C(Nc1ccc(cc1)CCNC[C@H](O)c2ccccc2)Cc3nc(sc3)N
  • InChI=1S/C21H24N4O2S/c22-21-25-18(14-28-21)12-20(27)24-17-8-6-15(7-9-17)10-11-23-13-19(26)16-4-2-1-3-5-16/h1-9,14,19,23,26H,10-13H2,(H2,22,25)(H,24,27)/t19-/m0/s1
  • Key:PBAPPPCECJKMCM-IBGZPJMESA-N

Mirabegron, sold under the brand name Myrbetriq among others, is a medication used to treat overactive bladder.[2] Its benefits are similar to 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]

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.[2][4]

Mirabegron was approved for medical use in the United States and in the European Union in 2012.[5][6][7] 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.[8] In 2017, it was the 191st most commonly prescribed medication in the United States, with more than three million prescriptions.[9][10]

Medical uses

Myrbetriq 50 mg both sides

Its used is in the treatment of overactive bladder.[1][11][12] It works equally well to antimuscarinic medication such as solifenacin or tolterodine.[3][7] In the United Kingdom it is less preferred to these agents.[4]

Adverse effects

Adverse effects by incidence:[1][11][12]

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

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

Rare (<1% incidence) adverse effects include:

Pronunciation

The brand name Myrbetriq is pronounced /mɪərˈbɛtrɪk/ meer-BET-rik.

References

  1. ^ a b c d e f g "mirabegron (Rx) - Myrbetriq". Medscape Reference. WebMD. Retrieved 17 November 2013.
  2. ^ a b c d e "Mirabegron Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Retrieved 18 March 2019.
  3. ^ a b "[93] Are claims for newer drugs for overactive bladder warranted?". Therapeutics Initiative. 22 April 2015. Retrieved 17 March 2019.
  4. ^ a b c d e British national formulary : BNF 76 (76 ed.). Pharmaceutical Press. 2018. p. 763. ISBN 9780857113382.
  5. ^ "Drug Approval Package: Myrbetriq (mirabegron) Extended Release Tablets NDA #202611". U.S. Food and Drug Administration (FDA). 10 August 2012. Retrieved 28 April 2020.
  6. ^ Sacco E, Bientinesi R, Tienforti D, Racioppi M, Gulino G, D'Agostino D, et al. (April 2014). "Discovery history and clinical development of mirabegron for the treatment of overactive bladder and urinary incontinence". Expert Opinion on Drug Discovery. 9 (4): 433–48. doi:10.1517/17460441.2014.892923. PMID 24559030.
  7. ^ a b "Betmiga EPAR". European Medicines Agency. Retrieved 28 April 2020. Public Domain This article incorporates text from this source, which is in the public domain.
  8. ^ "NADAC as of 2019-02-27". Centers for Medicare and Medicaid Services. Retrieved 3 March 2019.
  9. ^ "The Top 300 of 2020". ClinCalc. Retrieved 11 April 2020.
  10. ^ "Mirabegron - Drug Usage Statistics". ClinCalc. Retrieved 11 April 2020.
  11. ^ a b "Myrbetriq (mirabegron) tablet, film coated, extended release [Astellas Pharma US, Inc.]". DailyMed. Astellas Pharma US, Inc. September 2012. Retrieved 17 November 2013.
  12. ^ a b "Betmiga 25mg & 50mg prolonged-release tablets". electronic Medicines Compendium. Astellas Pharma Ltd. 22 February 2013. Archived from the original on 2 April 2015. Retrieved 17 November 2013.

Further reading

  • "Mirabegron". Drug Information Portal. U.S. National Library of Medicine.