Beta-3 agonists
- Relax detrusor during bladder filling
- Mirabegron/vibegron treat overactive bladder
- Avoid antimuscarinic cognitive/dry-mouth burden
- Mirabegron can raise BP
- Mirabegron inhibits CYP2D6
- Vibegron has fewer CYP interaction concerns
- Can combine with antimuscarinic if needed
Class at a glance
- Relax detrusor during bladder filling
Pharmacology
- Mirabegron inhibits CYP2D6
- Vibegron has fewer CYP interaction concerns
Clinical role
- Mirabegron/vibegron treat overactive bladder
- Mirabegron can raise BP
- Can combine with antimuscarinic if needed
Safety / monitoring
- Avoid antimuscarinic cognitive/dry-mouth burden
Pearls
- Benefit over placebo is modest
- Mirabegron: avoid with severe uncontrolled hypertension (≥180/110)
- Urinary retention can occur; watch with outlet obstruction
- Mirabegron: rare leukocytoclastic vasculitis
Self-check
- Which beta-3 agonist inhibits CYP2D6?
Mirabegron. - Which beta-3 agonist has fewer CYP interaction concerns?
Vibegron.
Drugs in this class (2)
Beta-3 agonists prescription history
Animated chart of estimated U.S. prescriptions per year, Overactive bladder meds (1970–2026). Beta-3 agonist highlighted from 2012.
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