Mirabegron Stada (Mirabegron)

Mirabegron acts on the β3‑adrenergic pathway to improve bladder storage function.

• Overactive bladder: increases bladder capacity and reduces urgency episodes.
• Urinary urgency: lessens the sudden need to void.
• Urinary frequency: decreases the number of daily voids.

• Mirabegron selectively activates β3‑adrenergic receptors located on the detrusor smooth muscle of the bladder. Receptor activation raises intracellular cyclic AMP, leading to relaxation of the detrusor during the storage phase, thereby expanding functional bladder capacity and reducing involuntary contractions.

Adverse reactions may vary in frequency and severity.

Common Side Effects

• Hypertension: elevated blood pressure observed in some patients.
• Nasopharyngitis: mild upper respiratory tract infection symptoms.
• Headache: transient cranial discomfort.
• Constipation: reduced bowel motility.
• Dry mouth: decreased salivary flow.
• Urinary retention: difficulty initiating voiding.

Serious or Rare Side Effects

• Severe hypertension: marked rise in blood pressure requiring medical attention.
• Acute urinary retention leading to bladder outlet obstruction.
• Tachycardia: rapid heart rate episodes.
• Angioedema: swelling of face, lips or airway.
• Allergic reactions: rash, pruritus or anaphylaxis.
• Renal impairment: worsening kidney function in susceptible individuals.

Before initiating therapy, several safety considerations should be reviewed.

• Cardiovascular assessment: evaluate baseline blood pressure and heart rate.
• Monitor blood pressure: check regularly during treatment, especially after dose changes.
• Renal function: assess creatinine clearance in patients with kidney disease.
• Hepatic impairment: use caution and consider dose adjustment in moderate to severe liver dysfunction.
• Uncontrolled hypertension: avoid use in patients with markedly elevated blood pressure.

Store at ambient temperature: keep in the original container, protect from moisture and direct sunlight.

Mirabegron may interact with other medicines through metabolic pathways or additive pharmacologic effects.

Major Interactions (Avoid)

• Strong CYP2D6 inhibitors (e.g., paroxetine, fluoxetine): may increase Mirabegron exposure.
• Potent CYP3A4 inhibitors (e.g., ketoconazole, itraconazole): can raise plasma concentrations.
• Anticholinergic agents used for bladder control: may reduce therapeutic benefit.

Moderate Interactions (Monitor Closely)

• CYP2D6 substrates (e.g., metoprolol, desipramine): monitor for enhanced effects.
• Diuretics (e.g., furosemide): watch for additive blood pressure changes.
• Antihypertensives (e.g., ACE inhibitors, ARBs): may require dose adjustment of blood pressure medication.