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Ther Adv Drug Saf. 2016 Oct;7(5):204-216. Epub 2016 Jul 19.

Mirabegron in overactive bladder patients: efficacy review and update on drug safety.

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Bristol Urological Institute, Southmead Hospital, Bristol BS10 5NB, UK.
Bristol Urological Institute, Southmead Hospital, Bristol, UK.


Overactive bladder is a common condition, which significantly affects people's quality of life. The use of anticholinergic medication has been the mainstay of managing overactive bladder when conservative measures are not enough. Many patients stop anticholinergic medication because of the side effects and more recently the concerns about the effect of an anticholinergic burden and the development of dementia have been studied. Activation of β3 adrenoceptors has been shown to relax the detrusor muscle and subsequently lead to the development of the first β3 adrenoceptor agonist. Mirabegron is the first drug in this class to be approved for the use in overactive bladder. It has been extensively studied in phase II and III trials and has significant improvement in key overactive bladder parameters when compared with placebo. The incidence of side effects such as constipation, hypertension and tachycardia were comparable to anticholinergic medication but there was significantly less dry mouth incidence in the mirabegron groups. Mirabegron has been shown to be used safely in combination with solifenacin and tamsulosin. Head-to-head studies comparing efficacy and safety of mirabegron with anticholinergic medication would further help in the management strategy for overactive bladder.


anticholinergic; mirabegron; overactive bladder; β3 agonist

Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: KW and HB have no conflicts of interest to declare. PA has previously received personal fees from Astellas, Ferring, Ipsen and Pfizer and had support for research projects from Astellas.

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