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Beta-3 adrenoceptor agonist (bladder relaxant)

Mirabegron

Brand names: Betmiga

Mirabegron is an oral beta-3 adrenoceptor agonist used to treat the symptoms of overactive bladder, namely urgency, increased frequency and urgency urinary incontinence, offering an alternative to antimuscarinics.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It stimulates beta-3 adrenoceptors in the detrusor smooth muscle, promoting bladder relaxation during the storage phase and increasing functional bladder capacity.

Prescribing in practice

  • Mirabegron can raise blood pressure and is contraindicated in severe uncontrolled hypertension, so measure blood pressure before and during treatment.
  • It inhibits CYP2D6, so it can increase exposure to substrates with a narrow margin such as some antiarrhythmics and certain antidepressants; review interacting medicines.
  • Dose reduction or avoidance applies in significant renal or hepatic impairment per the SPC.

Monitoring

Monitor blood pressure regularly, particularly in patients with pre-existing hypertension, and review symptom response.

Counselling the patient

  • Take once daily, swallowing the tablet whole with water.
  • Have your blood pressure checked, and seek urgent help for the rare symptoms of urinary retention (inability to pass urine) or facial/throat swelling.

Evidence & guidelines

Mirabegron is recommended by NICE as an option for overactive bladder, supported by randomised trials showing reduced incontinence episodes and frequency.

Reference: NICE NG123; EAU Guidelines; NICE TA290; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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