β3-adrenergic agonist Pregnancy: There are no available data on use in pregnant women to evaluate for a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes (US PI §8.1).

Vibegron

Brand names: Obgemsa

Vibegron is an oral beta-3 adrenergic receptor agonist used for the symptomatic treatment of overactive bladder, including urgency, urgency incontinence and frequency.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 75 mg once daily

Route: Oral

Frequency: Once daily

US prescribing information (GEMTESA §2.1): the recommended dosage is one 75 mg tablet orally once daily, with or without food. Swallow tablets whole with a glass of water. In adults, tablets may also be crushed, mixed with a tablespoon (approximately 15 mL) of applesauce and taken immediately with a glass of water. No dose titration is described and no maximum dose above 75 mg once daily is stated. No eMC/UK SPC was available in this bundle — US labelling may differ from UK; clinician to verify against the UK SPC. Paediatric: safety and effectiveness in paediatric patients have not been established. Elderly: no overall differences in safety or effectiveness observed in patients 65 years and older. No renal or hepatic dose adjustment appears in the retrieved sections.

Dose auto-extracted from US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Known hypersensitivity to vibegron or any component of the product — hypersensitivity reactions, such as angioedema, have occurred

Side effects

Headache
Urinary tract infection
Nasopharyngitis
Diarrhoea and nausea
Upper respiratory tract infection
Urinary retention — a clinically significant adverse reaction; risk may be greater with bladder outlet obstruction or concurrent muscarinic antagonists; discontinue if it develops
Angioedema of the face and/or larynx (may occur hours after the first or after multiple doses; may be life-threatening)

Interactions

Digoxin — vibegron increases digoxin maximal concentration (Cmax) and systemic exposure (AUC); measure serum digoxin concentrations before initiating vibegron, monitor during therapy and use them to titrate the digoxin dose, and continue monitoring on discontinuation of vibegron, adjusting the digoxin dose as needed

Clinical monograph

How it works

It selectively stimulates beta-3 adrenoceptors in the detrusor muscle, promoting bladder smooth muscle relaxation during the storage phase to increase bladder capacity.

Prescribing in practice

Avoid in patients with severe uncontrolled hypertension and monitor blood pressure, as beta-3 agonists can raise it.
It offers an alternative to antimuscarinics, which may be useful where anticholinergic burden is a concern.
Review response after an adequate treatment period and reassess if symptoms do not improve.

Monitoring

Monitor blood pressure before and periodically during treatment, particularly in patients with pre-existing hypertension.

Counselling the patient

It helps reduce the sudden urge to pass urine and may take some weeks to reach full effect.
Report any difficulty passing urine or new high blood pressure symptoms.
Swallow tablets whole and take regularly as prescribed.

Evidence & guidelines

Use is supported by randomised controlled trials demonstrating reduced micturition frequency and urgency incontinence episodes in overactive bladder.

Reference: SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Pathways