Mirabegron for Overactive Bladder

Indication and Mechanism

Mirabegron is a beta-3 adrenergic agonist that relaxes the detrusor muscle during bladder filling, thereby increasing bladder storage capacity, as stated by the European Association of Urology 1

The European Association of Urology recommends mirabegron 25-50 mg daily for storage symptoms (OAB component) in men with lower urinary tract symptoms 1
The European Association of Urology guidelines suggest that alpha-blockers or 5-alpha reductase inhibitors are indicated for voiding symptoms (BOO component), not mirabegron 1
Mirabegron can be added to alpha-blockers in men with both storage and voiding symptoms, according to the European Urology journal 2

The European Association of Urology recommends monitoring blood pressure periodically, especially in hypertensive patients, as mirabegron can increase blood pressure 1
Post-void residual volume should be monitored in men with lower urinary tract symptoms, particularly if on combination therapy, as advised by the European Association of Urology 1