Mirabegron Considerations in Geriatric Patients

Safety Profile in Geriatric Patients

The most common adverse events in geriatric patients include hypertension, urinary tract infections, headache, and nasopharyngitis 1, 2
Mirabegron does not affect voiding urodynamic parameters, and the overall change in post-void residual volume is small in elderly patients 2

Mirabegron is contraindicated in patients with severe uncontrolled hypertension 1, 2
Regular blood pressure monitoring is recommended, especially during the initial treatment period 3

The American Urological Association/Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (AUA/SUFU) guidelines recommend caution when prescribing β3-adrenoceptor agonists in frail OAB patients 4, 5
Frail patients (those with mobility deficits, weight loss, weakness, and cognitive deficits) may have a lower therapeutic index and higher adverse event profile with OAB medications 4, 5
For patients who cannot tolerate pharmacologic management, behavioral strategies including prompted voiding and fluid management may be helpful 5

Regular monitoring of blood pressure is recommended, especially in patients with pre-existing hypertension 1, 2
In men with lower urinary tract symptoms, regular re-evaluation of symptoms and post-void residual volume is advised 2, 6
Patients should be advised to discontinue medication if worsening voiding symptoms or urinary stream is noted after initiation of therapy 2

Avoid using mirabegron in patients with severe uncontrolled hypertension 1, 2
Be aware that long-term data on the efficacy and safety of mirabegron in men of any age with lower urinary tract symptoms are not yet available 2