Adrenergic beta-3 Receptor Agonists
Overview
Overview
Beta-3 receptor agonists activate beta-3 receptors in urinary-bladder detrusor muscle, increasing storage capacity without directly blocking muscarinic receptors.
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Classification
Classification
Mirabegron and vibegron are the principal therapeutic beta-3 agonists for overactive bladder. They differ in metabolic interactions and labelling details and should not be assumed to be identical.
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Mechanism of action
Mechanism of action
Beta-3 activation increases cyclic AMP and relaxes detrusor smooth muscle during the storage phase of the fill-void cycle, increasing bladder capacity.
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Important members
Important members
Mirabegron and vibegron are the important members. Mirabegron has the larger established pharmacology and interaction literature.
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Clinical uses
Clinical uses
Beta-3 agonists are used for overactive bladder with urgency, frequency or urge urinary incontinence. Product-specific indications may also include neurogenic detrusor overactivity.
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Adverse effects
Adverse effects
Hypertension, headache, urinary tract infection, nasopharyngitis, tachycardia and urinary retention may occur. Angioedema is an uncommon but serious labelled risk for mirabegron.
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Contraindications and precautions
Contraindications and precautions
Monitor blood pressure and use caution in clinically significant bladder-outlet obstruction or when combined with antimuscarinic therapy because urinary retention can occur.
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References
- Dawood O, El-Zawahry A. Mirabegron. NCBI Bookshelf. Updated 2023. SOURCE:NCBI:MIRABEGRON:2023