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Myrbetriq (mirabegron) is a widely used medication for managing overactive bladder (OAB) and neurogenic detrusor overactivity (NDO). With over 34 million adults in the US suffering from OAB, and 1 in 4 adult women experiencing urge incontinence—the most prevalent form of incontinence—it’s clear that bladder control issues are a significant concern for many.

These figures highlight Myrbetriq’s importance in the treatment landscape for OAB. However, its cost and potential side effects can be significant drawbacks for many patients.

Fortunately, several alternatives to Myrbetriq can offer similar, if not better, relief without breaking the bank or compromising your well-being. In this article, we’ll explore the best options available, helping you find the right treatment and improve your quality of life.

Key Takeaways

  • Botox injections are FDA-approved for both OAB and NDO, offering a safer option for patients with cardiovascular issues but requiring clinical visits for each session.
  • Gemtesa is a newer medication in the same drug class as Myrbetriq and may provide quicker symptom relief.
  • Ditropan XL is an old anticholinergic medication, FDA-approved for both OAB and NDO, in 1975.
  • Various studies have shown that alternatives like tolterodine and vibegron can offer similar or even greater efficacy compared to Myrbetriq in managing OAB symptoms.
  • Gradually reducing the dose of Myrbetriq is recommended to prevent withdrawal symptoms or a sudden return of OAB symptoms.

Why Patients Consider Alternatives to Myrbetriq

While Myrbetriq is a commonly prescribed medication for OAB and NDO, certain factors may lead patients to explore alternative treatments.

One primary reason is that Myrbetriq may raise blood pressure in certain patients. OAB is more common in older adults, with up to 40% of men and 30% of women aged 75 and above affected. In clinical trials involving patients with OAB, the increase in blood pressure was about 0.5 to 1 mm Hg higher than the placebo at the highest recommended dose.

Additionally, this drug may not be effective for everyone. Some patients may not experience the desired relief from their symptoms, making it necessary to try different medications or therapies to find the most effective treatment for their condition.

Finally, some patients may have hypersensitivity to mirabegron or any inactive ingredients. In this case, healthcare providers might recommend other treatments that pose less risk to the patient’s health.

These factors collectively drive the need for Myrbetriq alternatives, ensuring that patients have options tailored to their specific health profiles and needs.

Top 5 Best Myrbetriq Alternatives

Below are the most common alternatives to Myrbetriq:

1) Detrol LA

Detrol LA (tolterodine tartrate) extended-release capsules for overactive bladder, myrbetriq alternative

Price: starts at $83 per month

Active ingredients: Tolterodine tartrate

Drug class: Anticholinergic/Muscarinic antagonist

Dosage form: Extended-release capsules

Dosage frequency: Once daily

Approved indications: OAB

Common side effects: Dry mouth, headache, constipation, and abdominal pain.

Advantages:

  • Lower cost
  • Has been on the market longer than Myrbetriq
  • Less likely to increase blood pressure
  • Available as a generic

Disadvantages:

  • Long-term use of anticholinergics may impact cognitive function
  • Not indicated for NDO

A meta-analysis evaluated mirabegron’s efficacy and safety at doses of 50 mg and 100 mg compared to tolterodine (4 mg) and a placebo in treating OAB. Here are the key findings from the study:

  • Mirabegron and tolterodine significantly reduced incontinence episodes.
  • Both drugs reduced the number of micturitions (urinations) per day.
  • Both increased the volume of urine per void.
  • Both reduced urgency episodes per day.

Although, tolterodine did not improve nocturia and was linked to a significantly higher risk of adverse events compared to a placebo.

2) Vesicare

Buy Vesicare from Canada

Price: starts at $99 per month

Active ingredients: Solifenacin succinate

Drug class: Anticholinergic/Muscarinic antagonist

Dosage form: Tablets

Dosage frequency: Once daily

Approved indications: OAB

Common side effects: Dry mouth, constipation, urinary tract infection, and blurred vision.

Advantages:

  • Lower cost
  • Preferred choice for patients with hypertension
  • Well-established efficacy profile
  • Can be taken in combination with Myrbetriq

Disadvantages:

  • Generic versions are not available in the US
  • Risk of cognitive impairment
  • Not indicated for NDO

A 2023 comparative study of solifenacin and mirabegron showed that the OAB Symptom Score (OABSS), which measures the severity of OAB symptoms, improved in both groups. However, the improvement was slightly better in the mirabegron group (score reduced to 3.43) compared to the solifenacin group (score reduced to 4.20).

Another study later investigated the effectiveness of the two medications when combined. The combination offers higher efficacy than either drug alone.

3) Botox

Buy Botox from Canada

Price: starts at $295

Active ingredients: OnabotulinumtoxinA

Drug class: Acetylcholine release inhibitor and a neuromuscular blocking agent

Dosage form: Single-dose vial (for intradetrusor injection)

Dosage frequency: Once every 3 months

Approved indications: OAB, Urinary Incontinence, NDO, Chronic Migraine, Spasticity, Cervical Dystonia, Primary Axillary Hyperhidrosis, Blepharospasm, Strabismus

Common side effects: Urinary tract infection, dysuria, urinary retention, leukocyturia, and bacteriuria in patients treated for OAB and NDO.

Advantages:

  • Lower cost
  • Preferred choice for patients with hypertension
  • Well-established efficacy profile
  • Can be taken in combination with Myrbetriq

Disadvantages:

  • Generic versions are not available in the US
  • Risk of cognitive impairment
  • Not indicated for NDO

A 2023 comparative study of solifenacin and mirabegron showed that the OAB Symptom Score (OABSS), which measures the severity of OAB symptoms, improved in both groups. However, the improvement was slightly better in the mirabegron group (score reduced to 3.43) compared to the solifenacin group (score reduced to 4.20).

Another study later investigated the effectiveness of the two medications when combined. The combination offers higher efficacy than either drug alone.

4) Gemtesa

Buy Gemtesa from Canada

Price: starts at $594 (US price)

Active ingredients: Vibegron

Drug class: Beta-3 adrenergic agonist

Dosage form: Tablets

Dosage frequency: Once daily

Approved indications: OAB

Common side effects: Headache, urinary tract infection, nasopharyngitis, diarrhea, nausea, and upper

respiratory tract infection.

Advantages:

  • Dose adjustments aren’t necessary for patients with renal or hepatic impairment
  • Same drug class for a consistent treatment approach
  • May provide quicker relief of symptoms

Disadvantages:

  • Not indicated for NDO
  • Not available in generic
  • Higher price point

In a randomized crossover trial, patients were treated with mirabegron and vibegron. The results showed that both medications had similar effects on OAB symptoms, but vibegron showed a greater reduction in daytime frequency.

Additionally, a higher percentage of patients preferred vibegron, particularly those who experienced better control of urgency incontinence with it.

Another study conducted an indirect comparison by analyzing 11 randomized controlled trials involving 10,806 patients. The study found that the drug has shown greater efficacy than mirabegron in increasing mean voided volume per micturition.

Safety profiles for both drugs were similar, although mirabegron had a higher risk of nasopharyngitis and cardiovascular events.

5) Ditropan XL

Buy Gemtesa from Canada

Price: starts at $284 (US price)

Active ingredients: Oxybutynin

Drug class: Anticholinergic and antispasmodic

Dosage form: Extended-release tablets

Dosage frequency: Once daily

Approved indications: OAB, NDO

Common side effects: Dry mouth, constipation, diarrhea, headache, somnolence, and dizziness.

Advantages:

  • FDA-approved for both OAB and NDO
  • Better cardiovascular safety profile
  • Has been on the market since 1975
  • Available as a generic

Disadvantages:

  • Higher price point
  • Risk of cognitive impairment

Both medications offer comparable clinical benefits, potentially increasing bladder capacity by approximately 20%. Neither drug is deemed more effective than the other.

How To Stop Taking Myrbetriq

Depending on how long you’ve been taking Myrbetriq, your doctor might recommend gradually reducing your dose rather than stopping abruptly to avoid any potential withdrawal symptoms or a sudden return of your OAB symptoms.

A 2020 study demonstrated that gradually tapering off solifenacin, an alternative to Myrbetriq, significantly reduced the chances of the symptoms reappearing.

Once you stop taking Myrbetriq, monitor your symptoms closely. If your overactive bladder symptoms return or worsen, inform your healthcare provider immediately.

Final Thoughts: Which Myrbetriq Alternative is for You?

Exploring Myrbetriq alternatives allows you to find treatments that better suit your needs. Whether due to side effects, cost, or personal preference, these options provide effective ways for you to manage OAB and NDO symptoms.

Discuss these alternatives with your physician to determine the best fit for your health and lifestyle.

Frequently Asked Questions

Myrbetriq is available in some regions under the name Betanis. Additionally, it may be referred to as a beta-3 adrenergic agonist, which describes its class and mechanism of action.

Generic versions of oxybutynin are typically among the most affordable options for treating overactive bladder.

The safety of a drug for overactive bladder can vary depending on individual patient factors. However, Myrbetriq is often considered a safer option for many, particularly those who cannot tolerate anticholinergic medications because of side effects like dry mouth or constipation. Mirabegron has a different mechanism of action that may result in fewer side effects.

Yes, urinary retention is a potential side effect of Myrbetriq. While this side effect is relatively uncommon, it can occur due to the medication’s relaxation effect on the bladder muscle, which may sometimes inhibit complete bladder emptying.

Myrbetriq primarily works by relaxing the bladder muscle, which can help reduce symptoms of overactive bladder, including frequent urination and urgency. Although it is not specifically labeled for bladder spasms, its muscle-relaxing effects may alleviate some of these symptoms.

A medication comparable to Myrbetriq is vibegron, sold under the brand name Gemtesa. Both drugs belong to the same class of beta-3 adrenergic agonists and function similarly by relaxing the bladder muscle, thereby helping to reduce urinary frequency and urgency.

Beta-3 adrenergic agonists generally have milder side effects than anticholinergics, particularly for older adults. They carry a lower risk of dry mouth and aren’t linked to the dementia risk associated with anticholinergics, making them a safer choice for those concerned about cognitive health.

Oxytrol for Women is an over-the-counter option available for overactive bladder in the US. It is a patch that contains oxybutynin, which is also available by prescription in oral forms. However, the Oxytrol for Men skin patch is only available with a doctor’s prescription.

Myrbetriq is typically prescribed as a once-daily medication.

Myrbetriq is as effective as oxybutynin but tends to have fewer side effects. However, its higher cost can be a drawback. Your healthcare provider might recommend starting with oxybutynin. If you experience side effects or find it ineffective, Myrbetriq may be suggested as the next option.

Several natural remedies are available to manage overactive bladder symptoms, including herbal supplements like pumpkin seed extract and saw palmetto. Pelvic floor exercises are also commonly recommended as a non-pharmacological approach to strengthening bladder control.

Related Articles

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