Vesicare vs Myrbetriq

Overactive bladder (OAB) is a prevalent urological condition characterized by urinary urgency, usually accompanied by increased frequency and, in many cases, urge incontinence. Globally, it affects around 1 in 5 people and has become more common in the past two decades, rising from 18.1% to 23.9%.

When it comes to treatment, two prescription medications often come up in conversation–Vesicare (solifenacin succinate) and Myrbetriq (mirabegron). Both are FDA-approved, commonly prescribed, and backed by years of clinical research.

In this article, we’ll break down everything you need to know. This comparison combines clinical trial findings, real-world patient reviews, and expert recommendations to provide a practical understanding of how Vesicare vs. Myrbetriq compares.

Who should take Vesicare or Myrbetriq?

Both Vesicare (solifenacin) and Myrbetriq (mirabegron) are approved treatments for adults living with overactive bladder (OAB). You may be prescribed either drug if you experience:

• • Urinary urgency (a sudden need to pee)
  • Going to the bathroom often (8 times/day or more)
  • Leakage associated with urge
  • Nocturia (waking to pee at night)

They’re both backed by strong regulatory approval. Vesicare received FDA approval in 2004 and can be prescribed to adults, and, as a liquid formulation (Vesicare LS), to children aged 2 and above, for neurogenic detrusor overactivity (NDO).

Similarly, Myrbetriq, launched in 2012, is also available as a liquid formulation (Myrbetriq Granules) for children 3 years or older who weigh 35 kg or more with NDO.

How do Vesicare and Myrbetriq work?

In a normal bladder, the muscle stays relaxed as it fills, and you only feel the urge to urinate when it’s close to full. In people with OAB, the bladder muscle starts contracting too early or too often, even when there’s not much urine inside. These abnormal signals make you feel like you urgently need to go, and sometimes lead to leakage.

Vesicare (solifenacin succinate) is an antimuscarinic medication. It works by blocking certain signals between your nerves and bladder muscle, specifically targeting muscarinic receptors in the bladder wall, so your bladder stays relaxed until it’s time to go.

Myrbetriq (mirabegron), on the other hand, is a beta-3 adrenergic agonist. Instead of blocking nerve signals, like Vesicare, it activates a different kind of receptor that tells your bladder to relax and stretch more. This helps your bladder hold more urine without sending constant urgency signals to your brain.

Which is more effective for overactive bladder, Myrbetriq or Vesicare?

When compared in clinical trials, both drugs generally offer similar improvement. Other studies show mixed results, and while one drug might work a little better in some ways, the difference isn’t significant.

In a meta-analysis of 5 high-quality clinical trials, both medications were found to work equally well in treating OAB symptoms. However, a systematic review found that Vesicare slightly reduced incontinence more than Myrbetriq.

In another comparative study, Myrbetriq had a slight edge in all reported outcomes, fewer leaks, fewer daytime trips, and fewer nighttime awakenings. Here’s a look at the results:

Another study focused on women and found that both drugs work, but Myrbetriq is better tolerated. The authors suggest starting with Myrbetriq as a first-line treatment, and Vesicare can be used later if Myrbetriq doesn’t work well enough.

What Patients Are Saying About Vesicare & Myrbetriq for Overactive Bladder

In a Reddit thread, a 30-year-old male shared his long history of OAB, spanning over a decade, and his frustration with the lack of relief from natural remedies like CBD oil and pumpkin seed extract. After a failed trial with trospium (Mictonorm), his doctor prescribed Myrbetriq 50 mg and Vesicare 10 mg, which he had just started.

He wasn’t sure yet if the meds were working, but noticed increased straining to urinate and was concerned whether this was a side effect or a passing issue. He asked others how long it took for them to notice improvements and whether they had experienced similar issues.

Several users said Myrbetriq took a few weeks to show benefits. Some mentioned around 4-5 weeks, while others felt relief within a few days to two months, depending on the dosage and their body’s response.

For Vesicare, feedback was more varied. One user found it more effective than Myrbetriq, while another noted it mainly helped with nighttime symptoms but was less helpful during the day.

In a separate post, another user shared their hesitation about starting Myrbetriq 50mg. They hadn’t started the medication yet and wanted to hear from others about their personal experiences.

A few users said Myrbetriq reduced urgency quickly, in some cases, within a few days. One person noted it extended their bathroom intervals from every 30 minutes to every two hours.

Others reported little improvement or said the medication eventually lost effectiveness, especially for those with IC (interstitial cystitis). One commenter reported almost a year of successful treatment with no significant side effects. Another noted symptom relief lasted until a procedure (cystoscopy) triggered a relapse.

There’s no “best” medication that works for everyone. What helps one person may not work for another, and what one person tolerates well, another might not. That’s why treatment for OAB needs to be personalized, and why it’s so important to keep checking in with your doctor to adjust your plan based on how you’re feeling and responding.

Which causes fewer side effects?

In the studies mentioned earlier, all had similar findings. Myrbetriq caused fewer side effects, especially less dry mouth, and was better tolerated. This is primarily because muscarinic receptors, which Vesicare targets, also exist in your salivary glands and intestines, so blocking them there can lead to dry mouth and constipation.

Myrbetriq works through a different pathway that doesn’t significantly affect saliva or digestion. However, it can cause a slight increase in blood pressure, headache, and mild urinary tract infections.

In the same meta-analysis above, there was no major difference in blood pressure between Myrbetriq and Vesicare.

Who should not take Vesicare?

You should avoid or be cautious with Vesicare if:

Who should not take Myrbetriq?

You’ll want to avoid or be extra careful with Myrbetriq if:

What are the dosing instructions for Vesicare and Myrbetriq?

Both medications are taken by mouth, once a day, and don’t require complicated schedules.

Can You Take Vesicare and Myrbetriq Together?

Yes, you can take Vesicare and Myrbetriq together. In fact, this combination is sometimes prescribed intentionally for people with OAB who don’t get enough symptom relief from just one medication.

A long-term study involving 1,829 people with OAB showed that the combination therapy resulted in modest but meaningful improvements, reducing both leaks and urgency-related bathroom visits by about 0.4-0.5 times per day more than monotherapy.

How much do Vesicare and Myrbetriq cost?

The cost of bladder medications can vary a lot depending on whether you’re taking a brand-name or a generic version, what your insurance covers, and where you buy it from.

Brand-name Vesicare can cost anywhere from $400 to $500 per month if you pay cash. A generic version (solifenacin) is now widely available and much cheaper, sometimes as low as $15 to $60 per month with discount cards or coupons. Most insurance plans, including Medicare Part D, cover the generic version.

Myrbetriq is brand-only (no generic as of 2025), which makes it more expensive, usually around $500 to $600 per month at full retail price.

Pharma Giant, a Canadian-based online pharmacy service, provides a more budget-friendly alternative:

• • Myrbetriq: $113.95 per month
  • Vesicare: $99 per month
  • Solifenacin (Generic Vesicare): $67 per month

Ordering in bulk (up to a 3-month supply) can further reduce costs, and discount coupons are also available.

How to Decide Which Is Right for You

It depends on which symptoms bother you the most, any other health issues you may have, and how your body responds to each medication. Here’s how to think about it.

You might benefit more from Vesicare if:

• • You can tolerate dry mouth or mild constipation.
  • You don’t have issues with memory or confusion.
  • You’ve already tried Myrbetriq without good results.
  • You’re looking for a lower-cost option (especially if you need a generic).

Myrbetriq may be the better choice if:

• • You’ve experienced side effects from anticholinergic meds like dry mouth, constipation, or brain fog.
  • You’re older and want to avoid any risk of cognitive side effects.
  • You have other medications that interact with anticholinergics.
  • You prefer a newer option that works through a different pathway.

If neither works well enough alone, your doctor might recommend combination therapy. This has been shown to improve bladder control more than either drug on its own, especially in people with stubborn OAB symptoms.

Summary

Vesicare and Myrbetriq both treat overactive bladder effectively, but they work differently and suit different people. Vesicare blocks nerve signals to the bladder, while Myrbetriq helps the bladder relax and hold more urine. Studies show they offer similar results, but Myrbetriq usually causes fewer side effects, like dry mouth and constipation.

If cost is your main concern, Vesicare’s generic (solifenacin) is much cheaper. If you’ve had issues with anticholinergic side effects or are older, Myrbetriq may be a better option. Some people may benefit from taking both.

Talk to your doctor to figure out what works best for you.

Frequently Asked Questions

Sources

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Wang, J., Zhou, Z., Cui, Y., Li, Y., Yuan, H., Gao, Z., Zhu, Z., & Wu, J. (2018). Meta?analysis of the efficacy and safety of mirabegron and solifenacin monotherapy for overactive bladder. Neurourology and Urodynamics, 38(1), 22–30. https://doi.org/10.1002/nau.23863

Gratzke, C., Van Maanen, R., Chapple, C., Abrams, P., Herschorn, S., Robinson, D., Ridder, A., Stoelzel, M., Paireddy, A., Yoon, S. J., Al-Shukri, S., Rechberger, T., & Mueller, E. R. (2018). Long-term Safety and Efficacy of Mirabegron and Solifenacin in Combination Compared with Monotherapy in Patients with Overactive Bladder: A Randomised, Multicentre Phase 3 Study (SYNERGY II). European Urology, 74(4), 501–509. https://doi.org/10.1016/j.eururo.2018.05.005

Hsu, F. C., Weeks, C. E., Selph, S. S., Blazina, I., Holmes, R. S., & McDonagh, M. S. (2019). Updating the evidence on drugs to treat overactive bladder: a systematic review. International Urogynecology Journal, 30(10), 1603–1617. https://doi.org/10.1007/s00192-019-04022-8

Kumar, S., Tiwari, V., Chaurasia, D. K., Kumar, S., & Mishra, S. (2023). A comparative study of solifenacin, mirabegron, and their combination as bladder relaxants in the management of overactive bladder. Cureus. https://doi.org/10.7759/cureus.45612

Jamil, M. N., Irum, S., & Islam, E. U. (2023). Comparison Of Solifenacin And Mirabegron For The Treatment Of Overactive Bladder. Journal of Ayub Medical College, Abbottabad : JAMC, 35(2), 298–300. https://doi.org/10.55519/JAMC-02-11795

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