β3-Agonists for Overactive Bladder



Medical management of overactive bladder (OAB) has traditionally been with anticholinergic medications. While this drug class is effective for some patients, efficacy is not seen in all, and the side effect profile may result in decreased use. Mirabegron, a β3-adrenoceptor agonist, has been established as an alternative therapy. This chapter aims to review the history of mirabegron in addition to drug safety, efficacy, and reliability in a diverse group of patients including the elderly, those with cardiac comorbidities, and those with bladder outlet obstruction. Drug cost and comparison to anticholinergics and placebo is also addressed in this review. A growing body of evidence suggests that mirabegron is a safe and efficacious drug with a limited side effect profile rendering it as a potential first-line pharmacological option for the management of OAB.


Overactive bladder Mirabegron β3-adrenoceptor agonist Antimuscarinics Anticholinergics Lower urinary tract symptoms Urinary retention Bladder outlet obstruction Urinary urgency Urinary frequency Urgency urinary incontinence Urodynamics 



Adverse effects


Twice daily


Budget income model


Body mass index


Bladder outlet obstruction


Beats per minute


Diastolic blood pressure


Heart rate


Health-related quality of life




Lower urinary tract symptoms


Neurogenic detrusor overactivity


Overactive bladder


Overactive bladder questionnaire symptom score


Patient perception of bladder control


Post-void residual


Maximum flow


Detrusor pressure at maximum flow


Systemic blood pressure


Treatment emergent adverse effect


Treatment satisfaction-visual analog scale




Urinary incontinence


Urinary tract infection


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Vanderbilt UniversityDepartment of Urologic SurgeryNashilleUSA

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