Pharmacology of Mirabegron (Myrbetriq); Mechanism of action, Pharmacokinetics, Uses, Effects

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Mirabegron is a medication primarily used to treat overactive bladder (OAB) symptoms, such as urinary urgency, frequency, and incontinence. It belongs to a class of drugs known as beta-3 adrenergic receptor agonists. Here's a detailed overview of its pharmacology:

Mechanism of Action
Mirabegron works by selectively stimulating beta-3 adrenergic receptors in the bladder. This leads to relaxation of the detrusor smooth muscle during the storage phase of the urinary bladder fill-void cycle, thereby increasing bladder capacity and reducing symptoms of OAB1.

Pharmacokinetics
Absorption: Mirabegron is rapidly absorbed after oral administration, with peak plasma concentrations reached within 3-4 hours.

Distribution: It has a volume of distribution of approximately 300 liters.

Metabolism: Mirabegron is metabolized in the liver primarily by the cytochrome P450 enzyme system, particularly CYP3A4.

Excretion: The drug and its metabolites are excreted primarily in the urine.

Half-Life: The half-life of mirabegron is about 50 hours, allowing for once-daily dosing.

Clinical Uses
Overactive Bladder (OAB): Treatment of symptoms such as urgency, frequency, and incontinence.

Neurogenic Detrusor Overactivity: Management of bladder symptoms in patients with neurological conditions.

Adverse Effects
Common: Headache, hypertension, nasopharyngitis, and urinary tract infections.

Less Common: Dizziness, constipation, and dry mouth.

Serious: Severe allergic reactions and angioedema (swelling of the deeper layers of the skin).

Drug Interactions
CYP3A4 Inhibitors: Drugs that inhibit CYP3A4 (e.g., ketoconazole, ritonavir) can increase mirabegron levels.

CYP3A4 Inducers: Drugs that induce CYP3A4 (e.g., rifampicin) can decrease mirabegron levels.

Precautions
Hypertension: Monitor blood pressure regularly, especially in patients with a history of hypertension.

Pregnancy and Breastfeeding: Use with caution and only if clearly needed.

Allergies: Inform your healthcare provider if you have any allergies to mirabegron or its components

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