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Myrbetriq vs Detrol
Introduction
For patients with overactive bladder (OAB) syndrome or other urinary disorders, certain drugs that alter the function of the bladder and urinary tract can help in managing symptoms such as urgency, frequency, and incontinence. Myrbetriq and Detrol are two such drugs that are prescribed for OAB. Both have a similar therapeutic aim but achieve their results through different mechanisms of action. Myrbetriq is classified as a beta-3 adrenergic agonist which helps to relax the smooth muscle tissue in your bladder allowing it to store more urine before triggering an urge to void. On the other hand, Detrol acts primarily as an antimuscarinic agent which works by blocking muscarinic receptors on the surface of muscle cells preventing them from contracting thus reducing involuntary spasms that lead to feelings of urgency and potential leakage incidents.
Myrbetriq vs Detrol Side By Side
| Attribute | Myrbetriq | Detrol |
|---|---|---|
| Brand Name | Myrbetriq | Detrol |
| Contraindications | Urinary retention, gastric retention, uncontrolled narrow-angle glaucoma, kidney or liver problems. | Urinary retention, gastric retention, uncontrolled narrow-angle glaucoma, kidney or liver problems. |
| Cost | For the brand name, around $460 for 30 tablets (50 mg). Generic versions can start from around $1.40 per day. | For the brand name, around $410 for 60 capsules (4 mg). Generic versions can start from as low as roughly $0.70/day up to approximately $2.10/day. |
| Generic Name | Mirabegron | Tolterodine |
| Most Serious Side Effect | Increased blood pressure, signs of allergic reaction, kidney problems, liver problems, symptoms of bladder obstruction. | Painful or difficult urination, hallucinations, confusion and changes in mood, a fast or irregular heartbeat, severe headache with chest pain. |
| Severe Drug Interactions | Antifungal drugs like ketoconazole can raise levels of Myrbetriq in the body. | Macrolide antibiotics like erythromycin can increase the amount of Detrol. |
| Typical Dose | 25–50 mg/day, with an initial dose of 25 mg/day that can be increased to 50 mg/day if there is no adequate response after eight weeks. | 2 mg twice daily, can be adjusted to 1 mg twice daily based on tolerability. Doses can be increased back up to 2 mg twice daily if needed. |
What is Myrbetriq?
Mirabegron (the generic name for Myrbetriq) was a significant advancement in the class of drugs known as beta-3 adrenergic agonists, designed to treat overactive bladder (OAB). Mirabegron was first approved by the FDA in 2012. Unlike antimuscarinic medications such as Detrol, which work by blocking certain nerve impulses to relax the bladder muscles, Myrbetriq works differently. It helps relax the detrusor muscle that surrounds the bladder allowing it to hold more urine and reduce feelings of urgency. This selective action on beta-3 receptors results in fewer side effects than other OAB medications like Detrol that have broader effects on different types of receptors, thereby reducing unwanted side effects such as dry mouth and constipation.
What conditions is Myrbetriq approved to treat?
Myrbetriq is approved for the treatment of various types of urinary disorders:
- Overactive bladder (OAB) with symptoms of urgency, frequency and leakage
- Neurogenic detrusor overactivity (NDO), a type of bladder problem related to nerve damage, often due to conditions like spinal cord injury or multiple sclerosis.
How does Myrbetriq help with these illnesses?
Myrbetriq helps manage overactive bladder symptoms by relaxing the muscles in the bladder wall. It does this through its active ingredient, mirabegron, which stimulates beta-3 adrenergic receptors. When these receptors are activated, they cause relaxation of the detrusor muscle in the bladder, thus increasing the capacity to store urine and decreasing urinary frequency.
The nerves that control the function of your bladder use neurotransmitters like adrenaline (epinephrine) to communicate their instructions. These neurotransmitters attach themselves to specific sites on cells known as beta-3 adrenergic receptors. By stimulating these particular receptors, Myrbetriq reduces involuntary contractions of the muscle in your bladder wall.
Overactive bladder is a condition where individuals experience frequent urges to urinate or have difficulty controlling urination. Therefore, by causing relaxation of these muscles with Myrbetriq can limit negative effects such as discomfort and embarrassment associated with overactive bladder and help patients manage their condition more effectively.
What is Detrol?
Detrol, also known as tolterodine, is a medication that works by blocking the action of acetylcholine on muscarinic receptors in the bladder. This reduces involuntary contractions of the bladder muscles and can help with symptoms such as urinary frequency and urgency. Detrol was first approved by the FDA in 1998 for treating overactive bladder (OAB). Unlike Myrbetriq, which relaxes the smooth muscle of the bladder to increase capacity through activation of beta-3 adrenergic receptors, Detrol acts more specifically on reducing unwanted muscle spasms. While both medications can be effective for managing OAB symptoms, their side-effect profiles differ. Especially noteworthy is that Detrol's antimuscarinic effects mean it may cause dry mouth and constipation more commonly than Myrbetriq. However, its specific mode of action could be beneficial for those who haven't found symptom relief with other treatments.
What conditions is Detrol approved to treat?
Detrol is a medication that's been approved by the FDA for managing symptoms of overactive bladder, including:
- Frequent urination
- Urgency (having to rush to the bathroom)
- Urinary incontinence (leaking or wetting caused by an unstoppable need to pass urine)
How does Detrol help with these illnesses?
Acetylcholine is a neurotransmitter that plays key roles in many processes in the body, including muscle contraction and heart rate regulation. It also has significant influence on bladder control. Detrol works by blocking the action of acetylcholine on the smooth muscles of the bladder, thereby reducing urinary frequency and urgency. Unlike Myrbetriq which relaxes the bladder muscles to prevent urgent urination by stimulating beta-3 adrenergic receptors, Detrol primarily acts on muscarinic receptors to prevent unwanted contractions. Thus, it may be prescribed when patients do not respond well to other medications for overactive bladder or have certain contraindications for beta-3 agonists like Myrbetriq.
How effective are both Myrbetriq and Detrol?
Both mirabegron (Myrbetriq) and tolterodine (Detrol) have established histories of success in treating patients with overactive bladder, with their FDA approval dates only being a decade apart. Since they act on different receptors within the bladder, they may be prescribed under different circumstances. The effectiveness of Myrbetriq and Detrol in managing overactive bladder symptoms was directly compared in a double-blind clinical trial in 2013; both drugs exhibited similar efficacy as well as similar safety profiles. In this study, none of the metrics used to measure symptom improvement differed significantly between patients receiving Myrbetriq and those receiving Detrol.
A 2014 review of meta-analysis reports on Detrol demonstrated that it is effective at reducing urgency urinary incontinence episodes starting from the first week of treatment, has a side effect profile favorable over many other antimuscarinics due to its selectivity for the M2/M3 muscarinic receptors located primarily within the bladder, and that it is well-tolerated even among elderly populations who often struggle with medication side effects or polypharmacy issues.
As per a 2016 review and meta-analysis, Myrbetriq seems to be more effective than placebo at treating overactive bladder symptoms while also maintaining efficacy comparable to other common treatments like anticholinergics such as Detrol. Nonetheless, due to its unique mechanism acting on Beta-3 receptors causing relaxation instead of inhibitory action seen with anticholinergics like Detrol - an optimal treatment might involve prescribing Myrbetriq for patients who did not respond adequately or had problematic side effects related to anticholinergic medications.
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At what dose is Myrbetriq typically prescribed?
Oral dosages of Myrbetriq range from 25–50 mg/day, but studies have indicated that 25 mg/day is sufficient for treating overactive bladder in most people. However, the dosage can be increased to a maximum of 50 mg/day if there is no adequate response after eight weeks. On the other hand, Detrol is typically started at 2 mg twice daily. The dose may be lowered to 1 mg twice daily based on individual response and tolerability. For both medications, always follow your doctor's instructions and do not exceed the recommended maximum dosage.
At what dose is Detrol typically prescribed?
Detrol treatment initiates typically at a dosage of 2 mg twice daily. The dose can then be adjusted down to 1 mg twice daily depending on how well the patient tolerates the medication. If needed for symptom control, doses can be increased back up to 2 mg twice daily. If there's no adequate response to Detrol after several weeks, your healthcare provider may consider increasing your dose or switching you to another medication for bladder control. As with all medications, adjustments should always be under direct supervision and guidance from a medical professional.
What are the most common side effects for Myrbetriq?
Common side effects of Myrbetriq may include:
- Increased blood pressure
- Common cold symptoms (influenza-like symptoms)
- Urinary tract infection
- Headache
- Dizziness
- Diarrhea
And for Detrol, the common side effects are:
- Dry mouth
- Constipation
- Abdominal pain (stomach discomfort)
- Blurred vision
-Dizziness
-Urinary tract infection
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Are there any potential serious side effects for Myrbetriq?
Myrbetriq, like any other medication, can potentially cause serious side effects in some individuals. While it is generally well-tolerated, you should look out for the following:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue or throat.
- Increased blood pressure leading to headaches accompanied by chest pain and a severe pounding in your neck or ears.
- Kidney problems - little or no urination; painful or difficult urination; swelling in your feet or ankles
- Liver problems - nausea, upper stomach pain, itching, tired feeling, loss of appetite
- Symptoms of a bladder obstruction: trouble emptying your bladder (urinary retention), weak urine flow
If you experience any of these symptoms while taking Myrbetriq it’s vital that you seek immediate medical attention. As with all drugs do not stop taking them without first consulting with healthcare professional as sudden discontinuation could lead to withdrawal symptoms.
What are the most common side effects for Detrol?
Detrol, also known as tolterodine, may have a range of side effects including:
- Dry mouth and dry eyes
- Constipation or stomach discomfort
- Headache or dizziness
- Abnormal vision, such as blurred vision
- Drowsiness or fatigue
- Problems with memory or confusion
- Rapid heart rate (tachycardia) These side effects are usually mild and temporary but can be bothersome for some. It's important to remember that not everyone experiences these symptoms. If you do experience any persistent adverse reactions while taking Detrol, it is advised to seek immediate medical attention.
Are there any potential serious side effects for Detrol?
Detrol, while generally well-tolerated, could occasionally cause severe adverse reactions. You should immediately seek medical attention if you experience:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue or throat
- Painful or difficult urination
- Hallucinations (seeing or hearing things that are not real)
- Confusion and changes in your mood -A fast or irregular heartbeat -Unusual thoughts or behavior -Severe headache with chest pain, pounding heartbeats, nausea and sweating
If any of these occur after taking Detrol, contact a health professional promptly.
Contraindications for Myrbetriq and Detrol?
Both Myrbetriq and Detrol, like many other medications for overactive bladder, can cause side effects that may worsen certain conditions. If you notice any severe or unusual symptoms after starting these medications, it's important to seek medical attention promptly.
Neither Myrbetriq nor Detrol should be taken if you have urinary retention, gastric retention or uncontrolled narrow-angle glaucoma. Also, those with kidney or liver problems should take caution before using these drugs.
Always inform your healthcare provider about all the medications you are currently taking; this includes prescription drugs, non-prescription drugs and herbal products. Certain types of medication can interact negatively with both Myrbetriq and Detrol. For instance, antifungal drugs such as ketoconazole can raise the levels of Myrbetriq in your body while macrolide antibiotics like erythromycin can increase the amount of Detrol.
Patients with a history of QT prolongation (a heart rhythm condition) or who are taking Class IA (e.g., quinidine, procainamide) or Class III (e.g., amiodarone, sotalol) antiarrhythmic medications should use caution when starting treatment with these medicines.
How much do Myrbetriq and Detrol cost?
For the brand name versions of these drugs:
- The price of 30 tablets of Myrbetriq (50 mg) averages around $460, which works out to about $15/day.
- The price of 60 capsules of Detrol LA (4 mg) is about $410, working out to approximately $6.83/day.
Thus, if you are on a regular dosage for Myrbetriq, then brand-name Detrol is less expensive on a per-day treatment basis. Please remember that cost should not be your primary consideration in determining which drug is right for you.
When it comes to generic versions:
- Mirabegron (generic for Myrbetriq), costs vary but can start from around $1.40 per day.
- Tolterodine (the generic version of Detrol), has an average daily cost starting from as low as roughly $0.70/day up to approximately $2.10/day.
The exact pricing will depend on your location and pharmacy; however, these figures provide a general comparison between the two medications' prices.
Popularity of Myrbetriq and Detrol
Mirabegron, in generic form as well as under the brand name Myrbetriq, was estimated to have been prescribed to about 3.9 million people in the US in 2020. Mirabegron accounted for just over 16% of prescriptions for overactive bladder (OAB) medications. It appears to be a major option among "beta-3 adrenergic agonist" drugs used for OAB treatment and its use has been generally increasing since it was approved by FDA in 2012.
Tolterodine, including branded versions such as Detrol, was prescribed to approximately 5.8 million individuals in the USA during the same year. In America, tolterodine represents around 24% of antimuscarinic prescriptions which are commonly used for treating OAB and accounts for nearly a quarter of all overall OAB medication prescriptions. The prevalence of tolterodine has remained relatively steady over the past decade.
Conclusion
Both Myrbetriq (mirabegron) and Detrol (tolterodine) have a long history of use in managing overactive bladder symptoms, with numerous clinical studies affirming that they are more effective than placebo treatments. The two drugs may sometimes be used together under careful medical supervision as they work differently - Myrbetriq relaxes the bladder muscles to increase its capacity while Detrol reduces bladder contractions.
Myrbetriq is often considered as a second-line treatment after antimuscarinic agents like Detrol, particularly in patients who did not respond well to first-line medications or cannot tolerate their side effects.
Both Myrbetriq and Detrol are available in generic forms which can significantly reduce costs for those paying out-of-pocket. Similar to other medications, both may require an adjustment period before noticeable improvements occur.
The side effect profile between these two drugs does vary; while both are generally well-tolerated, common side effects of Myrbetriq include hypertension and urinary tract infections whereas with Detrol dry mouth and constipation tend to be more frequent. Patients should monitor their symptoms carefully when starting either medication and consult their healthcare provider immediately if any adverse reaction is experienced.
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Refrences
- Andersson, K.-E., Choudhury, N., Cornu, J.-N., Huang, M., Korstanje, C., Siddiqui, E., & Van Kerrebroeck, P. (2018, July 6). The efficacy of mirabegron in the treatment of urgency and the potential utility of combination therapy. Therapeutic Advances in Urology. SAGE Publications.http://doi.org/10.1177/1756287218781255
- Andersson, K.-E., & Yoshida, M. (2003, January). Antimuscarinics and the Overactive Detrusor—Which Is the Main Mechanism of Action?. European Urology. Elsevier BV.http://doi.org/10.1016/s0302-2838(02)00540-7
- Maman, K., Aballea, S., Nazir, J., Desroziers, K., Neine, M.-E., Siddiqui, E., … Hakimi, Z. (2014, April). Comparative Efficacy and Safety of Medical Treatments for the Management of Overactive Bladder: A Systematic Literature Review and Mixed Treatment Comparison. European Urology. Elsevier BV.http://doi.org/10.1016/j.eururo.2013.11.010
- Sripad, A., Raker, C., Shireman, T., & Sung, V. (2022, February 7). Overactive bladder medication prescription trends from 2014 to 2018. Neurourology and Urodynamics. Wiley.http://doi.org/10.1002/nau.24880