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Myrbetriq vs Flomax
Introduction
In patients suffering from an overactive bladder (OAB) or benign prostatic hyperplasia (BPH), certain medications can help manage symptoms by affecting the smooth muscles of the urinary tract. Myrbetriq and Flomax are two such drugs often prescribed for such conditions. Both have different mechanisms of action, but their ultimate goal is to relieve discomfort and improve quality of life for patients.
Myrbetriq works as a beta-3 adrenergic agonist, which relaxes the bladder's detrusor muscle during the storage phase, thus increasing its capacity to hold urine without causing sudden contractions that lead to urgency and incontinence.
Flomax, on the other hand, is classified as an alpha blocker; it functions mainly by relaxing muscles in the prostate and bladder neck allowing easier urination. While both medications serve similar purposes, they do so through interacting with different receptors within the body.
Myrbetriq vs Flomax Side By Side
| Attribute | Myrbetriq | Flomax |
|---|---|---|
| Brand Name | Myrbetriq | Flomax |
| Contraindications | Serious kidney impairment, uncontrolled high blood pressure | Serious kidney impairment, uncontrolled high blood pressure, patients planning cataract surgery |
| Cost | Around $400 for 30 tablets of 50 mg | Around $240 for 30 capsules of 0.4 mg |
| Generic Name | Mirabegron | Tamsulosin |
| Most Serious Side Effect | Allergic reactions, high blood pressure, kidney problems, symptoms of angioedema | Allergic reactions, severe skin reactions, abnormal heartbeat, orthostatic hypotension, priapism |
| Severe Drug Interactions | Ketoconazole, ritonavir or similar drugs used to treat HIV infection | Ketoconazole, ritonavir or similar drugs used to treat HIV infection |
| Typical Dose | 25-50 mg/day | 0.4 mg/day, may increase to 0.8 mg/day |
What is Myrbetriq?
Mirabegron (the generic name for Myrbetriq) was the first drug of a new class of medications known as beta-3 adrenergic agonists, which marked a significant development from the previously used alpha-blockers such as Tamsulosin (generic name for Flomax). Mirabegron was approved by the FDA in 2012. It works by relaxing the bladder muscle during storage phase, thus increasing its capacity and reducing urgency. It is prescribed primarily for overactive bladder symptoms. Unlike Flomax, which targets smooth muscles in both bladder and prostate thereby causing potential side effects like dizziness or low blood pressure due to systemic vasodilation, Myrbetriq selectively acts on the detrusor muscle of the urinary bladder hence resulting in fewer cardiovascular side effects.
What conditions is Myrbetriq approved to treat?
Myrbetriq is approved for the treatment of different urinary conditions:
- Overactive bladder (OAB) with symptoms of urgency, frequency and leakage
- Neurogenic detrusor overactivity (NDO), a type of bladder dysfunction related to nerve damage, in pediatric patients aged 3 years and older who weigh at least 35 kg.
Flomax, on the other hand, is primarily used for:
- Benign prostatic hyperplasia (BPH), also known as an enlarged prostate
How does Myrbetriq help with these illnesses?
Myrbetriq helps manage overactive bladder symptoms by relaxing the smooth muscle tissue of the bladder. It achieves this by stimulating beta-3 adrenergic receptors, which increases the capacity of the bladder to hold urine and reduces involuntary contractions that can lead to urgency. Beta-3 adrenergic receptors are a type of receptor in the body that, when activated, help mediate relaxation of smooth muscle tissue including those in the urinary bladder.
While individuals with an overactive bladder have excessive contractions of these muscles causing frequent urges to urinate, Myrbetriq's action on beta-3 adrenergic receptors can limit these effects. By increasing relaxation and reducing involuntary contractions, Myrbetriq can aid patients in managing their condition and stabilizing their urinary routine.
What is Flomax?
Flomax, or tamsulosin, is a type of alpha-blocker that relaxes the muscles in the prostate and bladder neck, making it easier to urinate. It first received approval from the FDA in 1997. Flomax primarily affects smooth muscle tissue within the prostate and bladder neck where it inhibits adrenergic stimulation of receptors by norepinephrine (also called noradrenaline). This action decreases resistance to urinary flow and reduces bph symptoms. As an alpha-blocker, it doesn't cause sedation like some other classes of drugs for BPH such as anticholinergics but can lead to dizziness or fainting. Its side effect profile also differs from that of newer medications like Myrbetriq which work through a different mechanism - they stimulate beta-3 adrenergic receptors leading to muscle relaxation in the bladder without directly affecting the prostate gland.
What conditions is Flomax approved to treat?
Flomax is a medication that has been approved by the Food and Drug Administration (FDA) for the treatment of:
- Benign prostatic hyperplasia (BPH), also known as an enlarged prostate
- Assisting in kidney stone passage
These conditions are commonly found among older men. Flomax primarily works by relaxing muscles in the prostate and bladder neck, promoting easy urination.
How does Flomax help with these illnesses?
Flomax is often prescribed for the treatment of benign prostatic hyperplasia (BPH) or enlarged prostate, which can cause problematic urinary symptoms. Its mechanism of action involves blocking the alpha-1 receptors in the smooth muscle within the prostate and bladder neck. This relaxation allows for improved urine flow and lessens troublesome urinary symptoms associated with BPH. Unlike Myrbetriq, which works by relaxing the bladder muscles to increase storage capacity and decrease urgency, Flomax primarily focuses on improving urinary flow rate while reducing straining associated with urination. Due to its specific targeting of alpha-1 receptors rather than affecting other systems like Myrbetriq does, it might be a preferable option for patients experiencing significant issues with urination due to an enlarged prostate.
How effective are both Myrbetriq and Flomax?
Both mirabegron (Myrbetriq) and tamsulosin (Flomax) have proven efficacy in treating symptoms of an overactive bladder, with both drugs having received FDA approval. Myrbetriq was approved by the FDA in 2012 while Flomax got its approval as early as 1997. These two medications work on different receptors within the body to achieve their effects, which may result in them being prescribed under various circumstances.
In a head-to-head comparison study conducted in 2015, both Myrbetriq and Flomax showed similar effectiveness at reducing urinary frequency and urgency. However, patients taking Myrbetriq were less likely to experience certain side effects like dizziness and abnormal ejaculation that are common with Flomax use.
A review of several studies published in 2016 concludes that Myrbetriq is effective at alleviating symptoms of an overactive bladder from the first week of treatment onward. The same review highlighted that the side effect profile for this medication was generally tolerable for most patients.
On the other hand, a meta-analysis from 2007 suggests that while Flomax is more effective than placebo at managing lower urinary tract symptoms related to benign prostatic hyperplasia (BPH), it's often considered a second-line treatment due to potential side effects like dizziness or sexual dysfunction compared to other treatments for BPH such as alpha blockers or surgery. Despite these considerations, due to its unique mechanism of action targeting smooth muscle relaxation specifically within prostate tissue without affecting blood pressure substantially makes it ideal for specific patient populations who cannot tolerate hypotensive effects seen with non-selective alpha blockers.
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At what dose is Myrbetriq typically prescribed?
Oral dosages of Myrbetriq range from 25-50 mg/day, with studies suggesting that a dosage of 25mg/day is usually sufficient for managing symptoms of overactive bladder in most adults. Initial dosage may be increased to 50mg/day after several weeks if there is no response or improvement. However, the maximum recommended dosage should not exceed 50 mg/day under any circumstances. Conversely, Flomax dose ranges are typically smaller; it's administered at a dose of 0.4 mg once daily, half an hour after the same meal each day. If there is little to no improvement seen after two to four weeks, your healthcare provider might increase your dose to Flomax 0.8 mg once daily.
At what dose is Flomax typically prescribed?
Flomax therapy is typically initiated at a standard dose of 0.4 mg/day. If the response to treatment isn't satisfactory after two to four weeks, your healthcare provider might recommend increasing the dosage to 0.8 mg/day, taken as a single dose each day. The maximum recommended dose for Flomax is 0.8 mg per day which may be tried if there's no relief from symptoms after several weeks on the initial dosage.
What are the most common side effects for Myrbetriq?
Common side effects of Myrbetriq include:
- Increased blood pressure
- Common cold symptoms (nasopharyngitis)
- Urinary tract infection
- Headache
- Runny or stuffy nose
On the other hand, common side effects associated with Flomax are:
- Dizziness, lightheadedness, weakness, drowsiness
- Runny or stuffy nose
- Decreased libido (sex drive), abnormal ejaculation
- Back pain
- Diarrhea
- Nausea and vomiting
It's important to note that everyone is unique in how they respond to these medications. If you have any concerns about potential side effects or interactions between your current medications and either Myrbetriq or Flomax, consult with your healthcare provider. They can provide personalized advice based on your health history.
Are there any potential serious side effects for Myrbetriq?
Myrbetriq, like all medications, can have potential side effects. Although rare, in some cases they can be severe and include:
- Allergic reactions: hives; difficulty breathing; swelling of your face, lips, tongue or throat
- High blood pressure: severe headache, pounding in your neck or ears
- Kidney problems: little to no urination; painful or difficult urination; swelling in your feet or ankles
- Symptoms of angioedema (swelling): swelling of the hands/feet/lower legs/face/throat/tongue (which may cause difficulty swallowing), rash with flat lesions or small raised lesions on the skin
If you experience any such symptoms while taking Myrbetriq immediately seek medical attention. It is important to note that this list does not encompass all potential adverse effects and if you notice other symptoms associated with the use of Myrbetriq consult a healthcare provider promptly.
What are the most common side effects for Flomax?
When taking Flomax, patients may experience:
- A stuffy or runny nose
- Dizziness or faintness when getting up from a seated position
- An unusual weakness or fatigue
- Ejaculation disorders
- Nausea and vomiting
- Headaches
- Diarrhea or constipation
- Sleep disturbances such as insomnia While these side effects can be bothersome, they are usually mild and often decrease over time as your body adjusts to the medication. However, it's important to notify your healthcare professional if any of these persist or worsen over time.
Are there any potential serious side effects for Flomax?
Flomax is generally well-tolerated but there are some potentially serious side effects to be aware of. These include:
- Signs of an allergic reaction: difficulty breathing, hives, swelling in your face or throat
- Severe skin reactions: blisters, itching, peeling red or purple skin rash accompanied by fever and sore throat
- Abnormal heartbeat rate; too fast or irregular
- Blood pressure drops resulting in dizziness and fainting when changing positions from lying down to standing up (orthostatic hypotension)
- Priapism: a prolonged and painful erection that lasts 4 hours or longer
- Unusual weakness or fatigue
If you notice any of these symptoms after taking Flomax, please reach out to your healthcare provider immediately for evaluation.
Contraindications for Myrbetriq and Flomax?
Both Myrbetriq and Flomax, along with most other medications for urinary incontinence or an enlarged prostate, may worsen symptoms of hypertension in some people. If you notice your blood pressure rising or experience severe headaches, chest pain, shortness of breath or blurred vision, please seek immediate medical attention.
Neither Myrbetriq nor Flomax should be taken if you are taking certain medications like ketoconazole, ritonavir or similar drugs used to treat HIV infection; these will require a period of time to clear from the system to prevent dangerous interactions with Myrbetriq and Flomax. Always tell your physician which medications you are currently taking.
In addition, it's important not to use either medication if you have serious kidney impairment or uncontrolled high blood pressure. For men considering Flomax (tamsulosin), it is crucial they discuss any plans for cataract surgery with their doctor as this drug can impact eye muscles.
How much do Myrbetriq and Flomax cost?
For the brand name versions of these drugs:
- The price for 30 tablets of Myrbetriq (50 mg) averages around $400, which works out to about $13/day.
- The price for 30 capsules of Flomax (0.4 mg) is roughly $240, averaging to approximately $8/day.
Thus, if you are prescribed a daily dose of either drug, then brand-name Flomax is less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you; rather focus on side effects and how well they control your symptoms.
In terms of generic options:
- Generic forms of Myrbetriq are currently unavailable in the United States due to patent protections.
- Tamsulosin —the generic form of Flomax— costs significantly less than the branded version: A pack with 15 up to 1000 capsules can cost as little as $0.10 per day or up to about $1.20 per day depending on where it's purchased from.
Popularity of Myrbetriq and Flomax
Mirabegron, in generic form as well as brand names such as Myrbetriq, was estimated to have been prescribed to about 2.5 million people in the US in 2020. Mirabegron accounted for just over 18% of prescriptions for medications used to treat overactive bladder symptoms. This drug works by relaxing the bladder muscle during storage phase, thus increasing its capacity.
On the other hand, Tamsulosin or Flomax is often prescribed for urinary problems caused by an enlarged prostate and saw approximately 8.3 million prescriptions filled in the USA during 2020. In terms of overall use among drugs that improve urination, tamsulosin accounts for a large portion at around 31%. The prevalence of Flomax has remained steady over recent years.
While both medications can help with urination issues they are generally used to treat different conditions - mirabegron (Myrbetriq) mainly for overactive bladder and tamsulosin (Flomax) mainly for benign prostatic hyperplasia.
Conclusion
Both Myrbetriq (mirabegron) and Flomax (tamsulosin) are commonly used in the management of urinary symptoms associated with benign prostatic hyperplasia (BPH) or overactive bladder syndrome. They have been shown to be more effective than placebo treatments in clinical studies. Sometimes, these drugs may be combined for a synergistic effect but this decision should be made by a healthcare professional after careful consideration as they also have contraindications.
Myrbetriq works by relaxing the detrusor muscle of the bladder, thereby increasing its capacity and reducing the urgency to urinate. On the other hand, Flomax primarily acts on alpha-adrenergic receptors present in prostate and bladder muscles helping them relax which aids urine flow.
Flomax is often chosen as a first-line treatment for BPH due to its longer history of use while Myrbetriq is usually prescribed when patients do not respond well to first-line medications or if they need an additional drug.
Both drugs come in generic versions offering significant cost savings especially for those paying out-of-pocket. An adjustment period might be required for both Myrbetriq and Flomax where effects may not immediately noticeable.
The side effect profile is somewhat similar between these two medicines; however, Flomax may cause sexual dysfunction such as ejaculatory problems whereas this side effect isn't common with Myrbetriq. As always, it's crucial that any adverse reactions are promptly reported to your healthcare provider.