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Myrbetriq vs Vesicare
Introduction
For individuals dealing with overactive bladder (OAB) symptoms, certain medications can help control these problems by affecting the nerves and muscles involved in bladder control. Myrbetriq and Vesicare are two such drugs commonly prescribed for this purpose. They each function differently but both aim to manage OAB symptoms including frequent urination, urgency, and incontinence. Myrbetriq is a beta-3 adrenergic agonist that works by relaxing the smooth muscle of the bladder which improves its ability to store urine, thereby reducing sudden urges to urinate. On the other hand, Vesicare falls under a class of drugs known as antimuscarinics or anticholinergics that work primarily by inhibiting involuntary contractions of the bladder muscles thus helping reduce urinary frequency and leakage.
Myrbetriq vs Vesicare Side By Side
| Attribute | Myrbetriq | Vesicare |
|---|---|---|
| Brand Name | Myrbetriq | Vesicare |
| Contraindications | Severe kidney disease, severe liver disease, uncontrolled narrow-angle glaucoma, gastric retention, significantly reduced gastrointestinal motility conditions, consumption of drugs that inhibit the CYP2D6 enzyme | Severe kidney disease, severe liver disease, uncontrolled narrow-angle glaucoma, gastric retention, significantly reduced gastrointestinal motility conditions |
| Cost | Around $370 for 30 tablets (50 mg) | Around $286 for 30 tablets (10 mg), Generic (solifenacin succinate) ranges from about $0.80-$2.60 per day |
| Generic Name | Mirabegron | Solifenacin |
| Most Serious Side Effect | Signs of an allergic reaction, painful or difficult urination, fast or irregular heartbeat/pulse, blood in the urine, eye pain or redness | Signs of an allergic reaction, severe abdominal pain, vision changes, problems with urination, high levels of potassium in the blood, heat stroke symptoms |
| Severe Drug Interactions | Drugs that inhibit the CYP2D6 enzyme | Not specifically mentioned, but caution is advised with any medication that could exacerbate side effects or conditions treated by Vesicare |
| Typical Dose | 25–50 mg/day | 5mg/day, can be increased to 10 mg/day |
What is Myrbetriq?
Mirabegron (the generic name for Myrbetriq) is a fairly recent development in the class of medications called beta-3 adrenergic agonists, which significantly differs from the antimuscarinic class that Solifenacin (Vesicare) falls under. Mirabegron was first approved by the FDA in 2012. It treats overactive bladder symptoms like frequent urination and urinary incontinence by relaxing the bladder muscle during storage phase, effectively increasing its capacity and reducing urgency. On the other hand, Vesicare works by blocking muscarinic receptors to prevent involuntary contractions of bladder muscles. Both drugs have their unique side effect profiles: while Myrbetriq can potentially raise blood pressure or cause urinary tract infections, Vesicare commonly causes dry mouth and constipation due to its anticholinergic effects.
What conditions is Myrbetriq approved to treat?
Myrbetriq is approved for the treatment of certain urinary conditions:
- Overactive bladder (OAB) with symptoms of urge urinary incontinence, urgency, and frequency
- Neurogenic detrusor overactivity (NDO), a type of bladder dysfunction related to neurological issues, in pediatric patients aged 3 years and older who weigh 35 kg or more.
How does Myrbetriq help with these illnesses?
Myrbetriq helps manage overactive bladder by increasing the amount of a chemical called cyclic adenosine monophosphate (cAMP) in the detrusor muscle, which is part of the urinary bladder's wall. It does this by stimulating beta-3 adrenergic receptors, leading to relaxation of this muscle and an increase in its capacity to hold urine. The cAMP molecule acts as a messenger inside cells and plays an essential role in many biological processes, including regulation of glycogen, sugar and lipid metabolism. Overactive bladder symptoms are thought to be associated with uncontrolled contractions or spasms of the detrusor muscle. Therefore, by increasing cAMP levels and relaxing these muscles, Myrbetriq can limit negative effects like frequent urination or inability to control urination effectively.
What is Vesicare?
Vesicare is a brand name for solifenacin, which is an anticholinergic agent that works by blocking the action of acetylcholine at muscarinic receptors in the bladder. This causes relaxation of smooth muscle tissue and reduces urinary urgency, frequency, and incontinence. Vesicare was first approved by the FDA in 2004.
As solifenacin does not act on serotonin or dopamine pathways, its side-effect profile is different to those of drugs affecting these neurotransmitters. Common side effects include dry mouth and constipation; it can also lead to blurred vision and heat intolerance due to decreased sweating.
The efficacy of Vesicare in treating symptoms of overactive bladder may be beneficial for patients who do not respond well to "typical" medications such as Myrbetriq (mirabegron), which acts through a separate mechanism involving beta-3 adrenergic receptor stimulation.
What conditions is Vesicare approved to treat?
Vesicare is a medication that has been approved for the treatment of:
- Overactive bladder with symptoms of urinary frequency
- Urgency and incontinence
It helps by relaxing the muscles in the bladder, thereby improving control over urination.
How does Vesicare help with these illnesses?
Acetylcholine is a neurotransmitter that plays key roles in many functions of the body, including muscle movement and contraction, pain responses and regulation of endocrine system function. It's also involved in enhancing memory and learning abilities. Low levels of acetylcholine have been linked to urinary disorders such as overactive bladder (OAB). Vesicare targets this specific issue by working as an anticholinergic medication which blocks the action of acetylcholine on the smooth muscles lining the urinary tract, thereby reducing contractions and alleviating symptoms such as frequent urination or urgency. Its selective action on M3 muscarinic receptors sets it apart from other drugs like Myrbetriq that work differently to manage OAB symptoms. Since it does not significantly affect beta-3 adrenergic receptor like Myrbetriq, it might be prescribed when a patient shows insufficient response to typical beta-3 adrenergic receptor agonists or could be combined with these drugs for better symptom control.
How effective are both Myrbetriq and Vesicare?
Both mirabegron (Myrbetriq) and solifenacin (Vesicare) have shown effectiveness in treating patients with overactive bladder, and they were approved by the FDA within a few years of each other. They act on different receptors; Myrbetriq is a beta-3 adrenergic agonist that relaxes the detrusor muscle during urine storage phase while Vesicare is an antimuscarinic agent that blocks cholinergic activity in the urinary tract.
Their efficacy for alleviating symptoms of overactive bladder was studied directly in numerous clinical trials where both drugs showed similar usefulness in managing symptoms such as urinary urgency, frequency, and nocturia. As these studies showed no significant differences in treatment outcomes between Myrbetriq and Vesicare users, prescribing decisions often come down to patient characteristics or preferences about side effect profiles.
A 2012 meta-analysis reported that Vesicare effectively alleviated symptoms starting from the first week of treatment without causing severe adverse effects. It's well-tolerated even among elderly populations suffering from this condition. The dose showing optimal efficacy ranges between 5 to 10 mg/day depending on individual tolerance levels.
On the other hand, a 2013 review indicated that Myrbetriq seems more effective than placebo at reducing daytime urinary frequency episodes although it may lead to higher incidence of hypertension compared to vesicare.Its unique mechanism makes it beneficial for patients who did not respond well to antimuscarinics or those who need to avoid typical side effects like dry mouth or constipation associated with them.
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At what dose is Myrbetriq typically prescribed?
Oral dosages of Myrbetriq range from 25–50 mg/day, with studies showing that a starting dose of 25 mg/day is effective for most people in managing overactive bladder symptoms. If there's no sufficient response after eight weeks, the dosage can be increased to 50 mg/day. On the other hand, Vesicare is typically started at 5mg per day and if necessary can be increased to 10mg per day after a few weeks if there is no sufficient improvement in symptoms. In either population, it's important not to exceed the maximum recommended dosage: for Myrbetriq this is 50 mg/day and for Vesicare it's 10mg per day.
At what dose is Vesicare typically prescribed?
Vesicare treatment is typically initiated at a dosage of 5mg/day. This dose can then be increased to 10 mg/day, taken as one single daily dose, if necessary and as advised by your healthcare professional. The maximum recommended dose per day is 10 mg. It should be noted that the adjustment from a lower to a higher dose may be tested if there is no significant improvement in alleviating bladder symptoms after an initial few weeks on the starting dosage. As with any medication regimen, it's important to adhere strictly to your doctor's instructions when taking Vesicare.
What are the most common side effects for Myrbetriq?
Common side effects associated with Myrbetriq include:
- High blood pressure
- Common cold symptoms (nasopharyngitis)
- Urinary tract infection
- Headache
- Dizziness
- Abdominal pain or discomfort
- Diarrhea, nausea, constipation
- Fatigue (general weakness and fatigue)
In contrast, common side effects of Vesicare are:
- Dry mouth
- Constipation.
- Blurred vision.
- Nausea.
- Upset stomach.
It is important to note that while these lists encompass the most common side effects from each drug, they do not cover all possible negative reactions. Always seek medical advice if you experience any unexpected or worsening symptoms while on medication.
Are there any potential serious side effects for Myrbetriq?
While both Myrbetriq and Vesicare are generally well-tolerated, they can cause side effects in rare cases. With Myrbetriq, these may include:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue or throat.
- Painful or difficult urination
- Fast or irregular heartbeat/pulse
- Blood in the urine
- Eye pain or redness
For those taking Vesicare, potential serious side effects could include:
- Swelling of the face, lips, tongue or throat
- Difficulty breathing
- Chest pain
- Blurred vision and decreased sweating (which might lead to heatstroke in hot weather)
If you experience any unusual symptoms while on either medication—especially those that affect urinary function—it's crucial to seek medical attention right away.
What are the most common side effects for Vesicare?
Some of the side effects often associated with Vesicare include:
- Dry mouth and throat
- Blurred vision
- Constipation or stomach discomfort
- Difficulty sleeping (insomnia)
- Headache or dizziness
- Increased urination, which is paradoxically both a symptom treated by Vesicare and a potential side effect
- Mild skin rash
It's important to note that while these symptoms can occur, they are not always indicative of a serious problem. However, if you experience severe abdominal pain, fast or uneven heartbeat, confusion or hallucinations, it's crucial to seek immediate medical attention as these could be signs of more serious side effects.
Are there any potential serious side effects for Vesicare?
While Vesicare is generally well tolerated, some patients may experience serious side effects. These can include:
- Signs of an allergic reaction such as hives, itching, difficulty breathing or swallowing, swelling in your face or throat
- Severe abdominal pain
- Vision changes including blurred vision or seeing halos around lights
- Problems with urination: little to no urinating; painful or difficult urination; lower back pain
- High levels of potassium in the blood which could lead to nausea, weakness and irregular heartbeat
- Heat stroke symptoms (Vesicare may decrease sweating causing the body to overheat) such as fever, hot dry skin without sweat.
If you observe any of these adverse reactions while using Vesicare, consult a healthcare professional immediately.
Contraindications for Myrbetriq and Vesicare?
Both Myrbetriq and Vesicare, like most other bladder control medications, may worsen symptoms of urinary retention in some people. If you notice your difficulty urinating intensifying or an increase in painful urination, please seek immediate medical attention.
Neither Myrbetriq nor Vesicare should be taken if you are consuming drugs that inhibit the CYP2D6 enzyme (such as certain antidepressants and antiarrhythmics), because these can heighten concentrations of Myrbetriq in the blood. Always inform your physician about any medications you are currently taking; drugs inhibiting CYP2D6 will require a period of several weeks to clear from your system to prevent dangerous interactions with Myrbetriq and Vesicare.
In addition, both drugs should not be used by patients with severe kidney disease, severe liver disease or uncontrolled narrow-angle glaucoma. They also pose potential risks for those suffering from gastric retention or who have significantly reduced gastrointestinal motility conditions.
How much do Myrbetriq and Vesicare cost?
For the brand name versions of these drugs:
- The price for 30 tablets of Myrbetriq (50 mg) averages around $370, which works out to about $12.33/day.
- The price for 30 tablets of Vesicare (10 mg) is approximately $286, working out to roughly $9.53/day.
Thus, if you are taking a standard dose of each drug, then Vesicare is less expensive on a per-day treatment basis than Myrbetriq. However, cost should not be your primary consideration in determining which medication will work best for you.
The generic version of Vesicare (solifenacin succinate), can significantly lower costs:
- Solifenacin succinate comes in packs starting from 30 up to 90 tablets (5 or 10mg), with prices ranging from about $0.80-$2.60 per day depending on dosage and quantity purchased.
Unfortunately as at this time, there's no generic equivalent available for Myrbetriq yet so patients may have fewer cost-saving options with this medication.
Popularity of Myrbetriq and Vesicare
Mirabegron, commonly known by the brand name Myrbetriq, was estimated to have been prescribed to about 4 million people in the US in 2020. Mirabegron accounted for just over 20% of prescriptions for medications designed to treat overactive bladder (OAB) symptoms. This drug has seen a general increase in usage since its approval in 2012 due to its effectiveness and relatively mild side effect profile.
Solifenacin, available under the brand name Vesicare among others, was prescribed to approximately 3 million people in the USA during the same year. Solifenacin accounts for around 15% of OAB prescriptions. Despite being effective at treating OAB symptoms like frequent urination and urinary urgency or leakage, solifenacin's prevalence has remained steady over time as newer medication options like mirabegron became available.
Conclusion
Myrbetriq (mirabegron) and Vesicare (solifenacin) are both widely used to manage symptoms of overactive bladder, with plenty of clinical trials backing their effectiveness compared to placebo treatments. In some cases, these drugs may be combined for enhanced symptom control, but this requires careful evaluation by a physician due to potential drug-drug interactions. Myrbetriq works primarily by relaxing the bladder muscle during the storage phase, thus increasing its capacity. On the other hand, Vesicare functions mainly as an antagonist for muscarinic receptors which reduces urinary urgency.
Both drugs are available in generic form providing significant cost savings especially for patients who have to pay out of pocket. Both Myrbetriq and Vesicare require an adjustment period where effects might not be immediately noticeable.
The side effect profile is somewhat similar between the two drugs; they are generally well-tolerated but can cause common anticholinergic side effects like dry mouth and constipation more frequently in case of Vesicare than Myrbetriq. It's crucial that patients closely monitor their responses when starting treatment and contact their doctor promptly if they notice any severe or persistent adverse reactions.
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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
- Digesu, A., Khullar, Bhide, & Fernando. (2012, July). Mirabegron – a selective ß3-adrenoreceptor agonist for the treatment of overactive bladder. Research and Reports in Urology. Informa UK Limited.http://doi.org/10.2147/rru.s28930
- Chilman Blair, K., & Bosch, J.L. (2004). Solifenacin: Treatment of overactive bladder. Drugs of Today. Portico.http://doi.org/10.1358/dot.2004.40.4.820080
- Staskin, D. R., & MacDiarmid, S. A. (2006, March). Using Anticholinergics to Treat Overactive Bladder: The Issue of Treatment Tolerability. The American Journal of Medicine. Elsevier BV.http://doi.org/10.1016/j.amjmed.2005.12.011
- West, E. G., McDermott, C., Chess-Williams, R., & Sellers, D. J. (2022, July 20). Mirabegron and solifenacin are effective for the management of the increased urinary frequency induced by psychological stress in female mice. Scientific Reports. Springer Science and Business Media LLC.http://doi.org/10.1038/s41598-022-16487-7
- Shvarts, P. G., Vinarov, A. Z., Kadykov, A. S., Borodulina, I. V., Popov, S. V., & Kravchenko, M. A. (2014). Current pharmacotherapy of overactive bladder in neurological patients. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. Media Sphere Publishing Group.http://doi.org/10.17116/jnevro2014114121152-160