NutriStack
Mirabegron
Prescription ·Strong evidence ·Reviewed May 2026
Mirabegron is the first-in-class beta-3 adrenergic receptor agonist approved for the treatment of overactive bladder (OAB) with symptoms of urge incontinence, urgency, and urinary frequency. It offers an alternative mechanism of action to anticholinergic agents, avoiding the troublesome anticholinergic side effects (dry mouth, constipation, cognitive impairment) that limit tolerability in many patients, particularly the elderly.
- Effective reduction of incontinence episodes, urgency, and frequency
- Avoids anticholinergic side effects (no significant dry mouth or cognitive effects)
- Once-daily dosing
- Suitable for elderly patients including those with cognitive concerns
The bottom line
Evidence rating strong. Most-documented uses: effective reduction of incontinence episodes, urgency, and frequency, avoids anticholinergic side effects (no significant dry mouth or cognitive effects), once-daily dosing. 10 sources indexed (2019–2024), with 0 interaction records on file.
How it works, mechanistically.
Core mechanism
Selectively activates beta-3 adrenergic receptors on the detrusor smooth muscle of the bladder during the storage phase, promoting muscle relaxation and increasing bladder capacity. Unlike antimuscarinics that block the voiding contraction signal, mirabegron relaxes the bladder during filling, allowing greater urine storage without the anticholinergic side effect profile.6,8
Dosing & protocol.
Absolute bioavailability ~29-35%; high-fat meal reduces Cmax but does not significantly affect AUC, so it can be taken with or without food. Dose adjustment needed for severe hepatic or renal impairment (max 25 mg).
Full safety detail.
Side effects
- Hypertension (dose-dependent blood pressure increase)
- Urinary tract infection
- Nasopharyngitis
- Headache
- Tachycardia
- Constipation (less than with antimuscarinics)
Sources, by evidence tier.
Numbered references. Citations throughout the page link here.
Meta-analyses & systematic reviews
5- 1Effects of mirabegron on brown adipose tissue and metabolism in humans: A systematic review and meta-analysisNeeds reviewPMIDMa L, Xiong L, Huang G · European journal of clinical pharmacology · 2024
Ma L, Xiong L, Huang G. Effects of mirabegron on brown adipose tissue and metabolism in humans: A systematic review and meta-analysis. European journal of clinical pharmacology. 2024
- 2Efficacy of mirabegron for ureteral stones: a systematic review with meta-analysis of randomized controlled trialsNeeds reviewPMIDWang Z, Chi J, Liu Y et al. · Frontiers in pharmacology · 2023
Wang Z, Chi J, Liu Y et al.. Efficacy of mirabegron for ureteral stones: a systematic review with meta-analysis of randomized controlled trials. Frontiers in pharmacology. 2023
- 3Mirabegron and antimuscarinics for treating ureteral stent-related symptoms: a systematic review and meta-analysis of RCTsNeeds reviewPMIDLu Y, Li Q, Zou Q et al. · Frontiers in pharmacology · 2023
Lu Y, Li Q, Zou Q et al.. Mirabegron and antimuscarinics for treating ureteral stent-related symptoms: a systematic review and meta-analysis of RCTs. Frontiers in pharmacology. 2023
- 4Adverse events associated with mirabegron 50mg versus placebo: A systematic review and meta-analysisNeeds reviewPMIDHou J, Xu F, Du H et al. · Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie · 2021
Hou J, Xu F, Du H et al.. Adverse events associated with mirabegron 50mg versus placebo: A systematic review and meta-analysis. Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2021
- 5Meta-analysis of the efficacy and safety of mirabegron and solifenacin monotherapy for overactive bladderNeeds reviewPMIDWang J, Zhou Z, Cui Y et al. · Neurourology and urodynamics · 2019
Wang J, Zhou Z, Cui Y et al.. Meta-analysis of the efficacy and safety of mirabegron and solifenacin monotherapy for overactive bladder. Neurourology and urodynamics. 2019
Reference material
5- 6Khullar V et al. Efficacy and tolerability of mirabegron, a beta(3)-adrenoceptor agonist, in patients with overactive bladder: results from a randomised European-Australian phase 3 trial. Eur Urol. 2013;63(2):283-295.Source linkedPMID
- 7Nitti VW et al. Results of a randomized phase III trial of mirabegron in patients with overactive bladder. J Urol. 2013;189(4):1388-1395.Source linkedPMID
- 8Herschorn S et al. A phase III, randomized, double-blind, parallel-group, placebo-controlled, multicentre study to assess the efficacy and safety of the beta-3 adrenoceptor agonist, mirabegron, in patients with symptoms of overactive bladder. Urology. 2013;82(2):313-320.Source linkedPMID
- 9He W, Zhang Y, Huang G et al.. Efficacy and safety of vibegron compared with mirabegron for overactive bladder: A systematic review and network meta-analysis. Lower urinary tract symptoms. 2023Source linkedPMID
- 10Liang P, Yu L, Xia B et al.. Comparative Efficacy and Safety of Mirabegron and Vibegron in Female Patients With Overactive Bladder: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Urology. 2025Source linkedPMID
Deep dives & adjacent profiles.
This page is educational. Do not start, stop, or change a supplement or medication based on it without checking with a qualified healthcare professional.
Use this with your stack
Mirabegron in NutriStack.
Add it to your stack, see how it interacts with everything else you take, and get a Stack Score that updates the moment it does.