Skip to main content
Drug Info

Gemtesa alternatives: What can I take instead?

Gemtesa is used to treat overactive bladder, but it doesn't work for everyone. Here are some alternatives to consider.
By | Updated on Jan. 6, 2025
Full glass of water: Gemtesa alternatives and how to switch your Rx

Key takeaways

  • Gemtesa is a brand-name medication that is FDA approved to treat overactive bladder symptoms, such as urinary incontinence, urgency, and frequency.

    • While Gemtesa is an effective medication for OAB, it isn’t right for everyone. It shouldn’t be taken if you’ve had an allergic reaction to vibegron. Healthcare providers may not prescribe Gemtesa if you have a bladder outlet obstruction. 

  • Fortunately, many Gemtesa alternatives are available. These include anticholinergic medicines, certain antidepressants, and Myrbetriq (mirabegron).

  • Always talk to a healthcare provider before switching to an alternative OAB medication. They can help determine which alternative is best for you and how to switch.

In this article:

Gemtesa is a brand-name medication approved by the Food and Drug Administration (FDA) to treat overactive bladder symptoms, including urinary urgency and frequency. Also known by its generic name, vibegron, Gemtesa is a beta-3 adrenergic agonist that works by activating specific proteins in the bladder to help relax the bladder muscle. This allows the bladder to carry more urine. 

While Gemtesa is an effective medication, it isn’t right for everyone. For example, a doctor may not prescribe Gemtesa for a patient with a bladder obstruction due to the risk of urinary retention. It also only comes as a brand-name medication, so it may be expensive if it’s not covered by insurance or Medicare plans. Lastly, Gemtesa can cause adverse effects, such as urinary tract infections, diarrhea, and respiratory infections. For these reasons, people may seek alternatives to Gemtesa. 

What can I take in place of Gemtesa?

Fortunately, there are alternative treatment options available if Gemtesa isn’t right for you. These include other beta-3 adrenergic agonists and other classes of drugs such as anticholinergics, certain types of antidepressants, and hormones. Each type of drug has its specific uses, side effect profiles, and dosages.

Compare Gemtesa alternatives
Drug name Uses Dosage Savings options
Gemtesa (vibegron) Overactive bladder (OAB) 75 mg once daily Gemtesa coupons
Myrbetriq (mirabegron) OAB 25-50 mg once daily Myrbetriq coupons
Oxybutynin extended-release (ER) OAB 5-15 mg once daily Oxybutynin ER coupons
Ditropan XL (oxybutynin) OAB 5-15 mg once daily Ditropan XL coupons
Vesicare (solifenacin) OAB 5-10 mg once daily Vesicare coupons
Tolterodine  OAB 1-2 mg twice daily Tolterodine coupons
Detrol LA (tolterodine) OAB 2-4 mg once daily Detrol LA coupons
Enablex (darifenacin) OAB 7.5-15 mg once daily Enablex coupons
Toviaz (fesoterodine) OAB 4 mg once daily Toviaz coupons
Trospium  OAB 20 mg once to twice daily Trospium coupons
Botox Neurogenic detrusor muscular overactivity, OAB, prevention of migraine headaches, hyperhidrosis 100 units injected into the detrusor muscle Botox coupons

Other alternatives to Gemtesa

Several other medications are prescribed off-label for overactive bladder. These include:

  • Norpramin (desipramine)
  • Tofranil (imipramine)
  • Cymbalta (duloxetine)
  • Premarin cream
  • Vagifem

Top 5 Gemtesa alternatives

The following are some of the most common alternatives to Gemtesa.

1. Myrbetriq (mirabegron)

Gemtesa and Myrbetriq are similar medications. They are both FDA approved to treat overactive bladder, however, Myrbetriq may also be prescribed for neurogenic detrusor overactivity (NDO) in certain children. Both drugs belong to the beta-3 adrenergic agonist drug class and work by relaxing the bladder muscle. The side effect profiles are Gemtesa and Myrbetriq are similar, but Myrbetriq is known to increase blood pressure. Therefore, Myrbetriq may not be appropriate for those with severe uncontrolled hypertension (high blood pressure). 

2. Oxybutynin

Oxybutynin is another commonly used prescription drug for OAB. It is available in immediate-release and extended-release formulations, and the dosage depends on which form is prescribed. Oxybutynin is an anticholinergic medication, so it works differently than Gemtesa. Therefore, if Gemtesa isn’t effective, a healthcare provider may consider switching to oxybutynin. Side effects of oxybutynin include constipation, dry mouth, drowsiness, and confusion. These side effects may be particularly risky for older adults. 

3. Vesicare

Vesicare is FDA approved to treat overactive bladder and neurogenic detrusor overactivity. It is available as a tablet and a suspension. Like Gemtesa, Vesicare is taken once daily and only available as a brand-name medication. It belongs to the anticholinergic drug class and works by relaxing the bladder muscle. However, possible side effects include constipation, dry mouth, dizziness, and dry eyes. 

4. Tolterodine

Tolterodine—also sold as its brand name counterpart Detrol—is a generic medication used to treat overactive bladder. It belongs to the anticholinergic drug class and helps relax the bladder muscle to prevent bladder contractions. Because it is available as a generic, tolterodine may be a suitable alternative if you’re looking for a more affordable drug.  

5. Enablex (darifenacin)

Enablex is the brand-name version of darifenacin. It’s used to treat OAB symptoms such as urinary urgency, frequency, and incontinence. While it can be less costly than Gemtesa, Enablex can cause bothersome side effects, such as dry mouth, constipation, upset stomach, and dry eyes. 

Natural alternatives to Gemtesa

Aside from medications, symptoms of OAB may be managed with behavioral changes and nonpharmacologic treatment. Lifestyle changes include limiting food and drinks that irritate the bladder, including citrus, spicy foods, and caffeine. In some cases, healthcare providers may also recommend reducing fluid intake or bladder retraining exercises. According to the National Association for Continence, nonpharmacologic interventions include pelvic floor muscle exercises, nerve stimulation, and injection therapy. 

How to switch to a Gemtesa alternative

If you’re looking to switch from Gemtesa to an alternative, talk to a healthcare provider. Each medication has risks that may depend on your medical conditions and current medications. If you and your healthcare provider decide it’s safe for you to switch to another drug, be sure to follow their directions exactly as prescribed. In most cases, Gemtesa does not need to be stopped slowly and it’s safe to stop it abruptly.

Sources