Myrbetriq alternatives: What can I take instead of Myrbetriq?

Compare Myrbetriq alternatives | Gemtesa | Oxybutynin | Tolterodine | Vesicare | Botox | Natural alternatives | How to switch meds

Overactive bladder (OAB) is a troublesome syndrome, marked by urinary urgency and urinary frequency, along with nocturia (urinating at night) and urinary incontinence in some cases. Understandably, the impact on one’s personal, social, and professional life can be substantial. Myrbetriq (mirabegron) is an effective treatment option for OAB and has a Food and Drug Administration (FDA) indication for the condition. The drug has fewer side effects than many other therapies, but nonetheless, the cost or common adverse effects of Myrbetriq can push an individual to look for alternatives. That search can also be prompted by Myrbetriq treatment failure, considering that the symptoms of overactive bladder can be quite challenging to adequately control. 

What can I take in place of Myrbetriq?

There are other options available to treat overactive bladder if the condition does not improve with Myrbetriq. These alternative prescription medications include other beta-3 adrenergic agonists, antispasmodics, antimuscarinics, and even neurotoxins. These options may be more appropriate for certain individuals based on their different uses, side effects, and dosages.

Top 5 Myrbetriq alternatives

1. Gemtesa

Beta-2 adrenergic agonists like Gemtesa and Myrbetriq relax the bladder muscles. They are both brand-name only drugs, meaning the price can be high. Gemtesa has not been noted to have a potential for hypertension like Myrbetriq, so it may be a better option for those who have experienced or are concerned about this side effect with Myrbetriq. It may also avoid the risk of possible side effects such as dizziness and hallucinations associated with Myrbetriq.

2. Oxybutynin

Oxybutynin is a long-standing treatment option for OAB, available in brand and generic, long- and short-acting, and topical and oral versions. It has positive and negative attributes in comparison to Myrbetriq. The generic regular and extended-release forms of oxybutynin may be less expensive alternatives to Myrbetriq. As a muscarinic receptor antagonist, oxybutynin risks anticholinergic common side effects, such as dry mouth, drowsiness, constipation, dizziness, and confusion. These are particular concerns for seniors. The gel and patch forms may have fewer systemic adverse effects compared to oral oxybutynin. In general, beta-2 adrenergic agonists and antimuscarinic agents have similar efficacy for OAB, but changing from Myrbetriq, if it is ineffective, to an antimuscarinic may be helpful.

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3. Tolterodine

Detrol and generic tolterodine can be obtained in regular and long-acting formulations. Since a generic option is available, it can be less costly than Myrbetriq. This antimuscarinic’s typical anticholinergic side effects may be limiting factors for tolterodine, but it has less risk of hypertension compared to Myrbetriq.

4. Vesicare

Another member of the muscarinic antagonist class, Vesicare has the usual adverse effects of the class. It also has the potential for QT prolongation, an effect on the heart’s electrical system in which dangerous cardiac rhythm disturbances can arise. Despite these limitations, Vesicare and generic solifenacin offer treatment options for OAB at a lower price and with less hypertension risk compared to Myrbetriq. In addition, Vesicare LS provides a liquid suspension option, which can be advantageous for those with swallowing problems. 

Avoidance of drug interactions with particular prescription drugs can be another reason why one might seek a different medication. For example, Myrbetriq interacts with the cardiac drug digoxin, but Vesicare does not. That may be enough for someone taking digoxin to favor Vesicare over Myrbetriq. Always consult with your prescribing doctor for guidelines and additional drug information. 

5. Botox

Botox injections into the muscle wall of the bladder are an expensive and invasive alternative to Myrbetriq. They have a significant risk of urinary retention and UTI. Nonetheless, in cases of OAB refractory to Myrbetriq or other oral agents, Botox may be offered by the treating healthcare provider.

Natural alternatives to Myrbetriq

A number of alternatives to prescription medications can be tried in the treatment of overactive bladder. Pelvic muscle weakness is often associated with OAB, and pelvic muscle strengthening can provide an improvement in symptoms. This can be done at home or with the help of a physical therapist. 

Lifestyle modifications can also help. Weight loss may improve OAB. Limiting caffeine and reconsidering diuretic use may be worthwhile as well.

Complementary and alternative therapies may also be of interest. Hypnotherapy has had some success, and acupuncture has shown promise. The over-the-counter traditional Chinese herbal blend Gosha-jinki-gan has had some clinical trials with benefits. Further investigation is needed into all these options.

How to switch to a Myrbetriq alternative

Whether your reason for considering changing from Myrbetriq is its ineffectiveness, adverse effects, or expense, get medical advice from your healthcare provider first. If, after the discussion, you both agree on stopping the drug, Myrbetriq can be discontinued without a taper. No significant withdrawal symptoms should occur. Myrbetriq is an effective treatment option for OAB, helping to regain bladder control and reduce leakage, but it is not the best option for everyone.