Comprehensive medication guide to Mirabegron XR including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$100 copay depending on plan tier; generic mirabegron is typically Tier 1–2 on most commercial plans; brand Myrbetriq is Tier 2–3; some plans require prior authorization or step therapy. Medicare Part D average is approximately $180 per claim.
Estimated Cash Pricing
$450–$625 retail for brand Myrbetriq; generic mirabegron ER costs $450–$663 at retail but as low as $121–$189 with GoodRx or SingleCare coupons for a 30-day supply when in stock.
Medfinder Findability Score
50/100
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Mirabegron XR is the extended-release formulation of mirabegron, a prescription medication used to treat overactive bladder (OAB) in adults. It is sold under the brand name Myrbetriq by Astellas Pharma and was first approved by the FDA in June 2012 — making it the first beta-3 adrenergic agonist approved for OAB in the United States. A generic version (mirabegron extended-release) became available in late 2022 following patent expiration, though supply is currently disrupted by patent litigation.
Mirabegron XR is FDA-approved for overactive bladder symptoms in adults — including urge urinary incontinence, urgency, and urinary frequency — and for neurogenic detrusor overactivity (NDO) in pediatric patients aged 3 years and older weighing at least 35 kg. It comes in 25 mg and 50 mg extended-release tablets taken once daily, with or without food. Tablets must be swallowed whole and should never be crushed or chewed.
Mirabegron XR is not a controlled substance and has no DEA scheduling restrictions. It can be prescribed by any licensed healthcare provider including primary care physicians, urologists, OB-GYNs, nurse practitioners, and physician assistants — including through telehealth.
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Mirabegron XR is a selective beta-3 adrenergic receptor agonist. The bladder wall contains a muscle called the detrusor, which contracts to push urine out and must relax to allow the bladder to fill. In overactive bladder, the detrusor contracts involuntarily, creating sudden, urgent urges to urinate. Mirabegron XR works by activating beta-3 adrenergic receptors on the detrusor smooth muscle, which triggers a molecular pathway that increases intracellular cyclic AMP (cAMP), causing the muscle to relax during the filling phase.
This mechanism is fundamentally different from older OAB drugs (antimuscarinics/anticholinergics), which block muscarinic receptors throughout the body to reduce bladder contractions — causing systemic side effects like dry mouth, constipation, blurred vision, and cognitive impairment. Because beta-3 receptors are most highly expressed in the bladder muscle rather than distributed throughout the body, mirabegron's approach produces fewer systemic side effects.
Mirabegron XR also moderately inhibits the liver enzyme CYP2D6, which means it can increase blood levels of other medications metabolized by that enzyme. The most clinically significant interaction is with digoxin. Patients should inform their prescriber of all current medications before starting mirabegron.
25 mg — extended-release tablet
Starting dose for adult OAB; effective within 8 weeks; take once daily with or without food
50 mg — extended-release tablet
Maintenance dose for adult OAB; may increase from 25 mg after 4-8 weeks based on response and tolerability
8 mg/mL — extended-release oral suspension (granules)
Pediatric formulation (Myrbetriq Granules) for NDO in children aged 3+ years weighing less than 35 kg; dose is weight-based; take with food
As of 2026, Mirabegron XR is not listed on the FDA's official drug shortage database. Brand-name Myrbetriq from Astellas Pharma is generally available at most major pharmacy chains. However, two significant access challenges are making it harder for many patients to fill their prescriptions: generic supply disruption from patent litigation, and new insurance step therapy requirements.
In April 2025, a federal court blocked two major generic mirabegron manufacturers — Lupin and Zydus — from selling their products due to ongoing patent litigation brought by Astellas. This removed significant generic supply from the market. While Alkem and other manufacturers continue to supply, pharmacy-level generic availability varies widely. One pharmacy may have it; another a mile away may not. Separately, UnitedHealthcare implemented step therapy requirements for mirabegron starting November 2025, requiring patients to first try two alternative OAB medications before coverage is approved.
If you are having trouble filling your Mirabegron XR prescription, medfinder is a paid service that calls pharmacies near you to find which ones have Mirabegron XR in stock, then texts you the results — so you don't have to spend hours on hold.
Mirabegron XR is not a controlled substance, so there are no DEA-related restrictions on who can prescribe it. Any licensed healthcare provider with prescribing authority in their state can write a prescription for Mirabegron XR. Common prescribers include:
Urologists — most commonly prescribe Mirabegron XR for OAB in both men and women
Urogynecologists — specialists in female pelvic floor disorders including OAB
OB-GYNs — frequently manage OAB in female patients, especially around menopause
Primary care physicians (PCPs) — family medicine and internal medicine doctors routinely prescribe Mirabegron XR
Geriatricians — particularly prefer Mirabegron XR for older patients to avoid anticholinergic cognitive effects
Nurse practitioners (NPs) and physician assistants (PAs) — can prescribe in most states with full or supervised prescribing authority
Because Mirabegron XR is not a controlled substance, it can be prescribed through telehealth in most states without an in-person visit. Many general telehealth platforms (Teladoc, MDLive) and women's health telehealth services can prescribe it after a video consultation, and the prescription can be sent electronically to any pharmacy.
No. Mirabegron XR (Myrbetriq) is not a controlled substance and is not scheduled by the DEA under the Controlled Substances Act. It has no recognized abuse potential, addiction risk, or diversion concern. This means:
No special DEA registration is required for a provider to prescribe it
It can be prescribed via telehealth, e-prescribed, called in, or faxed — no in-person visit required from a scheduling standpoint
Refills are unrestricted from a DEA scheduling standpoint (though insurance may have quantity or refill limits)
Any licensed healthcare provider with prescribing authority — including primary care physicians, urologists, OB-GYNs, urogynecologists, geriatricians, nurse practitioners, and physician assistants — can prescribe Mirabegron XR without any controlled substance prescribing restrictions.
The following side effects occurred in more than 2% of patients taking Mirabegron XR in clinical trials and more frequently than placebo:
Increased blood pressure (hypertension) — the most clinically significant common side effect; monitor BP regularly
Nasopharyngitis (cold-like symptoms: runny nose, sore throat)
Urinary tract infection (UTI)
Headache
Angioedema: Swelling of the face, lips, tongue, or throat. Can be life-threatening. Stop the medication immediately and call 911.
Urinary retention: Difficulty emptying the bladder, especially in patients with bladder outlet obstruction or on antimuscarinic drugs.
Atrial fibrillation: Irregular heartbeat reported in post-marketing experience. Report palpitations or chest discomfort to your provider.
Stevens-Johnson syndrome (rare): Severe blistering skin reaction. Seek emergency care immediately.
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Vibegron (Gemtesa)
Same beta-3 adrenergic agonist class as mirabegron; 75 mg once daily; does not inhibit CYP2D6 (fewer drug interactions); brand-only as of 2026; closest pharmacological equivalent to Mirabegron XR
Solifenacin (Vesicare)
Antimuscarinic OAB drug; 5-10 mg once daily; generic widely available and low cost; effective but can cause dry mouth, constipation, and cognitive effects in elderly
Oxybutynin (Ditropan XL)
Anticholinergic OAB drug; generic costs as little as $4-15/month; highly effective but most anticholinergic burden of OAB drugs; not preferred in elderly patients
Tolterodine (Detrol LA)
Antimuscarinic OAB drug; 4 mg once daily extended-release; better tolerated than oxybutynin; generic widely available
Darifenacin (Enablex)
M3-selective antimuscarinic; 7.5-15 mg once daily; relatively bladder-selective but more constipation than other antimuscarinics; generic available
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Digoxin
majorMirabegron XR increases digoxin AUC by approximately 10% and peak concentration by 14%. Use lowest effective digoxin dose and monitor serum digoxin concentrations.
Flecainide
majorCYP2D6 substrate; mirabegron inhibition of CYP2D6 can increase flecainide levels, raising risk of cardiac arrhythmia. Monitor and consider dose adjustment.
Metoprolol
moderateCYP2D6 substrate; mirabegron can increase metoprolol levels, potentially causing bradycardia or hypotension. Monitor heart rate and blood pressure.
Antimuscarinic OAB drugs (oxybutynin, tolterodine)
moderateConcurrent use increases risk of urinary retention. Use caution, especially in patients with bladder outlet obstruction.
Warfarin
moderateMonitor INR. Effect of mirabegron on multiple-dose warfarin pharmacodynamics is not fully characterized.
Ketoconazole
moderateStrong CYP3A and P-glycoprotein inhibitor; can increase mirabegron plasma levels. Use with caution.
Rifampin
moderatePotent enzyme inducer; can significantly reduce mirabegron blood levels, potentially decreasing efficacy.
Tricyclic antidepressants (amitriptyline, imipramine)
moderateCYP2D6 substrates; mirabegron inhibition can increase TCA levels, enhancing anticholinergic effects and cardiac risk.
Mirabegron XR (Myrbetriq) represents a meaningful advance in overactive bladder treatment — offering comparable efficacy to older anticholinergic drugs with a fundamentally different mechanism and a more tolerable side effect profile. It is particularly valuable for elderly patients, patients with cognitive concerns, and those who have failed or cannot tolerate antimuscarinic medications.
In 2026, access challenges — including generic supply disruption from patent litigation and new insurance step therapy requirements — are making it harder for some patients to fill their prescriptions. The good news is that brand-name Myrbetriq remains available, savings programs can dramatically reduce costs, and prior authorization exceptions are frequently granted when documented correctly. Patients who are persistent about finding their medication and working with their prescriber on coverage issues can generally access Mirabegron XR successfully.
If you are having trouble locating Mirabegron XR at a pharmacy near you, medfinder is a paid service that calls local pharmacies on your behalf to find which ones have your specific medication in stock, then texts you the results. It covers all medications — not just shortage drugs — and can save you hours of frustrating phone calls.
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Medfinder is actively checking pharmacy inventory for Mirabegron XR. We don't publish a number until we have enough verified pharmacy checks to be accurate — start a search and our team confirms current availability near you, usually within 24 hours.
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