Gemtesa vs. Myrbetriq: 5 Things to Consider When Comparing These Overactive Bladder Medications

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Gemtesa (vibegron) and Myrbetriq (mirabegron) are two medications that treat symptoms of overactive bladder (OAB). Myrbetriq is also FDA approved to treat neurogenic detrusor overactivity (NDO) in children who are 3 years and older who meet certain weight requirements.

Gemtesa and Myrbetriq have many similarities. For example, they belong to the same group of medications: beta-3 adrenergic agonists.

But they differ when it comes to certain side effects, drug interactions, and cost. Comparing the two medications can help you and your prescriber determine which might be best for you.

Below, we'll compare Gemtesa versus Myrbetriq on five factors.

1. Gemtesa and Myrbetriq may have different side effects

Gemtesa and Myrbetriq share most of the same side effects. Common ones include:

• Headache

• Cold symptoms

• Upper respiratory tract infection

• Urinary tract infection

Gemtesa can also cause nausea and diarrhea, which aren't commonly reported side effects of Myrbetriq. Myrbetriq may cause constipation and can increase your blood pressure, which aren't known side effects of Gemtesa. If you have high blood pressure (hypertension), it's important to keep it under control if you take Myrbetriq. Your prescriber may suggest checking your blood pressure at home more often, too.

Gemtesa and Myrbetriq tend to have fewer side effects compared to commonly used OAB medications. For example, other OAB medications (called anticholinergics) commonly cause dry mouth and constipation. They can also cause confusion and memory problems, especially if you're 65 years or older. Gemtesa and Myrbetriq aren't known to cause these effects (except constipation, which can happen but not as frequently as with anticholinergics).

2. Gemtesa and Myrbetriq work similarly but they're broken down by the body in different ways

As mentioned above, Gemtesa and Myrbetriq are in the same medication class. Both medications help with symptoms of OAB, such as an urgent need to pee and peeing frequently.

These medications work by relaxing your bladder muscles. This allows your bladder to hold more pee, which means you don't need to use the bathroom as often. But even though they work in the same way, the body handles Gemtesa and Myrbetriq differently. Myrbetriq is mainly broken down (metabolized) in the liver. However, Gemtesa isn't metabolized much by the liver.

For most people, the differences in how Gemtesa and Myrbetriq are metabolized don't matter. But if you have liver or kidney problems, you may need a lower dose of Myrbetriq. At usual doses, the medication could build up in your body, raising your risk of side effects. It's also possible your prescriber will recommend avoiding it altogether.

If you have severe liver or kidney problems, neither medication is recommended.

3. You can crush Gemtesa tablets but not Myrbetriq

Gemtesa and Myrbetriq both come in tablet form. Crushing tablets can be a helpful way to take medication if you have trouble swallowing pills. But not all medications can be crushed because it can change how well they work or increase your risk of side effects. You can crush Gemtesa tablets, but you shouldn't crush Myrbetriq.

Gemtesa can be crushed, mixed with 1 tablespoon (15 mL) of applesauce, and taken with a glass of water. If you're not crushing the tablet, you can just take it with a glass of water, with or without food.

You should also swallow Myrbetriq with a glass of water, with or without food (except for children, who should take it with food). But you shouldn't crush, chew, or split it. However, Myrbetriq Granules is an oral liquid form that's FDA approved for children 3 years and older with NDO.

4. Gemtesa has fewer medication interactions than Myrbetriq

Gemtesa has fewer known drug interactions than Myrbetriq. In fact, Gemtesa's label only contains one known drug interaction, with digoxin (Lanoxin). Gemtesa may increase digoxin levels in the body.

Myrbetriq has a few known drug interactions. They include digoxin and possibly warfarin (Coumadin, Jantoven). Myrbetriq may increase the levels of these medications in the body.

Myrbetriq also blocks a certain enzyme (protein) that helps metabolize some medications in the liver, which can increase the levels of these medications. Examples include flecainide and metoprolol (Lopressor, Toprol XL).

It can be hard to keep track of possible drug interactions. So it's a good idea to share a medication list with your healthcare team before starting Gemtesa or Myrbetriq. Include all medications and over-the-counter products you take. This will help them screen for possible drug interactions.

5. One medication isn't preferred over the other

When it comes to Gemtesa versus Myrbetric, one isn't preferred over another. We don't have much research comparing the two medications, but we'll discuss existing studies.

• One review found that Gemtesa may be better than Myrbetriq at reducing urinary incontinence (accidental loss of urine). Gemtesa also helped people empty their bladder more fully compared to Myrbetriq. However, this review looked at individual studies of each medication. It didn't compare the two medications directly.

• One small study directly compared Gemtesa and Myrbetriq in 80 women with OAB. Each person received Gemtesa for 8 weeks followed by Myrbetriq for 8 weeks, or vice versa. They worked similarly well overall. But more people in the study said they preferred Gemtesa compared to Myrbetriq.

The decision on which medication to use depends on several factors. Your personal preferences, overall health history, and other medications you take will be considered. For example, if you have high blood pressure that isn't well-managed, your prescriber may recommend Gemtesa over Myrbetriq.

Another factor is cost. Both medications are available as brand-name medications. But a generic version of Myrbetriq 25 mg tablets became available in April 2024. Your insurance may have better coverage for one or the other.

How to save on Gemtesa and Myrbetriq

Whether you're taking Gemtesa or Myrbetriq, there are ways to save on your prescription. Both medications have a manufacturer copay savings card that can make your prescription more affordable. If you're eligible, you could pay as little as $0 per month for Gemtesa or as little as $20 per month for Myrbetriq.

Myrbetriq's manufacturer also offers a patient assistance program. If you're uninsured or your insurance plan doesn't cover Myrbetriq, you may be eligible to receive your medication free of charge.

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