I’m Trying a Different Medication, Myrbetriq, for My Urinary Issues
I’ve had pee problems for as long as I’ve had multiple sclerosis. Many folks with MS have issues, including urinary urgency, frequency, or both, bladders that don’t empty completely, or streams that don’t start when you need to go.
There are medications to treat these problems. The best known is probably Ditropan (oxybutynin), which has been around for quite a while. Although I’ve been taking the generic oxybutynin once a day for a long time, I don’t think it works for me anymore. In fact, I think it’s been failing me for years.
So, during my last checkup with the neurologist, I asked if there was something better I could use. “Sure,” she said. “There’s Myrbetriq.”
Myrbetriq (mirabegron) works by helping to relax the detrusor muscle that surrounds the bladder. In MS, this muscle can spasm and act like the bladder is full when it isn’t. Relaxing the muscle allows the bladder to fill more completely, which lessens the urge to urinate quickly or frequently.
How are they different?
Ditropan is an anticholinergic that inhibits the transmission of some nerve impulses in the brain and spinal cord, which reduces smooth muscle spasms such as those in the bladder. To do this, it crosses the blood-brain barrier.
According to Gavin Giovannoni, a London-based neurologist and professor who writes for The MS Blog, anticholinergics can exacerbate cognitive problems in people with MS. Giovannoni says there’s also a risk that the bladder will be relaxed too much, which can prevent it from fully emptying.
Giovannoni said he prefers to prescribe Myrbetriq (called Betmiga in the U.K.) rather than Ditropan, because rather than crossing from the blood into the central nervous system, it targets a beta-3 adrenergic receptor directly on the detrusor muscle, which causes the bladder to relax.
Making the switch
Trying Myrbetriq sounded like a no-brainer, but my neurologist added a “but” to her recommendation: “It’s pretty expensive,” she said.
My copay for oxybutynin was about $0.23 a pill. The copay for Myrbetriq would be over $1 a dose and possibly higher. But I decided to bite the bullet (swallow the pill?) and give it a try.
It’s been so far, so good. I’ve only been using Myrbetriq for a couple of days, but my frequency and urgency seem to be somewhat improved. Things still aren’t normal, but I feel I’m controlling my bladder a bit better. My urgency seems to have lessened, and I think I’m doing a better job of fully emptying my bladder. We’ll see.
You’re invited to visit my personal blog at www.themswire.com.
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About the Author
Pete F.
I have progressive ms. Have oab and Nocturia. Get very little sleep. Have tried all the meds for this problem. Including Botox. Nothing works. So tired...
Ed Tobias
Hi Pete,
I'm sorry about your lack of success. So far, this med is helping both daytime and nighttime.
Ed
Adrian Sohn
I've been on Myrbetriq for several years and I'm happy with it, I'm on a bunch of meds for my bladder.
I take them all at bedtime. Myrbetriq, Toviaz and Flomax ( I live in Canada so they not be called this in your country)
The combo works quite well
I'm ++ thirsty a few minutes after I take them and have a sip of water, but... I can usually go through the night without having to pee, which is a blessing
Ed Tobias
Thanks for the info, Adrian. It's been a few days now and I've been feeling much less of that "gotta go right now" feeling.
Ed
Debbie W
I started Myrbetriq recently after being on oxybutynin for years. I have had great success. I had a few days about two weeks in that I felt like things were bad again, but I stuck with it am glad I did. Only getting up 2 or 3 times a night instead of 5 or 6! And the urgency has improved. Hope you have good results too.
Douglas Cain
Are you concerned about the anticholinergic aspect of many of these drugs? I know Myrbetriq is not an anticholinergic.
Jackie Hajji
I found Myrbetriq to be a wonderful solution for me but insurance would not cover it. Toviaz and intermittent self-catheterization are my new tools for fighting chronic UTIs and urinary issues. Looking forward to a generic version of Myrbetriq.
Ellen Lerner
I found this on the internet and it really has helped me for the first time. I alternate days between merbetriq and generic version of vesicare- sofiniciten. This regime has worked for me more than taking either medication alone, My doctor has agreed to this and had I needed to explain it to the pharmacist who did not know about this. I take it that Dr. Google is not widely consulted by medical professionals.
Paul Myres
I have switched to FloMax and Myrbetriq and it has really helped with my trips to the bathroom. I have SPMS and am taking Kisimpta. The above mention drugs have made everyday life at least controllable.
Jane Ellis
I had the same urinary issues described above with my MS. Always "gotta go gotta go". I couldn't hold it to find a bathroom and started to wear pads and pull-ups. I especially had problems when I travelled overseas and toilets are readily available. When I returned I saw a Neurourologist who wanted to use Botox. I tried Mybetric first and after several increased dosages I feel more in control. While traveling to places without bathrooms close by is not in the future for me I feel I can control myself better.
Beverly Walker
I was desperate for help with my bladder and started Myrbetriq a couple of years ago. It doesn't seem to work as well now as it did at first and I have terrible problems with constipation. I would be interested in hearing how Myrbetriq works out for you.
Ed Tobias
Hi Beverly,
So far, so good. I think my frequency and urgency have improved a bit. And, believe it or not, I think my bowels are moving better. That might be because I feel more comfortable drinking water and have increased my intake.
Ed
Jennifer Sand Bodurtha
Cranberry extract daily capsule may help avoid UTIs. Has worked for me for years!
Ed Tobias
UTIs haven't been a problem for me, Jennifer, but I do know that drinking cranberry juice can help overall. I try to remember to buy it.
Ed
Tracy Tucker
Hi, I've been using myrbetriq now for several years and I also get regular Botox injections to help me manage leakage, frequency and urge incontinence. Under my urologist's direction, I take 50mg myrbetriq every 12 hours (that's twice a day). The down side is I need to use a catheter every 4 hours, and I have very poor balance equilibrium. But, I have some indipendence from "the john" now. The trade off is worth it to me.
Ed Tobias
Hi Tracy,
I'm glad the benefit is worth the effort. Thanks for sharing the info.
Ed
Maria Mott
I am currently on vesicare and myerbetriq. That is what my neurologist prescribed. It works for me.
Ed Tobias
Others here have reported they're using the same combination with good effect. Thanks for adding your comments, Maria.
Ed
Eileen
Greetings warriors: I tried Myrbetriq and increased my blood pressure big time. Also this pill has horrible side effects, you might be fixing one thing and then damaging other things.
Ed Tobias
Hi Eileen,
I've been on a lot of meds (mostly DMTs) that can have bad side effects, so I'm always alert for that possibility. I've found that their benefits have outweighed the potential risks. Fortunately, my BP has always been normal and stable, so it'll be easy to see if it starts climbing and I can make changes.
Ed
Andy Skinner
I am just a week into the same switch. I could no longer take the impact of Oxybutynin on my ever-worsening heat intolerance or ability to control my internal thermostat. I understand the Myrbetriq can take weeks to show it's full effectiveness. While I too had some initial positive results, I've also found it extremely helpful to pay attention to the acid content/pH of foods and drinks. Being sure to 'flush' the bladder irritants by drinking a few glasses of plain water throughout the day has also paid great dividends. Hope your med change is successful!
Ed Tobias
Thanks, Andy. The med change has encouraged me to drink a little more water. I think it's a good combination.
Good luck with the new med.
Ed
Raegan Spence
I have been on Myrbetriq for quite a few years and it works well for me!
Ed Tobias
Thanks for sharing the info, Raegan. Glad to hear it's working for you.
Ed
Carolyn Meehan
Myrbetriq worked great for me. First time in 30+ years didn’t have to pee 3x at night. However became extremely constipated. Stopped Myrbetriq for a week. At end of week was able to poop. But decided being on Myrbetriq was worth it. Started again and will use laxative as needed.
Ed Tobias
Hi Carolyn,
Thanks for the info. Interestingly, I think my bowels improved after starting Myrbetriq. Maybe that's because I'm more comfortable drinking more water right now. (Like many MSers I've always been reluctant to drink anywhere near what I should drink.)
Ed
Edith Cheney
I am 84 yrs old and lived with MS more than 40 years. SPMS
My doctor prescribed Myrbetriq and after negotiation over price I'm paying $200.00/month.
I've been diagnosed after testing with a neurogenic bladder and am totally incontinent. I just read an article by Dr. Ben Thrower that this drug doesn't work on SPMS unless I am having relapses. I wear Walmart underwear with an overnight Tena pad inside. I've been taking this drug for about 6 months and have had no dramatic improvement. I do not want to self cath. Am I wasting my money? I no longer see a neurologist, just my PCP. Neuros don't seem to know what to do with me. I am walking with a rollator and use a small scooter. I'm not on any MS drugs and am getting steadily weaker - and older! Is Myrbetriq a good drug choice for me?
Ed Tobias
Hi Edith,
I can't say whether or not Myrbetriq is a good choice for you...only that, so far, it's working better for me than oxybutynin did. Two of the other people who've commented on my column this week are using a combination of Mybetrig and Vesicare. Perhaps you could ask your PCP about that.
Ed
Jen
Ed, I was on Betmiga for years with good results. I then tried Vesicare (solifenacin) for a while with similarly good results. But it was only when my urologist suggested combining them that something miraculous happened. I think it's because they work on the two different aspects of incontinence -- frequency and urgency. It probably helps that I also self-catheterise, but my bladder function is the best it's been for years. I can go for long drives, see movies, and scouting for the nearest toilet when arriving somewhere is no longer top of my mind (my husband is enjoying it too). It's not cheap, I pay about A$130 per month, but it's worth every cent for my new life.
Ed Tobias
Hi Jen,
Thanks for the info. One other reader has suggested the Vesicare/Myrbetriq combo but so far, so good going solo with Myrbetriq. I'm trying to avoid self-cathing.
Ed
Reg Bavis
I too have problems with surges I asked my Doctor too precscribe some medication for this problem , what do you suggest I do .
Ed Tobias
Reg,
What has your neurologist suggested when you've asked for bladder medication?
Ed
Michelle
Good luck with Myrbetriq. Hope it manages your symptoms.
I have SPMS and am chair-bound. I started out with Vesicare back when I could still walk and, when that wasn't working any longer, tried a combination of Vesicare with Myrbetriq. I did not like the UTI type symptoms. My insurance company insisted I try oxybutynin because it was cheaper but it made my mouth so dry that I was scared I would choke while eating. Then on to darifenacin (Enablex). Worked for a while.
As of four months ago, I had a suprapubic catheter placed. I now sleep through the night, which is wonderful. No urgency, no rushing to the bathroom. Which is great because when you have to transfer onto a scooter and then onto the toilet, there is no rushing to the bathroom.
Ed Tobias
Thanks for all of that information, Michelle. The Myrbetriq seems to be helping, so far. It's far from perfect but my bathroom needs have lessened.
One question. Can you swim with your catheter? I can't imagine not swimming and I also can't imagine how I'd hide the tube while wearing a swim suit. (I suspect it's a bit easier for a woman to do that.)
Ed
Jen
I tried (successfully) to avoid self-cathing for 14 years. For me it was just the 'eeuww' factor, I suppose. So when I eventually gave in, I was kicking myself. The confidence of knowing my bladder was empty -- priceless. Apart from the end of UTIs and constant antibiotics, of course.
Ed Tobias
Hi Jen,
Thanks for sharing that and I'm glad that self-cathing has made a difference. I'm having mixed results with the Myrbetriq but I'll give it a while longer before I take any further steps.
I'm sorry it took so long to respond. We just finished a long weekend holiday here in the States and it delayed things.
Ed