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Key takeaways
Gemtesa is a once-daily medication that helps treat overactive bladder (OAB).
Gemtesa can be taken at any time but should be taken at the same time each day.
Regardless of the time, Gemtesa should be taken with water, applesauce, or both.
Gemtesa (vibegron) is a brand-name drug used to treat overactive bladder (OAB) in adults, including men with OAB symptoms caused by benign prostatic hyperplasia (BPH). It works as a beta-3 adrenergic agonist that relaxes the bladder muscle to help control urinary urgency, frequency, and incontinence. You can take Gemtesa at any time, but it’s best to take it around the same time each day.
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When is the best time to take Gemtesa?
There is no definitive best time to take Gemtesa. It’s not known to be sedating or stimulating, and the recommended dosage on the drug label does not specify what time of day you should take it.
That said, Troy Alexander-EL, MD, board-certified internal medicine and primary care physician in Portland, Oregon, says you can time your Gemtesa dose to kick in when OAB symptoms are most frustrating. “I often empower my patients to assess how the medication is working for them,” she says. “If they find that they are having more nighttime awakenings, then the medication should definitely be taken in the evening.”
Ultimately, the best time to take Gemtesa is the time that makes sense for your symptoms and lifestyle. “Take Gemtesa at the time of day when you’ll be most consistent,” says Allie Buttarazzi, MD, a double board-certified physician and co-owner of Maine Street Medical near Portland, Maine. “The data show it can be taken in the morning or evening, with or without food, so it really comes down to what fits best with your routine.”
What if I miss a dose of Gemtesa?
If you forget your daily Gemtesa dose, it’s usually best to take the next dose as soon as you remember. However, Gemtesa is FDA-approved as a once-daily OAB treatment, so you shouldn’t take it more than once in 24 hours. If you normally take Gemtesa in the morning and don’t remember the missed dose until evening, you can simply wait until the next scheduled dose (the next morning).
It’s normal to miss a dose once in a while, but do your best to take Gemtesa every day at the same time. Gemtesa is not intended to be taken sporadically or every other day. Missing doses can make it less effective at controlling symptoms like urinary urgency, frequency, and leakage.
How long does it take for Gemtesa to start working?
Gemtesa starts working in the body within days of the first dose. Clinical studies show that the active ingredient, vibegron, reaches a steady level in the bloodstream after about one week of daily use.
Still, it may take about three months (12 weeks) for Gemtesa to reach maximum effectiveness in improving symptoms of OAB. In clinical trials, some people reported symptom improvement in as little as two weeks.
Bottom line: Gemtesa tablets might start working within days, but many people might not experience noticeable improvements in OAB symptoms for weeks or even months. Unless you experience severe side effects or your healthcare provider tells you to discontinue treatment, it’s best to continue taking it for at least three months to gauge how well it’s working.
How do I get the most out of my Gemtesa?
It’s important to give your healthcare provider the full picture of your medical conditions and other medications (including supplements and over-the-counter drugs) before starting Gemtesa. This can help prevent drug interactions and reduce the risk of serious side effects of Gemtesa.
You may want to follow these tips to get the most out of this treatment for an overactive bladder:
- Take Gemtesa at the same time every day. Gemtesa is a once-daily oral tablet. Taking it at the same time ensures drug levels stay as steady as possible throughout the 24 hours.
- Take Gemtesa as directed. You can swallow the tablet whole with water or crush it and mix it with applesauce if that’s easier. Pick whichever method is most convenient and comfortable for you.
- Don’t take other OAB medications without consulting a healthcare professional. Mixing Gemtesa with other OAB treatment options can increase the risk of Gemtesa side effects and complications.
- Seek medical advice before taking digoxin. Digoxin is a heart medication that is generally safe and effective, but mixing it with Gemtesa can cause digoxin to build up to unhealthy levels in the body.
- Monitor for serious side effects. These include allergic reactions, urinary tract infections, and urinary retention. “It is imperative for patients to monitor their urine output or sudden abdominal pain,” Dr. Alexander-EL says. “This can be a sign of bladder obstruction or urine retention if they have not urinated in more than 12 hours.”
- Stay hydrated. Though it can be tempting to cut back on fluids when dealing with incontinence and urinary urgency, it’s recommended to keep drinking water and other simple, unsweetened, non-caffeinated beverages while on Gemtesa.
- Eat a balanced diet. Gemtesa may sometimes cause cold-like symptoms or mild upper respiratory tract infections. Eating plenty of fruits, vegetables, and whole grains can help support your immune system. In addition, constipation is a potential side effect of Gemtesa, which may be managed with a fiber-rich diet.
The bottom line
There is no “best” time to take Gemtesa. Some people whose primary OAB symptom is frequent urination at night may prefer to take Gemtesa in the evening. Others may prefer a morning dosage to avoid drinking water before bedtime. The best time of day for you depends on when you are most likely to remember to take your medication and when you feel comfortable drinking a full glass of water with your medication.
Consistent timing is key. Beyond that, the choice is yours.
- Gemtesa drug label information, DailyMed (2025)
- Highlights of prescribing information: GEMTESA (vibegron) tablets, for oral use, U.S. Food and Drug Administration (2024)
- Selectivity and maximum response of vibegron and mirabegron for β3-Adrenergic receptors, Current Therapeutic Research (2022)
- Vibegron improves quality‐of‐life measures in patients with overactive bladder: Patient‐reported outcomes from the EMPOWUR study, International Journal of Clinical Practice (2021)
- International Phase III, randomized, double-blind, placebo and active-controlled study to evaluate the safety and efficacy of vibegron in patients with symptoms of overactive bladder: EMPOWUR, The Journal of Urology (2020)