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Key takeaways
Myrbetriq is an FDA-approved treatment for overactive bladder with fewer side effects than many other therapies, but alternatives may be sought due to cost, adverse effects, or treatment failure.
Alternatives to Myrbetriq include natural remedies, lifestyle changes, and a range of prescription medications such as beta-3 adrenergic agonists, antimuscarinics, and neurotoxins, each with distinct uses, side effects, and dosages.
Consultation with a healthcare provider is crucial when considering switching from Myrbetriq to an alternative treatment.
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.
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What can I take instead of Myrbetriq?
If Myrbetriq does not improve the condition, other options are available to treat an overactive bladder. These alternative prescription medications include other beta-3 adrenergic agonists, antimuscarinics, and even neurotoxins. Based on their different uses, side effects, and dosages, these options may be more appropriate for certain individuals.
Compare Myrbetriq alternatives |
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| Drug name | Price without insurance | SingleCare price | Savings options |
| Myrbetriq (mirabegron extended-release) | $630 per 30, 50 mg tablets | $190 per 30, 50 mg tablets of generic mirabegron extended-release | See latest prices |
| Gemtesa (vibegron) | $690 per 30, 75 mg tablets | $430 per 30, 75 mg tablets of brand-name Gemtasa | See latest prices |
| Oxybutynin | $30 per 30, 5 mg tablets | $5 per 30, 5 mg tablets of generic oxybutynin | See latest prices |
| Oxybutynin extended-release | $100 per 30, 10 mg tablets | $10 per 30, 10 mg tablets of generic oxybutynin extended-release | See latest prices |
| Oxytrol (topical oxybutynin patch) | $870 per 8, 3.9 mg/24-hour patches | $670 per 8, 3.9 mg/24-hour patches of brand-name Oxytrol | See latest prices |
| Oxytrol for Women (topical oxybutynin patch) | $30 per 8, 3.9 mg/24-hour patches | $22 per 8, 3.9 mg/24-hour patches of brand-name Oxytrol for Women | See latest prices |
| Detrol (tolterodine) | $320 per 30, 2 mg tablets | $14 per 30, 2 mg tablets of generic tolterodine | See latest prices |
| Tolterodine extended-release | $240 per 30, 4 mg capsules | $24 per 30, 4 mg capsules of generic tolterodine extended-release | See latest prices |
| Vesicare (solifenacin) | $480 per 30, 10 mg tablets | $16 per 30, 10 mg tablets of generic solifenacin | See latest prices |
| Toviaz (fesoterodine) | $470 per 30, 8 mg tablets | $36 per 30, 8 mg tablets of generic fesoterodine | See latest prices |
| Trospium | $200 per 60, 20 mg tablets | $26 per 60, 20 mg tablets of generic trospium | See latest prices |
| Trospium ER | $250 per 30, 60 mg capsules | $36 per 30, 60 mg capsules of generic trospium extended-release | See latest prices |
| Darifenacin extended-release | $470 per 30, 15 mg tablets | $30 per 30, 15 mg tablets of generic darifenacin extended release | See latest prices |
| Botox (botulinum toxin) | $1,900 per 1, 200 unit solution | $1,300 per 1, 200 unit solution | See latest prices |
Prescription drug prices often change. These are the most accurate medication prices at the time of publishing. The listed price without insurance references the price of brand-name drugs (unless otherwise specified). The listed SingleCare price references the price of generic drugs if available. Click the “Savings options” link to see the latest drug prices.
Top 5 Myrbetriq alternatives
1. Gemtesa
Beta-2 adrenergic agonists like Gemtesa and Myrbetriq relax the bladder muscles. Previously, they were both brand-name only drugs, meaning the price was high, but generic forms of Myrbetriq are now available and offer a lower cost. A SingleCare discount card can provide savings on either.
Gemtesa may have less potential for hypertension than 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 dizziness and hallucinations, side effects reported at times 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 common anticholinergic side effects, such as dry mouth, drowsiness, constipation, dizziness, and confusion. These are particular concerns for seniors.
Oxytrol for Women patches may have fewer systemic adverse effects than oral oxybutynin. They are even available over-the-counter (OTC) without a prescription.
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. Adding an antimuscarinic agent to a beta-2 adrenergic agonist can also be an option.
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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.
Another reason to seek a different medication is to avoid drug interactions with particular prescription drugs. For example, Myrbetriq interacts with the cardiac drug Lanoxin (digoxin), but Vesicare does not. That may be enough for someone taking digoxin to favor Vesicare over Myrbetriq. Always consult with your prescribing healthcare provider 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 (OAB). Pelvic muscle weakness is often associated with OAB, and pelvic muscle strengthening can improve 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, if a diuretic is used to control high blood pressure, getting medical advice from the healthcare provider about potential substitutes may also be worthwhile.
Complementary and alternative therapies may also be of interest. Hypnotherapy has had some success, and acupuncture has shown promise. The OTC 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.
Choosing the right path for OAB treatment
Getting relief from the frequency and urgency of bathroom trips due to OAB is certainly possible. Pelvic muscle exercises and weight loss can be used, and a myriad of pharmaceutical options exist. If Myrbetriq is not the answer, the alternative beta-2 agonist Gemtasa or one of the numerous antimuscarinic agents could be better suited. Botox injections are an alternative when other remedies have failed. At each step in the treatment journey, stay in close communication with your healthcare provider to discuss and decide which option is best.
- Gemtesa drug label, NIH DailyMed (2025)
- Myrbetriq drug label, NIH DailyMed (2024)
- Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women, Cochran Database of Systemic Reviews (2018)
- Hypnotherapy or medication: A randomized non-inferiority trial in urgency urinary incontinent women, American Journal of Obstetrics and Gynecology (2021)
- Acupuncture for adults with overactive bladder, Medicine (2018)
- Use of herbal supplements for overactive bladder, Reviews in Urology (2013)