QT-Interval Prolongation (see also Interaction(s) with other Common Medicines used in the Perioperative Period)
Mirabegron has not demonstrated clinically relevant QT-interval prolongation in clinical studies. However, since patient who are taking medicinal products known to prolong the QT-interval were not included in these studies, the manufacturer advises caution when administering mirabegron concurrently with drugs that prolong the QT-interval1 (e.g. desflurane, isoflurane, sevoflurane and possibly thiopental2).
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Tramadol
Mirabegron is predicted to increase the exposure to tramadol, but to reduce the exposure to its active metabolite; tramadol adverse effects are therefore increased but not its analgesic effect. The clinical importance of this interaction is unknown. If both drugs are given, be aware of reduced tramadol efficacy and monitor patients for serotonin syndrome (such as fever, tremors, diarrhoea, agitation); concurrent use should be stopped if serotonin syndrome occurs3.
Clarithromycin
Clarithromycin is predicted to increase the exposure to mirabegron – limit the mirabegron dose to 25mg daily with mild to moderate renal impairment or mild hepatic impairment1, 2, 3. Concurrent use is not recommended in severe renal impairment or moderate hepatic impairment2, 3. QT-Interval Prolongation
Mirabegron has not demonstrated clinically relevant QT-interval prolongation in clinical studies. However, since patient who are taking medicinal products known to prolong the QT-interval were not included in these studies, the manufacturer advises caution when administering mirabegron concurrently with drugs that prolong the QT-interval (e.g. domperidone, clarithromycin, ondansetron)2. |