Issues for Surgery
Risk of increased urinary frequency, urgency and urge incontinence if omitted.
Advice in the Perioperative period
Elective and Emergency Surgery
Monitor renal function – dose reduction may be necessary if renal function is impaired (consult current product literature).
Patients undergoing Overactive Bladder Surgery
Interaction(s) with Common Anaesthetic Agents
None1, 2, 3.
Interaction(s) with other Common Medicines used in the Perioperative Period
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 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.
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.