Vibegron is a selective β3-adrenergic receptor agonist. Approved in 2020, it is used for the treatment of overactive bladder (OAB) in adults, with symptoms including urge urinary incontinence, urgency, and frequency.
How to Use Vibegron (Vibegron)
Dosage Regimen
(1) Standard Dosage: The recommended dosage is one 75 mg tablet taken orally once daily, either with food or on an empty stomach.
(2) Administration Method: The tablet should be swallowed whole with water. For patients who have difficulty swallowing, the tablet can be crushed and mixed with 15 mL of applesauce, then taken immediately, followed by a glass of water.
Pretreatment and Monitoring Requirements
(1) Baseline Assessment: Before using the drug, bladder emptying function should be evaluated, especially in patients with concurrent bladder outlet obstruction or those taking antimuscarinic drugs at the same time.
(2) Long-Term Treatment Monitoring: Residual urine volume should be checked regularly to be alert to the risk of urinary retention.
Dosage Adjustment of Vibegron (Vibegron)
Dosage Adjustment for Adverse Reactions
(1) Urinary Retention: If symptoms occur, the drug should be discontinued immediately, especially in patients taking antimuscarinic drugs concurrently or with urinary dysfunction.
(2) Gastrointestinal Reactions: For grade ≥ 2 diarrhea or nausea, consideration may be given to suspending drug administration, and treatment can be resumed after symptoms resolve.
Medication for Special Populations of Vibegron (Vibegron)
Patients with Hepatic or Renal Impairment
(1) Renal Impairment: No dosage adjustment is required for mild to moderate renal impairment (eGFR ≥ 15 mL/min/1.73 m²); the drug is contraindicated in end-stage renal disease (eGFR < 15 mL/min).
(2) Hepatic Impairment: No dosage adjustment is required for mild to moderate hepatic impairment (Child-Pugh A/B); the drug is contraindicated in severe hepatic impairment (Child-Pugh C).
Elderly and Pediatric Patients
(1) Elderly Patients (≥ 65 Years Old): No dosage adjustment is needed. However, 46% of subjects in clinical trials were elderly, so enhanced monitoring of adverse reactions is required.
(2) Pediatric Patients: The efficacy has not been established, and the drug is contraindicated in patients under 18 years old.
Pregnancy and Lactation
(1) Pregnancy: Animal studies have shown that high doses (≥ 458 times the clinical exposure) may cause fetal developmental toxicity. Human data are limited, so the risks must be weighed carefully.
(2) Lactation: Animal studies (in rats) have shown that the drug can pass into breast milk. It is recommended to suspend breastfeeding during treatment.
