Vibegron is a beta-3 adrenergic receptor agonist, similar to mirabegron. The mode of action is via activation of the beta-3 adrenoreceptors causing the bladder to relax, which helps it to fill and store urine.  

NICE Technology Appraisal [TA999], recommends vibegron as a treatment option for symptoms of overactive bladder syndrome in adults. It can be initiated in primary care (NCL GREEN formulary status) and is positioned similarly to mirabegron. This is for patients who have tried two antimuscarinic medications without success, or where such medications are unsuitable or poorly tolerated. 

Vibegron (Obgemsa®) is the preferred second line beta-3 adrenergic receptor agonist choice in NCL (where antimuscarinics can’t be used) for treatment of overactive bladder syndrome. It has comparable efficacy and tolerability to mirabegron, and a lower acquisition cost. NCL primary care urology clinical pathways will be updated in due course to include vibegron.  

Mirabegron can elevate blood pressure (BP). Therefore, BP monitoring before and during treatment is required, particularly for hypertensive patients. It is contraindicated in severe uncontrolled hypertension. Vibegron's manufacturer information does not currently include specific warnings regarding hypertension, continued pharmacovigilance and emerging post-marketing data will further inform vibegron’s comparative cardiovascular safety.

For further information, refer to vibegron’s summary of product characteristics.  

Clinicians should also be aware that vibegron is currently under the MHRA Black Triangle scheme, therefore all suspected adverse drug reactions encountered should be reported through the Yellow Card Scheme.