Drug Guide
Vibegron
Classification
Therapeutic: Urinary Bladder Modulator
Pharmacological: Beta-3 adrenergic receptor agonist
FDA Approved Indications
- Overactive Bladder (OAB) with symptoms of urinary frequency, urgency, and urge incontinence
Mechanism of Action
Vibegron selectively stimulates beta-3 adrenergic receptors in the detrusor muscle of the bladder, leading to relaxation of the bladder muscle and increased storage capacity, thereby reducing symptoms of overactive bladder.
Dosage and Administration
Adult: 75 mg once daily, with or without food
Pediatric: Not approved for pediatric use
Geriatric: No specific dose adjustment needed but consider renal and hepatic function
Renal Impairment: No dose adjustment recommended in mild to moderate impairment; limited data in severe impairment
Hepatic Impairment: No specific dose adjustment necessary
Pharmacokinetics
Absorption: Rapid oral absorption, peak plasma levels in 1-2 hours
Distribution: Extensively distributed; plasma protein binding approximately 70%
Metabolism: Primarily metabolized via CYP3A4 enzyme
Excretion: Primarily excreted in feces (approximately 80%), with renal excretion of unchanged drug (~20%)
Half Life: about 48 hours
Contraindications
- Hypersensitivity to vibegron or any component of the formulation
Precautions
- Use with caution in patients with severe renal impairment or hepatic impairment; monitor for urinary retention or other urinary symptoms
Adverse Reactions - Common
- Headache (Common)
- Upper respiratory tract infection (Common)
- Urinary tract infection (Common)
Adverse Reactions - Serious
- Serious allergic reactions, including angioedema (Rare)
- Elevated blood pressure (Rare)
Drug-Drug Interactions
- CYP3A4 inhibitors may increase vibegron levels
Drug-Food Interactions
- No significant food interactions reported
Drug-Herb Interactions
- No significant herb interactions reported
Nursing Implications
Assessment: Monitor renal and hepatic function periodically; assess for urinary retention or worsening urinary symptoms.
Diagnoses:
- Risk for urinary retention
Implementation: Administer orally once daily; instruct patients to take with or without food.
Evaluation: Evaluate efficacy based on reduction of symptoms; monitor for side effects.
Patient/Family Teaching
- Take medication exactly as prescribed.
- Report any signs of allergic reactions, urinary retention, or adverse effects.
- Maintain adequate fluid intake.
- Do not discontinue medication abruptly without consulting healthcare provider.
Special Considerations
Black Box Warnings:
- None currently issued
Genetic Factors: Limited data available on pharmacogenomics affecting response
Lab Test Interference: No known interference
Overdose Management
Signs/Symptoms: Nausea, dizziness, hypertension, or urinary retention
Treatment: Supportive care; monitor vital signs; standard procedures for overdose management as indicated.
Storage and Handling
Storage: Store at room temperature, 20-25°C (68-77°F), away from moisture and light
Stability: Stable under recommended storage conditions for at least 2 years