January 26, 2025

Vibegron for Overactive Bladder: A Game-Changer for Men with Benign Prostatic Hyperplasia

Written by
Edward Calleja
Enlarged Prostate
Wave Blue

Understanding Overactive Bladder (OAB) and Benign Prostatic Hyperplasia (BPH)

What is Overactive Bladder (OAB)?

Overactive bladder (OAB) is a condition that makes you feel a sudden, uncontrollable urge to urinate. This urge can be hard to manage and may lead to involuntary loss of urine, known as urinary incontinence. OAB can disrupt daily activities and sleep due to frequent trips to the bathroom, both during the day and night.

What is Benign Prostatic Hyperplasia (BPH)?

Benign prostatic hyperplasia (BPH) is the non-cancerous enlargement of the prostate gland, common in older men. BPH can cause symptoms such as difficulty in starting urination, a weak urine stream, and frequent urination, especially at night (nocturia).

Introducing Vibegron: How It Works and Its Benefits

What is Vibegron, and How Does It Work?

Vibegron is a medication that helps to relax the bladder muscles, thereby reducing the symptoms of OAB. It targets specific receptors in the bladder, helping to control bladder contractions and improve the ability to hold urine.

Dosage and Dosing Information

The recommended dose of Vibegron is 75 mg taken once daily. It can be taken with or without food. Always follow your doctor's instructions regarding the dosage and timing of the medication.

Who Can Benefit from Vibegron?

Vibegron can benefit men who have OAB symptoms and are also being treated for BPH. If you experience frequent urges to urinate, urgency, or urinary incontinence, and you are already on medication for BPH, vibegron may help alleviate these symptoms.

How Does Vibegron Help with Bladder Emptying Difficulties?

Vibegron works by relaxing the bladder muscles, which makes it easier to hold urine and reduces the number of trips to the bathroom. This relaxation increases the bladder's capacity to hold urine, leading to fewer episodes of urgency and incontinence.

How Long Does Vibegron Take to Work?

Vibegron starts to show improvements in OAB symptoms relatively quickly. According to the COURAGE trial, significant benefits in reducing daily urination and urgency episodes were observed as early as two weeks after starting the medication. These improvements were maintained throughout the 24-week trial period.

Results from the COURAGE Trial

  • Reduction in Daily Urination: Patients taking vibegron had fewer daily trips to the bathroom compared to those on a placebo.
  • Reduction in Urgency Episodes: There were fewer urgent needs to urinate in patients using vibegron.
  • Improved Nighttime Urination: Vibegron reduced the number of times patients woke up at night to urinate.
  • Increased Urine Volume per Trip: Patients could hold more urine, which reduced the frequency of urination.

What are the Potential Side Effects?

Vibegron is generally well-tolerated, but like all medications, it can have side effects:

  • Common Side Effects: The most common side effect is hypertension (high blood pressure), occurring in about 9% of patients.
  • Other Side Effects: Include headaches, urinary tract infections, and diarrhoea, though these are less common.

Does Vibegron Cause Side Effects in Older People or Any Long-Term Side Effects?

Older adults might be more susceptible to the side effects of vibegron, such as high blood pressure and urinary tract infections. Long-term side effects are still being studied, but current data suggests that vibegron is generally safe for long-term use when taken as prescribed.

What are the Potential Drug Interactions of Vibegron?

Vibegron can interact with other medications, potentially altering their effectiveness or increasing the risk of side effects. Key interactions include:

  • Digoxin: Vibegron may increase the levels of digoxin, a heart medication, in your blood.
  • Anticholinergic Drugs: Combining vibegron with other drugs that affect bladder function can increase the risk of side effects.

Always inform your doctor about all the medications and supplements you are taking to avoid potential interactions.

Other Medical Conditions and Vibegron

If you have other medical conditions such as severe liver or kidney disease, it is important to discuss this with your doctor, as vibegron may not be suitable for you or may require dosage adjustments.

Vibegron and Other Drugs/Supplements

When taking vibegron, it is important to consider its interactions with other drugs and supplements:

  • Prescription Medications: Always check with your healthcare provider before combining vibegron with other prescription medications.
  • Over-the-Counter Drugs and Supplements: Inform your doctor about any over-the-counter drugs or supplements you are taking to ensure they do not interact with vibegron.

Are There Alternatives to Vibegron?

Yes, there are several alternatives to vibegron for treating OAB and BPH symptoms:

  • Lifestyle Changes: Including bladder training, pelvic floor exercises, and dietary modifications (avoid caffeine, artificial sweetener, spices and fizzy drinks)
  • Other Medications: Such as anticholinergics (e.g., oxybutynin, tolterodine) and other beta-3 agonists like mirabegron.

Words of Wisdom from a Consultant Urologist

For men experiencing OAB symptoms while being treated for BPH, Vibegron offers a promising option. Its ability to reduce urgency and frequency, especially at night, can significantly improve quality of life. However, always consult your urologist.