Oxybutynin vs mirabegron (Myrbetriq) for overactive bladder
Oxybutynin and mirabegron (Myrbetriq) both calm an overactive bladder, reducing urgency, frequency and leaks. Oxybutynin is an older, inexpensive anticholinergic that often causes dry mouth and constipation; mirabegron works differently, avoids those effects, but can raise blood pressure and usually costs more.
Updated October 4, 2026
At a glance
- How it works
- Oxybutynin
- Blocks nerve signals that make the bladder contract
- Mirabegron
- Relaxes the bladder muscle as it fills
- Common side effects
- Oxybutynin
- Dry mouth, constipation, blurred vision
- Mirabegron
- Raised blood pressure, headache
- Older adults
- Oxybutynin
- Can cause confusion; long-term use is a concern
- Mirabegron
- No anticholinergic effects
- Forms
- Oxybutynin
- Tablets, extended-release tablets, patch, gel
- Mirabegron
- Extended-release tablets and granules
- Cost
- Oxybutynin
- Inexpensive generic
- Mirabegron
- Usually costs more
Oxybutynin Ditropan, an anticholinergic | Mirabegron Myrbetriq, a beta-3 agonist | |
|---|---|---|
| How it works | Blocks nerve signals that make the bladder contract | Relaxes the bladder muscle as it fills |
| Common side effects | Dry mouth, constipation, blurred vision | Raised blood pressure, headache |
| Older adults | Can cause confusion; long-term use is a concern | No anticholinergic effects |
| Forms | Tablets, extended-release tablets, patch, gel | Extended-release tablets and granules |
| Cost | Inexpensive generic | Usually costs more |
Why the difference matters for older adults
Anticholinergic medicines such as oxybutynin can cause confusion and memory problems in older adults, and studies have linked long-term use of strongly anticholinergic medicines with a higher risk of dementia. For that reason, mirabegron or a less anticholinergic option is often preferred for older people or anyone already taking other anticholinergic medicines.
Side effects in practice
Oxybutynin’s dry mouth and constipation are common, though the extended-release tablets, patch and gel cause less dry mouth than standard tablets. It reduces sweating, so take care in heat. Mirabegron can raise blood pressure, which is checked, and it is not used with severe uncontrolled high blood pressure. It raises levels of some medicines, including metoprolol and some antidepressants.
Taking them together
When one medicine is not enough, mirabegron is sometimes combined with an anticholinergic. Both take a few weeks to show their full effect, so give a new medicine time before judging it.
Other measures
Bladder training, pelvic floor exercises, and cutting back on caffeine and evening fluids help many people and work well alongside medicine. Blood in the urine, pain or fever needs checking rather than treatment for overactive bladder.
Cost
Oxybutynin is an inexpensive generic. Mirabegron usually costs more, so check your plan’s price and compare cash quotes.
Questions for your prescriber
- Is an anticholinergic a concern for me given my age and other medicines?
- How will my blood pressure be checked on mirabegron?
- Which non-drug measures should I try alongside?
Already have a prescription?
Upload it and licensed pharmacies respond with their own cash price. You choose, and pay the pharmacy.
Read more
Sources
Written by the Script Unlock editorial team from the sources above. It is general information, not advice for you or your pet; your prescriber decides which medicine is right.
Script Unlock is a marketplace that lets licensed pharmacies quote a cash price on your prescription. It does not prescribe, dispense or sell medication, does not process patient payments, and does not give medical advice. Always follow the instructions of your prescriber and pharmacist and read the medication guide supplied with your medicine.