Researchers discover that mirabegron, a drug prescribed to treat overactive bladder, could help some men with erectile dysfunction. This could be good news to men who don’t respond to ED medications.
The only currently available oral medications for the treatment of erectile dysfunction belong to a family of drugs called PDE5 inhibitors.
Members of this family of medications include Viagra, Levitra, Cialis, Staxyn, Stendra, and the generic equivalents of Viagra and Cialis, marketed as sildenafil citrate and tadalafil, respectively.
While the PDE5 inhibitors work efficiently and safely in the majority of men with vascular-related ED, they don’t work for everyone. Columbia University recently estimated that 30 to 35 percent of men treated with PDE5 inhibitors fail to respond positively to the drugs.
Research scientists have now discovered that mirabegron — a drug prescribed for the treatment of urinary incontinence — may provide help for some of the impotent men for whom the PDE5 inhibitors are ineffective. Their findings indicate that mirabegron may be particularly helpful to men whose ED is caused or exacerbated by their use of beta-blockers, widely prescribed for the treatment of high blood pressure and heart-related problems. These promising findings are based on animal and laboratory studies that were scheduled to be followed by clinical trials at Johns Hopkins University.
Findings of Tulane Study
An earlier study, published in the September 2016 issue of BJUI, was conducted by urological and pharmacological researchers at Tulane University Health Sciences Center in New Orleans. The Tulane research team treated live laboratory rats as well as samples of human corpus cavernosal tissue — taken from the twin columns of spongy erectile tissue within the penis — with mirabegron to gauge its effects.
Mirabegron, marketed under the brand name Myrbetriq by Astellas Pharma Inc., is used to treat a common form of urinary continence known as overactive bladder. The drug works by relaxing the muscles of the bladder, thus reducing the urge to urinate. It accomplishes this goal by stimulating beta-3 adrenergic receptors in bladder tissue, which then signal the smooth muscles of the bladder to relax.
Stimulates Penile Receptors Too
Researchers have discovered that the drug also exercises a similar effect on the beta-3 adrenergic receptors found in penile tissue. Stimulated by the mirabegron, these penile receptors signal the smooth muscle tissue of penile blood vessels to relax, thus increasing blood flow and facilitating the erection process. To their surprise, researchers also have found that male patients taking both beta-blockers and mirabegron no longer suffered one of the most common side effects of beta blockers, namely ED.
The Tulane research team also noted that the mirabegron’s effects occur on a totally different pathway from the one utilized by Viagra and the other PDE5 inhibitors. The PDE5 inhibitors operate along the nitric oxide-cyclic guanosine monophosphate pathway, which is independent of the beta-3 adrenergic receptors acted upon by mirabegron.
An Important Step Forward
Interviewed for an article posted at DailyMail.com, Mike Wyllie, a member of the research team that developed Viagra, was asked his opinion of the promising research into mirabegron’s potential as an ED treatment. He said, “The research is an important step in trying to find a way to help men who do not respond to PDE5 inhibitors like Viagra, by looking for alternative erection-producing mechanisms.”
Wyllie, who is today chief scientific officer of U.K.-based Plethora Solutions, added that “it has become obvious that for every patient satisfied with PDE inhibitors, there is one who gets an inadequate erection. So we really do need a treatment for this group of patients.”
Side Effects of Mirabegron
As with most prescription medications, mirabegron can cause side effects, most of which are mild and some of which are similar to those of the PDE5 inhibitors. The most common adverse effects of mirabegron include bloating, blurred vision, constipation, diarrhea, dizziness, dry mouth, fatigue, headache, increased blood pressure, joint pain, memory issues, and sinus pain. Although rare, more serious side effects of mirabegron include dangerously high blood pressure, difficulty urinating, fast or pounding heartbeats, and pain or burning when urinating. Patients who experience these more serious side effects should seek medical attention immediately.
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