Mirabegron

ID: mirabegron

Aliases: Myrbetriq

Type: compound

Route/form: oral

Status: approved

Evidence level: approved / labelled

Best data tier: approved label

Support scope: human, non-human/mechanistic

Source types: human_physiology, label, preclinical

Linked sources: 4

Broad outcomes: Fat loss / metabolic health, Hormones / fertility / sexual health

Reading note: These are curation notes anchored to linked sources, not a clinical recommendation or protocol.

Targets / mechanism

• beta-3 adrenergic agonist

Optimization domains

• urology
• brown fat
• metabolic

Research basis

• Acute and four-week human physiology studies support BAT activation, higher resting energy expenditure, and metabolic-marker changes at studied doses.
• A 2026 brown-fat preprint gives an adjacent mechanism for why glucose uptake can become thermogenic when de novo lipogenesis is limited.
• The approved overactive-bladder label provides route, dosing, blood-pressure, urinary-retention, and interaction context.

Limits, risks, and missing evidence

• The strongest BAT signal used doses above routine overactive-bladder starting doses, so metabolic extrapolation is dose- and safety-limited.
• Blood pressure, heart rate, urinary retention, and CYP2D6 interactions matter, especially when combined with stimulants or other adrenergic agents.
• BAT activation and resting-energy-expenditure changes are not the same as demonstrated long-term fat-loss outcomes.

Risk flags

• prescription
• cardiovascular
• medical supervision

Linked papers, labels, and reviews

1. Activation of human brown adipose tissue by a beta3-adrenergic receptor agonist
   human_physiology / pubmed_mirabegron_bat_2015
   Acute human mirabegron BAT activation and resting-energy-expenditure study; direct physiology anchor, not a weight-loss outcome trial.
2. Chronic mirabegron treatment increases human brown fat, HDL cholesterol, and insulin sensitivity
   human_physiology / jci_mirabegron_chronic_2020
   Four-week open-label human study using 100 mg mirabegron; supports BAT/metabolic physiology and also highlights dose/safety extrapolation issues.
3. Limiting De Novo Lipogenesis Unlocks the Thermogenic Potential of Glucose in Brown Fat
   preclinical / researchsquare_bat_dnl_thermogenesis_2026
   2026 preprint; not a mirabegron trial, but supports the related BAT idea that beta-adrenergic/glucose-driven thermogenesis depends on whether glucose is diverted into de novo lipogenesis.
4. DailyMed label: MYRBETRIQ mirabegron
   label / dailymed_myrbetriq_label
   Official overactive-bladder label context for oral route, dosing, blood-pressure warning, urinary-retention risk, and CYP2D6 interaction language.