{"id":59089,"date":"2024-02-28T05:41:40","date_gmt":"2024-02-28T05:41:40","guid":{"rendered":"https:\/\/medsname.com\/mirago\/"},"modified":"2026-04-30T10:24:04","modified_gmt":"2026-04-30T10:24:04","slug":"mirago","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/mirago\/","title":{"rendered":"Mirago"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:18px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin-top:0;color:#8a5a00;\">Rychl\u00e1 odpov\u011b\u010f \u2014 Co je Mirago?<\/h3>\n<p style=\"margin:0;font-size:15px;line-height:1.6;\"><strong>Mirago<\/strong> obsahuje <strong>mirabegron 25 mg<\/strong> (tableta s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm) \u2014 prvn\u00ed v t\u00e9to t\u0159\u00edd\u011b <strong>beta-3 (\u03b23) adrenergn\u00ed receptorov\u00fd agonista<\/strong> pro l\u00e9\u010dbu <strong>hyperaktivn\u00edho mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e (OAB)<\/strong>. Na rozd\u00edl od star\u0161\u00edch anticholinergn\u00edch l\u00e9k\u016f na OAB (oxybutynin, tolterodin, solifenacin) mirabegron p\u016fsob\u00ed relaxac\u00ed hladk\u00e9ho svalstva detruzoru B\u011aHEM pln\u011bn\u00ed mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e, nikoli blok\u00e1dou acetylcholinov\u00fdch receptor\u016f. V\u00fdsledek: podobn\u00e1 \u00fa\u010dinnost bez sucha v \u00fastech, z\u00e1cpy, rozmazan\u00e9ho vid\u011bn\u00ed, zpomalen\u00ed kognitivn\u00edch funkc\u00ed a rizika p\u00e1d\u016f, kter\u00e9 omezuj\u00ed pou\u017eit\u00ed anticholinergik u star\u0161\u00edch pacient\u016f. Standardn\u00ed d\u00e1vka: <strong>jedna tableta 25 mg jednou denn\u011b<\/strong>; po 4-8 t\u00fddnech lze zv\u00fd\u0161it na 50 mg\/den, pokud je odpov\u011b\u010f nedostate\u010dn\u00e1. U\u017e\u00edvejte s j\u00eddlem nebo bez j\u00eddla. Krit\u00e9ria Beers 2023 Americk\u00e9 geriatrick\u00e9 spole\u010dnosti ozna\u010duj\u00ed v\u0161echny anticholinergn\u00ed l\u00e9ky na OAB jako <strong>\u201cpotenci\u00e1ln\u011b nevhodn\u00e9\u201d u dosp\u011bl\u00fdch ve v\u011bku 65+<\/strong> \u2014 co\u017e \u010din\u00ed z mirabegronu preferovan\u00fd l\u00e9k prvn\u00ed volby pro OAB v t\u00e9to populaci. <strong>Nej\u010dast\u011bj\u0161\u00ed vedlej\u0161\u00ed \u00fa\u010dinky:<\/strong> m\u00edrn\u00e9 zv\u00fd\u0161en\u00ed krevn\u00edho tlaku (monitorujte TK na za\u010d\u00e1tku), tachykardie, infekce mo\u010dov\u00fdch cest, bolest hlavy, nazofaryngitida. <strong>Kontraindikov\u00e1no u t\u011b\u017ek\u00e9 nekontrolovan\u00e9 hypertenze<\/strong>.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch <a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\"><strong>Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n<div style=\"background:#f4f8fb;border:1px solid #d6e4ec;padding:12px 18px;margin:14px 0;border-radius:4px;font-size:14px;color:#3a5160;text-align:center;\">\n<strong>\ud83d\udd12 \u0160ifrovan\u00e9 platby<\/strong> \u00b7 <strong>\ud83d\udcb3 Ov\u011b\u0159en\u00fd platebn\u00ed procesor<\/strong> \u00b7 <strong>\ud83d\ude9a Doprava do cel\u00e9ho sv\u011bta<\/strong> \u00b7 <strong>\u2b50 4,9\/5 od 1 400+ z\u00e1kazn\u00edk\u016f<\/strong>\n<\/div>\n<p><!-- medsbase-why-order --><\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Ka\u017ed\u00e1 \u0161ar\u017ee je dod\u00e1v\u00e1na od <strong>v\u00fdrobce certifikovan\u00e9ho WHO-GMP<\/strong>. Objedn\u00e1vky jsou expedov\u00e1ny v nen\u00e1padn\u00fdch obalech bez loga od na\u0161ich partnersk\u00fdch sklad\u016f a jsou pokryty na\u0161\u00ed <a href=\"\/cs\/medsbase-re-shipment-assurance-policy\/\">Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/a>: pokud z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, za\u0161leme zdarma n\u00e1hradn\u00ed z\u00e1silku, bez dotaz\u016f.<\/p>\n<div style=\"background:#fafafa;border:1px solid #e0e0e0;padding:16px 20px;margin:18px 0;border-radius:4px;\">\n<strong style=\"display:block;margin-bottom:8px;color:#333;\">Na t\u00e9to str\u00e1nce<\/strong><\/p>\n<ul style=\"margin:0;padding-left:20px;line-height:1.8;\">\n<li><a href=\"#what-is\">Co je Mirago?<\/a><\/li>\n<li><a href=\"#how-it-works\">Jak mirabegron funguje<\/a><\/li>\n<li><a href=\"#uses\">Kdy se mirabegron pou\u017e\u00edv\u00e1<\/a><\/li>\n<li><a href=\"#how-to-take\">D\u00e1vkov\u00e1n\u00ed &amp; zp\u016fsob u\u017e\u00edv\u00e1n\u00ed<\/a><\/li>\n<li><a href=\"#side-effects\">Vedlej\u0161\u00ed \u00fa\u010dinky &amp; bezpe\u010dnost<\/a><\/li>\n<li><a href=\"#bp-monitoring\">Monitorov\u00e1n\u00ed krevn\u00edho tlaku<\/a><\/li>\n<li><a href=\"#contraindications\">Kontraindikace a varov\u00e1n\u00ed<\/a><\/li>\n<li><a href=\"#interactions\">Interakce l\u00e9k\u016f<\/a><\/li>\n<li><a href=\"#alternatives\">Mirabegron vs anticholinergn\u00ed l\u00e9ky na OAB<\/a><\/li>\n<li><a href=\"#storage\">Skladov\u00e1n\u00ed a trvanlivost<\/a><\/li>\n<li><a href=\"#faq\">\u010casto kladen\u00e9 dotazy<\/a><\/li>\n<\/ul>\n<\/div>\n<h2 id=\"what-is\" class=\"wp-block-heading\">Co je Mirago?<\/h2>\n<p>Mirago je zna\u010dka <strong>mirabegron 25 mg tablety s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm<\/strong>. Mirabegron je prvn\u00ed a st\u00e1le dominantn\u00ed agonista \u03b23-adrenergn\u00edch receptor\u016f pro l\u00e9\u010dbu hyperaktivn\u00edho mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e. Na mezin\u00e1rodn\u00edm trhu je zna\u010dkov\u00e1n jako <strong>Myrbetriq (USA), Betmiga (UK\/EU), generick\u00fd Mirabegron<\/strong>. Dostupn\u00e9 balen\u00ed na MedsBase: 30, 60, 90 nebo 180 tablet.<\/p>\n<h2 id=\"how-it-works\" class=\"wp-block-heading\">Jak mirabegron funguje<\/h2>\n<p>Svalovina mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e (detrusor) m\u00e1 jak <strong>kontraktiln\u00ed<\/strong> (M3 muskarinov\u00e9 acetylcholinov\u00e9 receptory), tak <strong>relaxa\u010dn\u00ed<\/strong> (\u03b23 adrenergn\u00ed receptory) vstupy. B\u011bhem pln\u011bn\u00ed mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e sympatick\u00e1 nervov\u00e1 aktivita stimuluje \u03b23 receptory, co\u017e umo\u017e\u0148uje detrusoru relaxovat a mo\u010dov\u00e9mu m\u011bch\u00fd\u0159i pojmout v\u011bt\u0161\u00ed objemy bez vyvol\u00e1n\u00ed urgency nebo kontrakce.<\/p>\n<p>P\u0159i hyperaktivn\u00edm mo\u010dov\u00e9m m\u011bch\u00fd\u0159i je tato relaxa\u010dn\u00ed f\u00e1ze naru\u0161ena \u2014 detrusor se nevhodn\u011b stahuje p\u0159i mal\u00fdch objemech, co\u017e zp\u016fsobuje urgentn\u00ed nucen\u00ed na mo\u010den\u00ed, frekvenci a urgentn\u00ed inkontinenci. <strong>Mirabegron je selektivn\u00ed agonista \u03b23 receptor\u016f<\/strong>: zesiluje p\u0159irozen\u00fd relaxa\u010dn\u00ed sign\u00e1l b\u011bhem pln\u011bn\u00ed, zvy\u0161uje funk\u010dn\u00ed kapacitu mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e a redukuje tri\u00e1du urgency-frekvence-inkontinence.<\/p>\n<p>Kl\u00ed\u010dov\u00e9 je, \u017ee mirabegron NEBLOKUJE muskarinov\u00e9 acetylcholinov\u00e9 receptory \u2014 nezp\u016fsobuje tedy sucho v \u00fastech, z\u00e1cpu, rozmazan\u00e9 vid\u011bn\u00ed, retenci mo\u010di, zpomalen\u00ed kognitivn\u00edch funkc\u00ed ani anticholinergn\u00ed riziko p\u00e1d\u016f, kter\u00e9 v\u017edy limituj\u00ed oxybutynin, tolterodin, solifenacin a dal\u0161\u00ed antimuskarinov\u00e9 l\u00e9ky na hyperaktivn\u00ed mo\u010dov\u00fd m\u011bch\u00fd\u0159. Tento benefit je nejv\u00fdznamn\u011bj\u0161\u00ed u star\u0161\u00edch pacient\u016f a u pacient\u016f u\u017e\u00edvaj\u00edc\u00edch v\u00edce anticholinergn\u00edch l\u00e9k\u016f.<\/p>\n<h2 id=\"uses\" class=\"wp-block-heading\">Kdy se mirabegron pou\u017e\u00edv\u00e1<\/h2>\n<ul>\n<li><strong>Syndrom hyperaktivn\u00edho mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e (OAB)<\/strong> \u2014 p\u0159\u00edznaky urgency, frekvence mo\u010den\u00ed, nokturie, s nebo bez urgentn\u00ed inkontinence, u dosp\u011bl\u00fdch. Schv\u00e1len\u00e1 indikace.<\/li>\n<li><strong>Neurogenn\u00ed hyperaktivita detruzoru<\/strong> u dosp\u011bl\u00fdch a d\u011bt\u00ed od 3 let (licence Myrbetriq v USA)<\/li>\n<li><strong>OAB u star\u0161\u00edch dosp\u011bl\u00fdch<\/strong> \u2014 st\u00e1le v\u00edce preferov\u00e1no p\u0159ed anticholinergiky kv\u016fli absenci kognitivn\u00edch vedlej\u0161\u00edch \u00fa\u010dink\u016f a riziku p\u00e1d\u016f (American Geriatrics Society Beers Criteria 2023)<\/li>\n<li><strong>OAB u pacient\u016f u\u017e\u00edvaj\u00edc\u00edch v\u00edce anticholinergik<\/strong> (stabiliz\u00e1tory n\u00e1lady, antipsychotika, l\u00e9ky na alergii, prost\u0159edky na span\u00ed) \u2014 zabra\u0148uje kumulaci anticholinergn\u00ed z\u00e1t\u011b\u017ee<\/li>\n<li><strong>Kombina\u010dn\u00ed terapie se solifenacinem<\/strong> \u2014 nejnov\u011bj\u0161\u00ed d\u016fkazy podporuj\u00ed p\u0159id\u00e1n\u00ed mirabegronu k n\u00edzk\u00e9 d\u00e1vce anticholinergika u refraktern\u00edch p\u0159\u00edznak\u016f OAB (studie BESIDE)<\/li>\n<\/ul>\n<h2 id=\"how-to-take\" class=\"wp-block-heading\">D\u00e1vkov\u00e1n\u00ed &amp; zp\u016fsob u\u017e\u00edv\u00e1n\u00ed<\/h2>\n<ul>\n<li><strong>Po\u010d\u00e1te\u010dn\u00ed d\u00e1vka: 25 mg jednou denn\u011b<\/strong> (jedna tableta p\u0159\u00edpravku Mirago). U\u017e\u00edvejte s j\u00eddlem nebo bez j\u00eddla, p\u0159ibli\u017en\u011b ve stejnou dobu ka\u017ed\u00fd den.<\/li>\n<li><strong>Polykejte cel\u00e9<\/strong> s vodou \u2014 ne\u017ev\u00fdkejte, ned\u011blte ani nedr\u0165te (tablety s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm)<\/li>\n<li>\u00da\u010dinek se rozv\u00edj\u00ed postupn\u011b b\u011bhem 4-8 t\u00fddn\u016f. Pokud je odpov\u011b\u010f po 4-8 t\u00fddnech nedostate\u010dn\u00e1, d\u00e1vka m\u016f\u017ee b\u00fdt zv\u00fd\u0161ena na <strong>50 mg jednou denn\u011b<\/strong>.<\/li>\n<li><strong>Porucha funkce ledvin:<\/strong> m\u00edrn\u00e1 a\u017e st\u0159edn\u011b z\u00e1va\u017en\u00e1 \u2014 standardn\u00ed d\u00e1vkov\u00e1n\u00ed. Z\u00e1va\u017en\u00e1 (eGFR 15-29) \u2014 maxim\u00e1ln\u011b 25 mg\/den. Kone\u010dn\u00e9 stadium \/ dial\u00fdza \u2014 nedoporu\u010duje se.<\/li>\n<li><strong>Porucha funkce jater:<\/strong> m\u00edrn\u00e1 \u2014 standardn\u00ed d\u00e1vkov\u00e1n\u00ed. St\u0159edn\u011b z\u00e1va\u017en\u00e1 (Child-Pugh B) \u2014 maxim\u00e1ln\u011b 25 mg\/den. Z\u00e1va\u017en\u00e1 (Child-Pugh C) \u2014 nedoporu\u010duje se.<\/li>\n<li><strong>Star\u0161\u00ed pacienti:<\/strong> standardn\u00ed d\u00e1vkov\u00e1n\u00ed (toto je preferovan\u00e1 v\u011bkov\u00e1 skupina)<\/li>\n<li>Pokud vynech\u00e1te d\u00e1vku, vezm\u011bte ji, jakmile si vzpomenete, pokud do dal\u0161\u00ed d\u00e1vky zb\u00fdv\u00e1 v\u00edce ne\u017e 6 hodin. Nedvojte d\u00e1vku.<\/li>\n<\/ul>\n<h2 id=\"side-effects\" class=\"wp-block-heading\">Vedlej\u0161\u00ed \u00fa\u010dinky &amp; bezpe\u010dnost<\/h2>\n<ul>\n<li><strong>\u010cast\u00e9 (1 z 10):<\/strong> m\u00edrn\u00e9 zv\u00fd\u0161en\u00ed srde\u010dn\u00ed frekvence (~1 tep\/min), m\u00edrn\u00e9 zv\u00fd\u0161en\u00ed krevn\u00edho tlaku (~1 mmHg), infekce mo\u010dov\u00fdch cest, bolest hlavy, nazofaryngitida, sucho v \u00fastech (m\u00e9n\u011b \u010dast\u00e9 ne\u017e u anticholinergik)<\/li>\n<li><strong>M\u00e9n\u011b \u010dast\u00e9:<\/strong> palpitace, fibrilace s\u00edn\u00ed, z\u00e1cpa, nevolnost, bolest kloub\u016f nebo sval\u016f, vyr\u00e1\u017eka, z\u00e1vrat\u011b<\/li>\n<li><strong>Vz\u00e1cn\u00e9:<\/strong> angioed\u00e9m (otok obli\u010deje, rt\u016f, jazyka) \u2014 OKAM\u017dIT\u011a P\u0158ERU\u0160TE a vyhledejte pohotovostn\u00ed p\u00e9\u010di, retence mo\u010di (zejm\u00e9na u pacient\u016f s obstrukc\u00ed v\u00fdtoku mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e), Stevens-Johnson\u016fv syndrom<\/li>\n<li><strong>NEN\u00cd typick\u00e9:<\/strong> anticholinergn\u00ed vedlej\u0161\u00ed \u00fa\u010dinky \u2014 minim\u00e1ln\u00ed sucho v \u00fastech, \u017e\u00e1dn\u00e1 v\u00fdznamn\u00e1 z\u00e1cpa, \u017e\u00e1dn\u00e9 zpomalen\u00ed kognitivn\u00edch funkc\u00ed, \u017e\u00e1dn\u00e9 zv\u00fd\u0161en\u00ed rizika p\u00e1d\u016f<\/li>\n<\/ul>\n<h2 id=\"bp-monitoring\" class=\"wp-block-heading\">Monitorov\u00e1n\u00ed krevn\u00edho tlaku<\/h2>\n<p>Mirabegron zp\u016fsobuje mal\u00e9, ale m\u011b\u0159iteln\u00e9 zv\u00fd\u0161en\u00ed krevn\u00edho tlaku (obvykle 1-3 mmHg systolick\u00e9ho tlaku p\u0159i standardn\u00edch d\u00e1vk\u00e1ch, m\u00edrn\u011b v\u00edce p\u0159i 50 mg). Pro v\u011bt\u0161inu pacient\u016f je to klinicky nev\u00fdznamn\u00e9. U pacient\u016f s preexistuj\u00edc\u00ed hypertenz\u00ed:<\/p>\n<ul>\n<li>Zm\u011b\u0159te v\u00fdchoz\u00ed TK p\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby<\/li>\n<li>P\u0159em\u011b\u0159te po 4-6 t\u00fddnech a p\u0159i ka\u017ed\u00e9m zv\u00fd\u0161en\u00ed d\u00e1vky<\/li>\n<li><strong>Nezahajujte mirabegron u t\u011b\u017ek\u00e9 nekontrolovan\u00e9 hypertenze<\/strong> (systolick\u00fd &gt;180 NEBO diastolick\u00fd &gt;110)<\/li>\n<li>Pokud TK v\u00fdrazn\u011b stoupne p\u0159i u\u017e\u00edv\u00e1n\u00ed mirabegronu, optimalizujte antihypertenzn\u00ed terapii nebo p\u0159ejd\u011bte na anticholinergn\u00ed l\u00e9k na OAB<\/li>\n<\/ul>\n<h2 id=\"contraindications\" class=\"wp-block-heading\">Kontraindikace a varov\u00e1n\u00ed<\/h2>\n<p><strong>Neu\u017e\u00edvejte mirabegron, pokud m\u00e1te:<\/strong><\/p>\n<ul>\n<li>T\u011b\u017ekou nekontrolovanou hypertenzi (SKK \u2265180 NEBO DKK \u2265110)<\/li>\n<li>Kone\u010dn\u00e9 st\u00e1dium ren\u00e1ln\u00edho onemocn\u011bn\u00ed (eGFR &lt;15) nebo na dial\u00fdze<\/li>\n<li>T\u011b\u017ek\u00e9 jatern\u00ed po\u0161kozen\u00ed (Child-Pugh C)<\/li>\n<li>P\u0159ecitliv\u011blost na mirabegron<\/li>\n<li>Sou\u010dasn\u00e9 u\u017e\u00edv\u00e1n\u00ed siln\u00fdch substr\u00e1t\u016f CYP2D6 s \u00fazk\u00fdm terapeutick\u00fdm indexem (opatrnost; mirabegron je st\u0159edn\u00edm inhibitorem CYP2D6)<\/li>\n<\/ul>\n<p><strong>Pou\u017e\u00edvejte s opatrnost\u00ed, pokud m\u00e1te:<\/strong> obstrukci v\u00fdtoku z mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e (riziko retence mo\u010di, zejm\u00e9na v kombinaci s anticholinergn\u00edmi l\u00e9ky na OAB), vrozen\u00e9 nebo z\u00edskan\u00e9 prodlou\u017een\u00ed QT intervalu, kontrolovanou hypertenzi, anamn\u00e9zu angioed\u00e9mu.<\/p>\n<h2 id=\"interactions\" class=\"wp-block-heading\">Interakce l\u00e9k\u016f<\/h2>\n<ul>\n<li><strong>Siln\u00e9 substr\u00e1ty CYP2D6 s \u00fazk\u00fdm terapeutick\u00fdm indexem<\/strong> (metoprolol, propafenon, flekainid, desipramin, thioridazin) \u2014 mirabegron je st\u0159edn\u00edm inhibitorem CYP2D6, m\u016f\u017ee zv\u00fd\u0161it plazmatick\u00e9 hladiny; m\u016f\u017ee b\u00fdt nutn\u00e1 \u00faprava d\u00e1vky<\/li>\n<li><strong>Digoxin<\/strong> \u2014 mirabegron m\u00edrn\u011b zvy\u0161uje hladiny digoxinu; monitorujte hladiny digoxinu a zva\u017ete sn\u00ed\u017een\u00ed d\u00e1vky<\/li>\n<li><strong>Warfarin<\/strong> \u2014 minim\u00e1ln\u00ed interakce p\u0159i standardn\u00edch d\u00e1vk\u00e1ch; doporu\u010duje se kontrola INR po zah\u00e1jen\u00ed l\u00e9\u010dby<\/li>\n<li><strong>Anticholinergn\u00ed l\u00e9ky na OAB<\/strong> (solifenacin, tolterodin, oxybutynin) \u2014 kombinace je dob\u0159e podlo\u017een\u00e1 (studie BESIDE) pro refraktern\u00ed OAB; monitorujte retenci mo\u010di<\/li>\n<li><strong>Siln\u00e9 inhibitory CYP3A4<\/strong> (ketokonazol, ritonavir) \u2014 m\u00edrn\u011b zvy\u0161uj\u00ed expozici mirabegronu; p\u0159i kombinaci sni\u017ete d\u00e1vku na 25 mg\/den<\/li>\n<\/ul>\n<h2 id=\"alternatives\" class=\"wp-block-heading\">Mirabegron vs anticholinergn\u00ed l\u00e9ky na OAB<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:14px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Vlastnost<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Mirabegron (\u03b23 agonista)<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Oxybutynin \/ tolterodin \/ solifenacin (anticholinergikum)<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">\u00da\u010dinnost<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Ekvivalent<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Ekvivalent<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Sucho v \u00fastech<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Minim\u00e1ln\u00ed<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">\u010cast\u00e9 (10-30 %)<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Z\u00e1cpa<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Ne<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">B\u011b\u017en\u00e9<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Kognitivn\u00ed \u00fa\u010dinky u star\u0161\u00edch pacient\u016f<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Ne<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Ano \u2014 riziko p\u00e1d\u016f, deliria, demence (Beersova krit\u00e9ria)<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Krevn\u00ed tlak<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">M\u00edrn\u00e9 zv\u00fd\u0161en\u00ed<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Obvykle neutr\u00e1ln\u00ed<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:10px;border:1px solid #ddd;\">Cena<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Dra\u017e\u0161\u00ed (nov\u011bj\u0161\u00ed)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Levn\u011bj\u0161\u00ed (generikum)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Dal\u0161\u00ed relevantn\u00ed str\u00e1nky na tomto webu: <a href=\"https:\/\/medsbase.com\/cs\/oxyspas\/\"><strong>Oxyspas (oxybutynin)<\/strong><\/a>, <a href=\"https:\/\/medsbase.com\/cs\/roliten\/\"><strong>Roliten (tolterodin IR)<\/strong><\/a>, <a href=\"https:\/\/medsbase.com\/cs\/terol-la\/\"><strong>Terol LA (tolterodin s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm)<\/strong><\/a>, <a href=\"https:\/\/medsbase.com\/cs\/urispas\/\"><strong>Urispas (flavox\u00e1t antispasmodikum)<\/strong><\/a>.<\/p>\n<h2 id=\"storage\" class=\"wp-block-heading\">Skladov\u00e1n\u00ed a trvanlivost<\/h2>\n<p>Skladujte tablety Mirago p\u0159i teplot\u011b ni\u017e\u0161\u00ed ne\u017e 25\u00b0C v p\u016fvodn\u00edm blistru. Chra\u0148te p\u0159ed vlhkost\u00ed a sv\u011btlem. Uchov\u00e1vejte mimo dosah d\u011bt\u00ed. Nepou\u017e\u00edvejte po uplynut\u00ed doby pou\u017eitelnosti uveden\u00e9 na krabi\u010dce.<\/p>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">Jak rychle mirabegron \u00fa\u010dinkuje?<\/h3>\n<p>M\u00edrn\u00e9 zlep\u0161en\u00ed urgentn\u00edho nucen\u00ed na mo\u010den\u00ed a frekvence mo\u010den\u00ed je obvykle patrn\u00e9 b\u011bhem 1-2 t\u00fddn\u016f; pln\u00fd \u00fa\u010dinek se rozv\u00edj\u00ed b\u011bhem 4-8 t\u00fddn\u016f. Pokud se p\u0159\u00edznaky po 8 t\u00fddnech u\u017e\u00edv\u00e1n\u00ed 25 mg v\u00fdznamn\u011b nezlep\u0161\u00ed, d\u00e1vku lze zv\u00fd\u0161it na 50 mg\/den; pokud je \u00fa\u010dinek st\u00e1le nedostate\u010dn\u00fd, je t\u0159eba zv\u00e1\u017eit alternativn\u00ed l\u00e9ky (anticholinergika pro OAB nebo kombinovanou terapii).<\/p>\n<h3 class=\"wp-block-heading\">Pro\u010d je mirabegron preferov\u00e1n u star\u0161\u00edch dosp\u011bl\u00fdch?<\/h3>\n<p>Krit\u00e9ria Beers od Americk\u00e9 geriatrick\u00e9 spole\u010dnosti z roku 2023 klasifikuj\u00ed v\u0161echna anticholinergika pro OAB jako \u201cpotenci\u00e1ln\u011b nevhodn\u00e1\u201d u dosp\u011bl\u00fdch ve v\u011bku 65+ kv\u016fli kumulativn\u00ed anticholinergn\u00ed z\u00e1t\u011b\u017ei \u2013 kter\u00e1 je spojena se zv\u00fd\u0161en\u00fdm rizikem p\u00e1d\u016f, deliria, kognitivn\u00edho \u00fabytku a mo\u017en\u00e9ho dlouhodob\u00e9ho rizika demence. Mirabegron nen\u00ed anticholinergn\u00ed, t\u011bmto rizik\u016fm se vyh\u00fdb\u00e1, a je proto preferovan\u00fdm l\u00e9kem prvn\u00ed volby pro OAB u star\u0161\u00edch pacient\u016f.<\/p>\n<h3 class=\"wp-block-heading\">Zv\u00fd\u0161\u00ed mirabegron m\u016fj krevn\u00ed tlak?<\/h3>\n<p>Mirabegron zp\u016fsobuje m\u00edrn\u00e9 pr\u016fm\u011brn\u00e9 zv\u00fd\u0161en\u00ed TK (1-3 mmHg systolick\u00e9ho p\u0159i 25 mg, o n\u011bco v\u00edce p\u0159i 50 mg) \u2013 obvykle klinicky nev\u00fdznamn\u00e9. Pacienti s kontrolovanou hypertenz\u00ed jej mohou u\u017e\u00edvat s pravideln\u00fdm monitorov\u00e1n\u00edm TK. Je kontraindikov\u00e1n u t\u011b\u017ek\u00e9 nekontrolovan\u00e9 hypertenze (\u2265180\/110).<\/p>\n<h3 class=\"wp-block-heading\">Lze mirabegron kombinovat s oxybutyninem nebo solifenacinem?<\/h3>\n<p>Ano \u2013 tato kombinace je dob\u0159e podlo\u017eena (studie BESIDE prok\u00e1zala, \u017ee solifenacin 5 mg + mirabegron 50 mg vykazoval v\u00fdrazn\u011b v\u011bt\u0161\u00ed sn\u00ed\u017een\u00ed p\u0159\u00edznak\u016f ne\u017e ka\u017ed\u00fd l\u00e9k samostatn\u011b u refraktern\u00ed OAB). Kombinace vy\u017eaduje pe\u010dliv\u00e9 monitorov\u00e1n\u00ed kv\u016fli riziku retence mo\u010di, zejm\u00e9na u mu\u017e\u016f s obstrukc\u00ed v\u00fdtoku z mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e.<\/p>\n<h3 class=\"wp-block-heading\">Mohu u\u017e\u00edvat mirabegron s antidepresivy?<\/h3>\n<p>Mirabegron je st\u0159edn\u00edm inhibitorem CYP2D6, proto m\u016f\u017ee m\u00edrn\u011b zv\u00fd\u0161it plazmatick\u00e9 hladiny n\u011bkter\u00fdch tricyklick\u00fdch antidepresiv (desipramin, nortriptylin) a betablok\u00e1tor\u016f (metoprolol). U v\u011bt\u0161iny pacient\u016f u\u017e\u00edvaj\u00edc\u00edch antidepresiva to nen\u00ed klinicky v\u00fdznamn\u00e9, ale pora\u010fte se se sv\u00fdm l\u00e9ka\u0159em, pokud u\u017e\u00edv\u00e1te metoprolol, propafenon, flekainid nebo thioridazin \u2013 tyto l\u00e9ky mohou vy\u017eadovat \u00fapravu d\u00e1vkov\u00e1n\u00ed.<\/p>\n<h3 class=\"wp-block-heading\">Zp\u016fsobuje mirabegron sucho v \u00fastech jako oxybutynin?<\/h3>\n<p>Minim\u00e1ln\u011b \u2013 mirabegron neblokuje acetylcholinov\u00e9 receptory, proto je sucho v \u00fastech neobvykl\u00e9 a obvykle m\u00edrn\u00e9. To je hlavn\u00ed praktick\u00e1 v\u00fdhoda mirabegronu oproti anticholinergik\u016fm pro OAB (oxybutynin, tolterodin, solifenacin), kde sucho v \u00fastech postihuje 10-30 % u\u017eivatel\u016f a je hlavn\u00edm d\u016fvodem pro ukon\u010den\u00ed l\u00e9\u010dby.<\/p>\n<h3 class=\"wp-block-heading\">Pom\u016f\u017ee mi mirabegron p\u0159i urgentn\u00ed inkontinenci?<\/h3>\n<p>Ano \u2014 klinick\u00e9 studie ukazuj\u00ed, \u017ee mirabegron sni\u017euje pr\u016fm\u011brn\u00fd po\u010det epizod inkontinence za t\u00fdden o 40\u201360 %, podobn\u011b jako anticholinergika. Stejn\u011b jako u v\u0161ech l\u00e9k\u016f na OAB je odpov\u011b\u010f individu\u00e1ln\u00ed; n\u011bkte\u0159\u00ed pacienti zaznamenaj\u00ed v\u00fdrazn\u00e9 zlep\u0161en\u00ed, jin\u00e9 jen m\u00edrn\u00e9. Pro posouzen\u00ed \u00fa\u010dinnosti je vhodn\u00e9 prov\u00e9st 4\u20138t\u00fddenn\u00ed zku\u0161ebn\u00ed l\u00e9\u010dbu.<\/p>\n<h3 class=\"wp-block-heading\">Lze mirabegron u\u017e\u00edvat dlouhodob\u011b?<\/h3>\n<p>Ano \u2014 OAB je obvykle chronick\u00e9 onemocn\u011bn\u00ed a mirabegron je ur\u010den k dlouhodob\u00e9mu u\u017e\u00edv\u00e1n\u00ed. Doporu\u010duje se pravideln\u00e9 hodnocen\u00ed (jednou ro\u010dn\u011b) k potvrzen\u00ed trvaj\u00edc\u00edho prosp\u011bchu a kontrole krevn\u00edho tlaku a funkce ledvin.<\/p>\n<h3 class=\"wp-block-heading\">Kde si mohu objednat Mirago online?<\/h3>\n<p>M\u016f\u017eete si objednat tablety Mirago 25 mg na MedsBase v balen\u00edch po 30, 60, 90 nebo 180 tablet\u00e1ch. Objedn\u00e1vky jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm balen\u00ed. Mirabegron je ve v\u0161ech zem\u00edch dostupn\u00fd pouze pod odborn\u00fdm dohledem.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:24px 0;border-radius:4px;\">\n<strong>\u2695 L\u00e9ka\u0159sk\u00e9 upozorn\u011bn\u00ed.<\/strong> Tato str\u00e1nka slou\u017e\u00ed pouze pro informa\u010dn\u00ed \u00fa\u010dely a nenahrazuje l\u00e9ka\u0159skou pomoc kvalifikovan\u00e9ho odborn\u00edka. P\u0159ed zah\u00e1jen\u00edm, zm\u011bnou nebo ukon\u010den\u00edm jak\u00e9koli l\u00e9\u010dby mo\u010dov\u00fdch nebo prostatick\u00fdch p\u0159\u00edznak\u016f se v\u017edy pora\u010fte se sv\u00fdm l\u00e9ka\u0159em nebo l\u00e9k\u00e1rn\u00edkem \u2014 tyto p\u0159\u00edznaky mohou b\u00fdt \u010dasn\u00fdmi projevy stav\u016f (infekce mo\u010dov\u00fdch cest, rakovina prostaty, kameny mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e), kter\u00e9 vy\u017eaduj\u00ed diagn\u00f3zu a c\u00edlenou l\u00e9\u010dbu, ne pouze symptomatickou \u00falevu. MedsBase neposkytuje diagn\u00f3zy, p\u0159edpisy ani klinick\u00e1 doporu\u010den\u00ed.\n<\/div>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Souvisej\u00edc\u00ed alternativy<\/h3>\n<p>Dal\u0161\u00ed produkty v <strong>Obecn\u00e9 zdrav\u00ed<\/strong> kter\u00e9 z\u00e1kazn\u00edci tak\u00e9 prohl\u00ed\u017eej\u00ed:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/cynomycin\/\">Cynomycin<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/alfusin-tab\/\">Alfusin Tab<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/levoflox\/\">Levoflox<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/lurafic\/\">Lurafic<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/omez-d\/\">Omez D<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>\u2705 Zm\u00edr\u0148uje p\u0159\u00edznaky mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e<br \/>\n\u2705 Sni\u017euje \u010detnost mo\u010den\u00ed<br \/>\n\u2705 Redukuje urgentn\u00ed inkontinenci<br \/>\n\u2705 Zlep\u0161uje kapacitu mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e<br \/>\n\u2705 Zvy\u0161uje kontrolu nad mo\u010den\u00edm<\/p>\n<p>Mirago obsahuje Mirabegron.<\/p>","protected":false},"featured_media":59090,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3614,3141,3342],"product_tag":[4624,4625],"class_list":{"0":"post-59089","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-bladder-prostate","7":"product_cat-category-overview","8":"product_cat-general-health","9":"product_tag-mirabegron","10":"product_tag-mirago","12":"first","13":"instock","14":"shipping-taxable","15":"purchasable","16":"product-type-variable","17":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/59089","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=59089"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/59090"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=59089"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=59089"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=59089"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=59089"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}