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mirabegron + fesoterodine is a combination therapy used for overactive bladder (OAB). Mirabegron acts as a **β3 adrenoceptor agonist**, relaxing detrusor smooth muscle by activating adenylyl cyclase and increasing bladder capacity. Fesoterodine is a **nonselective muscarinic receptor antagonist** (prodrug for 5-hydroxymethyl tolterodine), blocking M2 and M3 receptors, thus inhibiting acetylcholine-mediated bladder contractions. The combination leverages **complementary mechanisms** for potentially synergistic improvement in bladder storage symptoms. Animal studies show that the combination increases bladder capacity more than either drug alone, with additive relaxant effects on the bladder.
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