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Alpha Blockers
Alpha Blockers
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News & Research:
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Erectile dysfunction worsened, testosterone levels decreased by some
treatments of prostate enlargement - Science Daily, 6/12/15 -
"The researchers found that the men treated with
finasteride experienced marked and significant gradual decrease in their
erectile function and had significant and progressive decline in total
testosterone levels while those on the tamsulosin therapy did not"
- In Prostate
Hyperplasia, Combo Pill Slows Progress - Medscape, 4/18/14 -
"All men received lifestyle advice about caffeine
and alcohol avoidance, fluid management, and bladder retraining. They were
then randomized to watchful waiting (n = 373) or to daily treatment for 2
years with a single capsule containing the 5-alpha reductase inhibitor
dutasteride 0.5 mg plus the alpha blocker tamsulosin 0.4 mg (n = 369) ... At
the end of the study, the rate of clinical progression of benign prostate
hyperplasia was 43.1% lower in the treatment group than in the watchful
waiting group (18% vs 29%; P < .001) ... Similarly, improvements in
hyperplasia symptoms and related quality of life were significantly greater
the treatment group"
- Effect
of Selective Alpha-blocker Tamsulosin on Erectile Function in Patients With
Lower Urinary Tract Symptoms due to Benign Prostatic Hyperplasia -
Urology. 2013 May 25 - "randomized single blinded
study in one-to-one fashion conducted upon 60 patients, all of them married,
between May 2010 and May 2011 ... Tamsulosin HCl capsules showed a
significant statistical improvement in the erectile function, sexual desire,
and intercourse satisfaction score with significant improvement in total
IIEF in patients with lower urinary tract symptoms because of benign
prostatic hyperplasia" - Note: Tamsulosin is Flomax.
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Finasteride May Be Helpful for Benign Prostatic Hypertrophy - Medscape,
10/8/10 - "Finasteride improves long-term urinary
symptoms versus placebo, but is less effective than doxazosin," the study
authors write. "Long-term combination therapy with alpha blockers
(doxazosin, terazosin) improves symptoms significantly better than
finasteride monotherapy. Finasteride + doxazosin improves symptoms equally —
and clinically — to doxazosin alone. In comparison to doxazosin, finasteride
+ doxazosin appears to improve urinary symptoms only in men with medium (25
to < 40 mL) or large prostates (≥ 40 mL), but not in men with small
prostates (25 mL)."
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FDA Approves Dutasteride/Tamsulosin Combo Pill for BPH - Medscape,
6/18/10 -
"daily use of the drug combination yielded
significantly greater relief of BPH symptoms compared with either 0.5 mg
dutasteride or 0.4 mg tamsulosin alone, as measured by point changes on the
International Prostate Symptom scale from baseline (mean Δ, −6.2 vs −4.9 and
−4.3; P < .001 for both). The difference was observed by month 9 and
continued through month 24" - See dutasteride at
OffshoreRx1.com.
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Alfuzosin Improves Ejaculatory Dysfunction in Men With Probable BPH -
Medscape, 4/20/10 - "Alfuzosin (Uroxatral, Sanofi
Aventis), a uroselective alpha-1-adrenergic receptor blocker, ameliorates
ejaculatory dysfunction in sexually active men with lower urinary tract
symptoms (LUTS) suggestive of benign prostatic hypertrophy (BPH) ...
Alfuzosin significantly improved IPSS score (7.9 [–41%]; P < .0001) and
nocturia (–0.9 [–18%]; P < .001) from baseline. Bother due to LUTS also
significantly improved (–1.5 [–28%]; P < .0001)"
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Generic Drug for Enlarged Prostate Approved - WebMD, 3/2/10 -
"The first generic version of Flomax, a medication
to treat the signs and symptoms of an enlarged prostate gland, has won the
approval of the FDA"
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Combination therapy more effective for enlarged prostate - Science
Daily, 3/2/10 - "On the strengths of both
dutasteride and tamsulosin, participants reported fewer symptoms, and we
observed a 25 percent reduction in prostate volume ... subjects who received
the combination therapy also showed a 50 percent reduction of
prostate-specific antigen (PSA), a protein produced by both cancerous and
noncancerous prostate tissue ... Compared with tamsulosin alone, the
combination of drugs reduced the incidence of acute urinary retention by 67
percent and reduced the need for BPH-related surgery by 70 percent" -
See - See
dutasteride at OffshoreRx1.com.
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Use of alpha-Blockers for Hypertension Declined After Publication of
Unfavorable Clinical Trial Results - Doctor's Guide, 1/6/04
Abstracts:
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Efficacy and Safety of
Tadalafil vs Tamsulosin in Lower Urinary Tract Symptoms (LUTS) as a Result of
Benign Prostate Hyperplasia (BPH)-open Label Randomised Controlled Study -
Int J Clin Pract 2020 Jun 15;e13530 - "100 patients of
BPH with an IPSS score of more than 7, without any complications of the disease
were computer randomised to receive therapy with either tamsulosin 0.4 mg or
tadalafil 5 mg once daily for a period of 2 months ... once daily monotherapy
with tadalafil 5 mg or tamsulosin 0.4 mg was equally efficacious in the
management of moderate to severely bothersome LUTS in majority of patients as a
result of BPH. The role of Tadalafil monotherapy in BPH patients with
predominant storage LUTS merits further evaluation with larger trials" -
ReliableRXPharmacy carries tadalafil.
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Effect of
tamsulosin on stone expulsion in proximal ureteral calculi: an open-label
randomized controlled trial - Int J Clin Pract. 2013 Dec 22 -
"Tamsulosin was associated with significantly higher stone
expulsion rate and shorter expulsion time in proximal UC ≤ 6 mm compared with
conservative managements only" - Note: Tamsulosin is an alpha-blocker
under the brand name is Flomax.
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The efficacy
and safety of alpha-1 blockers for benign prostatic hyperplasia: an overview of
15 systematic reviews - Curr Med Res Opin. 2013 Jan 16 - "Doxazosin could significantly reduce urinary symptom
scores compared with tamsulosin (MD -1.60, 95%CI -1.80--1.40) and alfuzosin
(MD1.7, 95%CI 0.76-1.64). Indirect evidence suggested that the urinary symptom
score and PUF at end point in men treated with naftopidil were similar to those
treated with other α1-blockers. α1-blockers generally lead to more adverse
effects compared with placebo, and those caused by terazosin were more frequent
than others. Conclusions: α1-blockers are more effective than placebo for BPH,
doxazosin and tamsulosin seem to be more effective than other α1-blockers. The
adverse effects caused by α1-blockers are generally mild and well tolerated"
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Dutasteride/Tamsulosin: in benign prostatic hyperplasia - Drugs Aging. 2012
May 1;29(5):405-19 -
"Dutasteride 0.5 mg/day plus tamsulosin 0.4���mg/day
improved lower urinary tract symptoms (LUTS) to a significantly greater extent
than dutasteride or tamsulosin alone in men with BPH, moderate to severe LUTS
and an increased risk of disease progression, according to the results of the
randomized, double-blind, multinational CombAT trial. The mean change from
baseline in the total International Prostate Symptom Score was significantly
greater with dutasteride plus tamsulosin than with dutasteride or tamsulosin
alone after 2 years (primary endpoint) and 4 years of therapy. After 4 years'
therapy in the CombAT trial, the time to first acute urinary retention or
BPH-related surgery (primary endpoint) significantly favoured men with
symptomatic BPH who were receiving dutasteride plus tamsulosin versus those
receiving tamsulosin alone, with no significant difference between recipients of
dutasteride plus tamsulosin and recipients of dutasteride alone. In the CombAT
trial, health-related quality of life and treatment satisfaction were improved
to a significantly greater extent with dutasteride plus tamsulosin than with
dutasteride or tamsulosin alone. Combination therapy with oral dutasteride plus
tamsulosin was generally well tolerated in patients with symptomatic BPH in the
CombAT trial" - See
dutasteride (Avodart) 30 x 0.5mg capsules at International Antiaging
Systems.
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A randomized
crossover study comparing patient preference for tamsulosin and silodosin in
patients with lower urinary tract symptoms associated with benign prostatic
hyperplasia - J Int Med Res. 2011;39(1):129-42 - "A
significant difference was observed between the proportion of patients who
preferred tamsulosin (59/84 patients; 70.2%) and those who preferred silodosin
(18/84 patients; 21.4%). A major reason for preference of either drug was 'good
efficacy'. Incidence of adverse effects was significantly lower with tamsulosin
(3/91 patients; 3.3%) than with silodosin (25/88 patients; 28.4%). These
findings indicate that tamsulosin is very effective for BPH, has few adverse
effects and that patients want to continue to use it" - See tamsulosin
(generic Flomax) at
OffshoreRx1.com.
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The effects of combination therapy with dutasteride plus tamsulosin on clinical
outcomes in men with symptomatic BPH: 4-year post hoc analysis of European men
in the CombAT study - Prostate Cancer Prostatic Dis. 2011 Apr 19 -
"Patients were randomised to daily tamsulosin 0.4 mg,
dutasteride 0.5 mg or both for 4 years ... Combination therapy significantly
reduced the relative risk of AUR or BPH-related surgery compared with either
monotherapy at 4 years, and also significantly reduced the risk of BPH clinical
progression. Combination therapy also provided significantly greater symptom
improvement than either monotherapy at 4 years. Safety and tolerability of
dutasteride plus tamsulosin was consistent with previous experience of this
combination and with the monotherapies. These data provide further evidence to
support the use of long-term combination therapy (dutasteride plus tamsulosin)
in men with moderate-to-severe lower urinary tract symptoms because of BPH and
prostatic enlargement"
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Comparison
of Effects of Alpha Receptor Blockers on Endothelial Functions and Coagulation
Parameters in Patients with Benign Prostatic Hyperplasia - Urology. 2011 Jan
20 - "When coagulation tests were evaluated, there were
significant increases in bleeding and coagulation times in the groups using
doxazosin and terazosin. Doxazosin and terazosin lowered arterial blood pressure
significantly compared with other treatments. With regard to effects on
endothelial function, there were significant differences in flow-mediated
dilation rates of the brachial artery at 60 and 90 seconds before and during
treatment in the alfuzosin and terazosin groups ... Alpha receptor blockers can
decrease the risk of cardiovascular complications by both reducing platelet
aggregation and protecting endothelial functions in patients with prostatic
hyperplasia. The only drug with a favorable effect in all 4 areas of interest,
including BPH symptoms, blood pressure, platelet aggregation, and endothelial
functions, was terazosin"
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Reduction of
Prostate-specific Antigen After Tamsulosin Treatment in Patients With Elevated
Prostate-specific Antigen and Lower Urinary Tract Symptoms Associated With Low
Incidence of Prostate Cancer at Biopsy - Urology. 2010 Jun 8 -
"A total of 80 patients completed the present study. The
mean patient age was 66.3 years, and the mean PSA level was 7.8 +/- 8.4 ng/mL at
baseline and 7.1 +/- 9.1 ng/mL after treatment (P < .001). A total of 29
patients (36.25%) were diagnosed with prostate cancer from the biopsy findings.
A significant increment in the PSA level was observed in patients with prostate
cancer (6.7 versus 7.9 ng/mL; P = .002). A significant decrease in the PSA level
was observed in patients with negative biopsy findings (6.9 versus 5.1 ng/mL, P
= .000). Of the 38 patients with a decrease in the PSA level, 1 (2.6%) was
diagnosed with prostate cancer and 37 (97.4%) with an benign prostatic
hyperplasia/prostatitis. Of the 42 patients with no change in the PSA level, 28
(66.7%) had prostate cancer and 14 (33.3%) had negative findings. A change in
PSA level after treatment gave a sensitivity of 96.6%, specificity of 72.5%, and
diagnostic accuracy of 81% for prostate cancer. CONCLUSIONS: Treatment with
tamsulosin seemed to reduce the PSA levels and identified patients at high risk
of prostate cancer"
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Effect of
dutasteride, tamsulosin and the combination on patient-reported quality of life
and treatment satisfaction in men with moderate-to-severe benign prostatic
hyperplasia: 4-year data from the CombAT study - Int J Clin Pract. 2010 May
7 - "Subjects were randomised to receive 0.5 mg
dutasteride, 0.4 mg tamsulosin or the combination once daily for 4 years ... At
4 years, combination therapy resulted in significantly superior improvements
from baseline in BII and IPSS Q8 than either monotherapy; these benefits were
observed from 3 months onwards compared with dutasteride and from 9 months (BII)
or 12 months (IPSS Q8) onwards compared with tamsulosin. Also at 4 years, the
PPSM questionnaire showed that a significantly higher proportion of patients was
satisfied with, and would request treatment with, combination therapy compared
with either monotherapy. Conclusions: Combination therapy (dutasteride plus
tamsulosin) provides significantly superior improvements in patient-reported
quality of life and treatment satisfaction than either monotherapy at 4 years in
men with moderate-to-severe BPH symptoms" - See dutasteride at
OffshoreRx1.com.
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alpha-Blocker Use Is Associated With Decreased Risk of Sexual Dysfunction
- Urology. 2009 May 8 - "Lower urinary tract
symptoms (LUTS) ... alpha-Blocker use was associated with a decreased risk
of sexual dysfunction across all domains for men >/=50 years old
(age-adjusted hazard ratio 0.53-0.69). A decreased risk of erectile
dysfunction and low libido remained significant only among those using
alpha-blockers who also experienced an improvement in LUTS (P = .01)"
-
Safety
and efficacy of the simultaneous administration of udenafil and an
alpha-blocker in men with erectile dysfunction concomitant with BPH/LUTS
- Int J Impot Res. 2009 Feb 5 - "The
coadministration of udenafil and an alpha-blocker in patients with comorbid
BPH and ED was safe and gave significant improvements in both LUTS and ED"
- Note: Udenafil isn't available in the U.S. but it would seem that the
results would be the same with the competition.
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Association of Sexual Dysfunction With Lower Urinary Tract Symptoms of BPH
and BPH Medical Therapies: Results From the BPH Registry - Urology. 2009
Jan 21 - "The severity of lower urinary tract
symptoms (LUTS) has correlated with erectile dysfunction (ED) and
ejaculatory dysfunction (EjD) ... The alpha(1A)-subtype nonsuperselective
quinazoline alpha(1)-blockers alfuzosin, doxazosin, and terazosin appeared
to be associated with better ejaculatory function than were the
alpha(1A)-subtype superselective sulfonamide alpha(1)-blocker tamsulosin,
5alpha-reductase inhibitors, and alpha(1)-blocker plus 5alpha-reductase
inhibitor combination therapy"
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Sexuality and the management of BPH with alfuzosin (SAMBA) trial - Int J
Impot Res. 2008 Dec 11 - "Alfuzosin for the
treatment of patients with BPH is effective in improving sexual function, as
well as lower urinary tract symptoms (LUTSs) and quality of life, and is
well tolerated"
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