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Home > Health Conditions > Hypertension > Alpha Blockers

Alpha Blockers

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News & Research:

  • 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.
  • 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)."
  • 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.
  • 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)"
  • 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"
  • 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.
  • Use of alpha-Blockers for Hypertension Declined After Publication of Unfavorable Clinical Trial Results - Doctor's Guide, 1/6/04

Abstracts:

  • 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.
  • 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"
  • 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.
  • 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.
  • 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"
  • 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"
  • 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"
  • 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.
  • 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.
  • 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"
  • 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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