Combination antimuscarinics and alpha-blockers for benign prostatic hyperplasia

2007 ◽  
Vol 5 (2) ◽  
pp. 71-77
Author(s):  
Scott A. MacDiarmid
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Prostatic Hyperplasia ◽  
Alpha Blockers

scholarly journals Alfuzosin for the medical treatment of benign prostatic hyperplasia and lower urinary tract symptoms: a systematic review of the literature and narrative synthesis

2021 ◽  
Vol 13 ◽  
pp. 175628722199328
Author(s):  
Andrea Mari ◽  
Alessandro Antonelli ◽  
Luca Cindolo ◽  
Ferdinando Fusco ◽  
Andrea Minervini ◽  
...  
Keyword(s):  
Systematic Review ◽  
Urinary Tract ◽  
Benign Prostatic Hyperplasia ◽  
Lower Urinary Tract Symptoms ◽  
Lower Urinary Tract ◽  
Prostatic Hyperplasia ◽  
Safety And Efficacy ◽  
Alpha Blockers ◽  
Urinary Tract Symptoms ◽  
Lower Urinary

Background: Lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) are a bothersome frequent symptom in adult males. This systematic review analyzed the available evidence on the pharmacokinetic and pharmacodynamic features of alfuzosin, and its clinical efficacy both as monotherapy and in combination with other drugs for the treatment of male LUTS/BPH. Methods: A systematic review of the last 10 years was performed using the MEDLINE, EMBASE and Cochrane libraries in March 2020. The protocol for this systematic review was registered on PROSPERO (Central Registration Depository: CRD42020136120) and is available in full on the University of York website. Results: Alfuzosin is a quinazoline derivative and, although a nonspecific α1-blocker, exhibits a selective concentration in the prostate compared with plasma in patients with BPH. Three registration trials assessed the safety and efficacy of alfuzosin. The 10 mg daily formulation has a three-layered matrix containing the active substance between two inactive coats allowing a drug release over 20 h. Alfuzosin showed high tolerability, few vasodilatory effects and a low rate of ejaculation disorders over older alpha-blocking compounds thanks to the high uroselectivity of alfuzosin and its preferential concentration at urinary level. Six randomized clinical trials (RCTs) assessed efficacy and safety of alfuzosin versus other alpha-blockers ± placebo: three studies comparing with tamsulosin, one with doxazosin, and two with silodosin or tamsulosin. One RCT investigated the clinical outcomes of alfuzosin with finasteride, two with propiverine and two with phosphodiesterase-5 inhibitors. Conclusions: Alfuzosin is an effective drug for the treatment of LUTS/BPH, with a lower rate of sexual disorders compared with other alpha-blockers. Alfuzosin is also safe with low adverse events in case of concomitant antihypertensive therapy and in patients with cardiovascular morbidity. Safety and efficacy of alfuzosin has been reported also in case of combination therapy with antimuscarinic agents and PDE5i.

Prescriber Monitoring for Benign Prostatic Hyperplasia Within a Family Medicine Clinic

2012 ◽  
Vol 25 (2) ◽  
pp. 164-168
Author(s):  
Justin J. Sherman ◽  
Ron W. Welch ◽  
T. Matthew Hill ◽  
Corey McEwen
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Family Medicine ◽  
Adverse Effects ◽  
Chart Review ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Prostatic Hyperplasia ◽  
Symptom Index ◽  
Alpha Blockers ◽  
Medicine Clinic

Purpose: The purpose of this study was to compare prescriber monitoring for safety and efficacy of medication classes used to treat benign prostatic hyperplasia (BPH). Methods: This was a retrospective chart review of patients diagnosed with BPH who were prescribed medications within a family medicine clinic between January 2008 and August 2010. Patients were divided into those receiving nonselective and uroselective alpha-blockers, 5-alpha reductase inhibitors (5-ARIs), and combination therapy. A chart review was performed with regard to predetermined criteria to monitor how efficacy and adverse effects were assessed by providers in the clinic. Results: A general genitourinary assessment was documented most frequently for patients receiving 5-ARIs and least frequently in patients receiving nonselective alpha-blockers. A digital rectal examination was documented in 11% of patients. Prostate-specific antigen concentrations were assessed evenly across all medication classes and documented in 47% of eligible patients.  However, the American Urological Association Symptom Index and quality-of-life questions were not performed on any patients, and assessments of adverse effects were not documented. Conclusion:  Although prescribers in a family medicine clinic recorded a general genitourinary assessment for patients receiving BPH medications, a more standardized approach is needed.

scholarly journals Role of alpha blockers and 7-days catheterization in enhancing the success of trial void in acute urinary retention due to benign prostatic hyperplasia: a double-blind randomized control trial

2018 ◽  
Vol 5 (10) ◽  
pp. 3256
Author(s):  
Rohit Garagadahalli Rangaiah ◽  
Vilvapathy Senguttuvan Karthikeyan
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Urinary Retention ◽  
Acute Urinary Retention ◽  
Primary Outcome Measure ◽  
Prostatic Hyperplasia ◽  
Double Blind ◽  
Alpha Blockers ◽  
Treatment Groups ◽  
First Time

Background: Acute urinary retention (AUR) in patients with benign prostatic hyperplasia (BPH) is common. This study evaluated the efficacy of three alpha-blockers with urethral catheterization for 7 days in trial without catheter (TWOC).Methods: This was a prospective, randomized, double-blind, active-control study conducted between November 2013 and May 2016. Patients aged more than 50 years, presenting with first-time painful AUR due to BPH were enrolled in this study. Eligible patients were randomized (1:1:1) to one of the three treatment groups to receive tamsulosin 0.4 mg, alfuzosin 10 mg or silodosin 8 mg for one week. The primary outcome measure was successful TWOC at 7 days.Results: A total of 118 patients were included in the study (tamsulosin, n=40; alfuzosin, n=38; and silodosin, n=40). The baseline parameters were comparable between the three groups. A total of 84 (71.2%) patients had successful TWOC at the end of 7 days (tamsulosin, n=30 (75%); alfuzosin, n=32 (84%); and silodosin, n=22 (55%)) and was significantly (p=0.015) different between three groups. Higher age, larger volume at retention and higher prostate volume were significantly (p<0.05) associated with the failure of TWOC.Conclusions: Results from this study demonstrate that there is a definite role of 7-day catheterization with alpha blockers in improving the rates of success of TWOC in men presenting with AUR due to BPH. The success of TWOC is multifactorial.

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