Document Detail

A Comparison of Varying alpha-Blockers and Other Pharmacotherapy Options for Lower Urinary Tract Symptoms.
MedLine Citation:
PMID:  16986051     Owner:  NLM     Status:  In-Data-Review    
alpha(1)-Adrenoceptor antagonists are now well established as the most common treatment for lower urinary tract symptoms (LUTS) suggestive of bladder outflow obstruction associated with benign prostatic hyperplasia. Both alpha(1)-adrenoceptor antagonists and 5alpha-reductase inhibitors are accepted treatments for LUTS, but with finasteride this applies only to patients with clinically enlarged prostates, whereas alpha(1)-adrenoceptor antagonists are considered to be appropriate treatment for all patients, irrespective of prostate size. Systematic analyses of placebo-controlled studies show that commonly used alpha(1)-blockers are significantly superior to placebo in improving urinary flow and reducing symptoms. Efficacy of alpha-blockers appears to be well maintained over time, and there is no evidence of tolerance or tachyphylaxis to alpha(1)-blockade after 6-12 months' usage. Direct comparative trials show that, in the short term, alpha(1)-adrenoceptor antagonists are more effective than finasteride in reducing symptom score. For alpha(1)-adrenoceptor antagonists, the most commonly reported adverse effects are dizziness, asthenia, postural hypotension, and syncope. Alfuzosin has a more pronounced effect on blood pressure than does tamsulosin, especially in elderly patients. Tamsulosin is well tolerated and has minimal effects on blood pressure; tamsulosin 0.4 mg has the lowest potential to reduce blood pressure and causes less symptomatic orthostatic hypotension than terazosin.
Christopher R Chapple
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Reviews in urology     Volume:  7 Suppl 4     ISSN:  1523-6161     ISO Abbreviation:  Rev Urol     Publication Date:  2005  
Date Detail:
Created Date:  2006-09-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100889067     Medline TA:  Rev Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S22-30     Citation Subset:  -    
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