The evolution of alpha blocker therapy for benign prostatic hyperplasia BPH has focused on improving convenience and tolerability. Indications for treating BPH include reversing signs and symptoms or preventing progression of the disease. All are well tolerated and have comparable dose-dependent effectiveness. Tamsulosin and alfuzosin SR do not require dose titration. Benign prostatic hyperplasia BPH describes a proliferative process of both stomal and epithelial elements of the prostate.
Flomax is a drug that is often used Alpha blockers prostate treat benign prostatic hyperplasia BPH. The catheter is usually attached to a drainage bag, which you strap on to your body under your clothing. Finasteride for benign prostatic hyperplasia. The major preparations are goserelin Zoladexleuprolide Lupron, Eligard, ViadurAlpha blockers prostate triptorelin Trelstar. GreenLight XPS for treating benign prostatic blociers. Sleep deprivation: A cause of high blood pressure?
Naked viking. Browse by Topic
Guideline on the management of benign prostatic hyperplasia BPH Interestingly, in a recent randomized, placebo-controlled study of men at high risk for BPH progression PSA levels between 1. Alpha blockers prostate risk of first Alpha blockers prostate phenomenon may be reduced or eliminated Alpha blockers prostate gradual-dose titration, since the adverse effects of Prazosin are dose-related. Secuado Secuado asenapine is a transdermal atypical antipsychotic formulation Cochrane Database of Systematic Reviews. If this occurs, see a doctor immediately or you could suffer permanent damage. On the other hand, the drug a elevates risk for floppy iris syndrome, and b might show adverse drug reactions ADRs characteristic of the sulfa related drugs. The first effective treatment for benign prostatic hyperplasia BPH was a non-selective alpha blocker phenoxybenzamine which was irreversible. Alpha Blockers for Prostatitis. International Brazilian Journal of Urology. Eliminations half-life for terazosin is between 8—13 hours. All rights reserved.
- Alpha-1 blockers also called alpha-adrenergic blocking agents constitute a variety of drugs that reduce the effect alphaadrenergic receptors.
- Alpha-blockers are medicines that are mainly used to treat high blood pressure hypertension and problems with passing urine in men who have enlargement of the prostate gland.
- Alpha blockers for prostatitis are prescribed for all symptomatic types of prostatitis.
- Alpha blockers are used in combination with other drugs to treat high blood pressure and can treat prostate problems in men.
But Flomax does not work well for everyone. Some alternatives can help men with this condition relieve their symptoms and feel better. Benign prostatic hyperplasia BPH or an enlarged prostate can cause painful and frequent urination, bladder stones , and incontinence. According to one estimate , nearly 1 in 5 men between 55 and 74 experience this condition.
Flomax, the branded version of the drug tamsulosin, is often prescribed to relieve the symptoms of BPH. Commonly known as alpha-blockers , these drugs change the behavior of the hormones adrenaline and noradrenaline.
This can relax muscles in the urinary tract, making it easier to urinate. Flomax is considered a selective alpha-blocker, which means it targets the urinary tract specifically and has less effect on other muscles. In men with a moderately enlarged prostate who have no serious health issues, Flomax often works well. But for some, it causes unpleasant side effects. Common side effects of Flomax include:. For some men, however, the cost is also a significant concern.
Other alpha-blockers work in much the same way as Flomax. Hytrin, another generic drug, also works well. Both drugs are nonselective alpha-1 blockers, which means they can lower a person's blood pressure.
Selective alpha-blockers, such as Flomax, can also lower blood pressure but not quite as much as nonselective alpha-blockers. They do this by preventing the body from converting testosterone into dihydrotestosterone DHT.
DHT can cause the prostate to grow, putting pressure on the urethra and making it difficult for the urine to flow. Drugs in this group include Avodart dutasteride and Proscar finasteride. These drugs may lower libido, cause problems with ejaculation, or lead to erectile dysfunction ED. Rarely, they can cause gynecomastia, a condition in which a man develops breasts. Phosphodiesterase-5 inhibitors are drugs for erectile dysfunction ED. Sometimes phosphodiesterase-5 inhibitors are used alongside other BPH drugs to combat erectile side effects.
Drugs in this group include:. These drugs can cause headaches, nausea, and drops in blood pressure. Rarely, they may cause a painful erection that does not go away. Combining certain medications may help when a single drug does not work. Occasionally, doctors use other drugs on an off-label basis to treat BPH.
It is crucial for a person to discuss the risks and benefits of BPH medications with their doctor. When drug treatment fails or when there are other problems with the prostate, such as frequent prostate infections, a doctor might recommend a prostatectomy.
A prostatectomy is a procedure in which the surgeon removes all or a portion of the prostate. In some people, this can alleviate symptoms with few or no side effects. However, a prostatectomy may cause incontinence , sexual dysfunction, and other health concerns.
A less invasive treatment heats the prostate, often with a laser, and can slow prostate growth. This procedure may require general anesthesia. Less frequently, a doctor may recommend the temporary or permanent use of a catheter. A catheter is a tube that goes through the urethra to help empty the bladder. It can help people whose prostates are very large and swollen. A catheter can also be used as a temporary remedy when the prostate has swollen due to surgery or another medical procedure.
Some herbal remedies may help with some symptoms of BPH. Those include:. It is essential to speak with a doctor before using any supplements.
A person should also be aware that the United States Food and Drug Administration FDA do not monitor the effectiveness, quality, or safety of supplements. A few lifestyle changes may improve symptoms, but they will not reverse BPH.
Those remedies include:. Men should see a doctor if they suspect they have BPH, as some other disorders, including prostate cancer , might cause similar symptoms to BPH. A person should see a doctor if they experience difficulty urinating, painful urination, or frequent urination. A person with BPH whose symptoms suddenly worsen should also see a doctor. BPH is a manageable condition but left untreated it can be uncomfortable and even dangerous.
Not everyone responds to Flomax, so people who continue to experience strong urges to urinate or other urinary symptoms should discuss this with their doctors. Another drug, a combination of multiple drugs, or the right lifestyle changes might improve symptoms. How does diet affect the prostate? In this article, learn about which foods to eat and which to avoid if you have an enlarged prostate gland.
Treatment for benign prostate conditions, such as hyperplasia, can have many complications and an extensive recovery time. Flomax is a drug that is often used to treat benign prostatic hyperplasia BPH.
It is an alpha-blocker and it affects the hormones adrenaline and…. Viagra treats erectile dysfunction and pulmonary arterial hypertension. For sexual purposes, it helps someone with erectile dysfunction achieve and…. Prostate cancer affects men. Find out about the symptoms, treatments, and causes.
Are there any alternatives to Flomax? What is Flomax? Other alpha-blockers for BPH. Other drugs for BPH. Other medical treatments for BPH. Lifestyle changes and home remedies. When to see a doctor. Latest news Monkeys: Past social stress impacts genes, health. Could an existing heart drug help treat cancer? Brain activity has role in human aging and longevity. Which foods are beneficial for a healthy gut microbiome? Douching linked to dangerous chemicals in blood. What are bone metastases in prostate cancer?
What to expect from Lupron treatment. Prostate cancer and back pain. PSA levels after prostatectomy. Related Coverage. What foods are good for an enlarged prostate? What happens if you have prostate surgery? Uses and risks of viagra Viagra treats erectile dysfunction and pulmonary arterial hypertension. Prostate cancer in detail Prostate cancer affects men.
Enlarged prostate treatments. Relationship of symptoms of prostatism to commonly used physiological and anatomical measures of the severity of benign prostatic hyperplasia. The BMJ. Adding these six foods to your diet may reduce your risk for prostate cancer. Whelton PK, et al. All rights reserved. As a result, the vessels remain open and relaxed.
Alpha blockers prostate. When are alpha-blockers usually prescribed?
Alpha Blockers for the Treatment of Benign Prostatic Hyperplasia
Medicine is a rapidly changing field. And a steady stream of new treatments continues to improve the outlook for patients with a broad range of problems. This progress is wonderful, but many challenges remain and new ones continue to arise. It's particularly true of medications; some new drugs are indeed unique and novel, but many are modifications of existing drugs.
Developing, testing, and marketing new medications is expensive — and a business. And because clinical experience is limited when a drug is first approved, it takes time to learn if the benefits hold up and to recognize any side effects. The drug treatment for prostate disorders has come a long way. As of spring , new prescription medications are available for the two leading diseases, benign prostatic hyperplasia BPH and prostate cancer.
Although the medications do not represent dramatic breakthroughs, they can be helpful. Men with prostate problems should understand what's behind the names scribbled on their doctor's prescription form.
It begins with tiny microscopic nodules in the transition zone of the prostate. The location is important because the transition zone surrounds the urethra , the tube that carries urine from the bladder through the prostate, then out through the penis. Over time, the nodules of BPH enlarge and become macroscopic nodules. This slow process starts in midlife and continues at a steady pace; nearly all men who live to the age of 85 have macroscopic nodules of BPH.
But the nodules won't cause any trouble unless they press on the urethra, restricting the flow of urine much as a gardener's foot can pinch a hose. BPH responds to a number of treatments. Many gents with mild to moderate symptoms can manage the problems themselves with simple lifestyle adjustments see below ; others may decide to try herbal preparations such as saw palmetto. These symptoms may include a weak, slow urinary stream, a hesitancy and straining to urinate, prolonged voiding, dribbling at the end of urination, an inability to empty the bladder completely, an urgent, sometimes uncontrollable need to void, the frequent passage of small amounts of urine, and nighttime urination nocturia.
For many men, a few simple adjustments can reduce the bother of BPH. Here are a few tips:. Limit your intake of alcohol and caffeine and avoid them after midafternoon; both are diuretics that increase urine flow. Avoid medications that stimulate muscles in the bladder neck and prostate. Pseudoephedrine Sudafed and other decongestants are the chief culprits. Avoid medications with anticholinergic properties that weaken bladder contractions.
Various antidepressants and antispasmodics have similar properties. If you are taking diuretics for high blood pressure or heart problems, ask your doctor to consider reducing your dose or substituting another medication that will work as well. Never pass up a chance to use the bathroom, even if your bladder does not feel full. Take your time, so you empty your bladder as much as possible.
Plan to stop at regular intervals during car trips. Request an aisle seat for air travel or at theatrical and sports events. When you are in new surroundings, learn the location of the bathroom before you really need it.
Men with complications such as urinary bleeding, recurrent urinary tract infection, acute urinary retention, and kidney damage due to back pressure from urine hydronephrosis need treatment. Fortunately, these problems are relatively uncommon. Men with uncomplicated BPH can reasonably decide to "live with" symptoms that don't impair their quality of life to a significant degree. And men who are bothered enough to seek treatment can choose between an expanding array of surgical therapies and an increasing number of prescription drugs.
Alpha blockers don't change the size or structure of the prostate. Instead, they relax the smooth muscle cells in the bladder neck and in the prostate itself. The alpha blockers act quickly, taking effect in days to weeks, but their benefits disappear just as rapidly if they are discontinued.
All the alpha blockers work the same way, and all have similar success rates. But they do have different side effects and drug interactions. The difference depends on whether the medications act selectively on the smooth muscle cells in the urinary tract or if they also relax the smooth muscle cells in the walls of arteries throughout the body.
The older alpha blockers act on both groups of muscles. In fact, terazosin Hytrin and doxazosin Cardura were originally developed to treat high blood pressure; they continue to fill that role but are considered third-tier antihypertensive medications. Because they lower blood pressure, the nonselective alpha blockers can produce lightheadedness, dizziness, or even fainting, particularly when men stand up quickly.
It also means that they should be used with caution by men with a somewhat low blood pressure, by men taking other antihypertensives, and by men taking sildenafil Viagra — and they should not be used at all by men taking vardenafil Levitra or tadalafil Cialis for erectile dysfunction. Finally, the potential to lower blood pressure means their dosage must be adjusted gradually. Doctors usually start with 1 milligram mg of either medication at bedtime, and then gradually increase it as needed to a maximum of 10 mg of terazosin or 8 mg of doxazosin.
Nasal congestion, dizziness, headache, or fatigue sometimes occurs. Dry mouth and swelling in the ankles are less common. Hypotension low blood pressure , although rare, may pose a problem for some men using doxazosin or terazosin. Doctors should prescribe a low dose of doxazosin or terazosin, and then increase gradually if needed. This approach isn't necessary for tamsulosin and alfuzosin because those drugs do not lower blood pressure.
Uroxatral is less likely to cause diminished ejaculation. Decreased libido, decreased volume of ejaculate, and impotence may occur rarely. Helps shrink larger prostate glands. Reduces need for surgery. Not beneficial for small prostates. Slow to act; can take up to two years to see full benefits.
Can lower PSA levels considerably. The third alpha blocker, tamsulosin Flomax , is a bit different. As a result, dosing is simpler: 0. A low dose of tamsulosin can be used cautiously by men taking vardenafil or tadalafil.
The newest alpha blocker for BPH as of is alfuzosin Uroxatral. Like tamsulosin, alfuzosin is a selective alpha blocker, so it does not lower blood pressure. Uroxatral is a time-release formulation of alfuzosin, so a single mg tablet is taken once a day immediately after a meal. It has not been evaluated in men taking pills for erectile dysfunction, but it's probably similar to tamsulosin. Alfuzosin costs about the same as the 0. Unlike the alpha blockers, the second group of drugs for BPH actually shrink the gland.
The prostate is stimulated by the male hormone testosterone. But these drugs don't stop the testicles from producing the male hormone, nor do they reduce the amount in the blood. Instead, they inhibit 5 alpha-reductase , the enzyme that normally converts testosterone to dihydrotestosterone DHT , the chief male hormone in the prostate. This selective action explains why these medications affect some male traits without changing others.
Because DHT is central to testosterone's action in the prostate and the hair follicles, the inhibitors are active in these regions. But since testosterone can act in other tissues without being converted to DHT, they do not influence other male characteristics such as sperm production, musculature, or voice, and they affect libido and potency only infrequently.
In the first 5 alpha-reductase inhibitor, finasteride , was greeted enthusiastically when it was marketed in a 5-mg dose as Proscar. Until then, surgery was the only effective treatment for BPH. Some of that enthusiasm has worn off as it has become clear that finasteride does not help all men with BPH and as alpha blockers have proved their worth.
On average, the drug takes three to six months to begin reducing the size of the prostate, and the gland may continue to shrink during the next 12—18 months if treatment is continued. In general, men with glands smaller than 30—40 ml should not expect to improve. In men with larger glands, though, the drug can reduce symptoms, control urinary bleeding caused by BPH, lower the risk of acute urinary retention, and lower the need for surgery.
The new player in the 5 alpha-reductase-inhibitor game as of spring is dutasteride Avodart. It inhibits both forms of 5 alpha-reductase; a 0. Like finasteride, it has no effect on testosterone levels.
Dutasteride also acts slowly, producing some reduction in symptoms in as little as one month, with maximum benefit in six months. Although finasteride and dutasteride have not been compared in head-to-head trials, they seem very similar in their effectiveness. To benefit, however, men must take the medication every day. Even with prolonged use, the drugs appear equally safe. Men who choose to monitor their PSAs should take the test before starting the drug and another after 6—12 months of therapy.
How do the 5 alpha-reductase inhibitors compare to the alpha blockers? Only the older drugs have been investigated to date. A study of 1, men compared terazosin, finasteride, and a combination of the two with a placebo.
At the end of a year, terazosin was the clear winner. Combination therapy was no better than the alpha blocker alone. Finasteride was no better than the placebo, but that does not mean the drug is worthless, since many men in the study did not have the large prostates that respond best to finasteride.
However, a major trial found potentially important benefits for long-term combination therapy. In that study, 3, men with BPH were randomly assigned to take doxazosin, finasteride, a combination of the two, or a placebo. This large study shows that doctors are learning to use old drugs in new ways.
But it's too soon to recommend combination therapy for all men with moderate BPH. For one thing, serious complications were uncommon even in men taking only an alpha blocker.