Alpha-blockers for BPH

Most often used medications for BPH

Alpha-blockers relax muscles in the bladder neck and prostate so that urine can flow more easily.

Alpha-blockers: Non-selective and selective

Alpha-blockers relieve the symptoms of BPH by relaxing the "smooth" muscles of the prostate and the bladder neck. In effect, alpha-blockers "unclamp" the hose (the urethra) allowing urine to flow more freely. Although alpha-blockers do not change the size of the prostate, they work quickly to relieve symptoms, sometimes in a matter of days or weeks. All the alpha-blockers used in the treatment of BPH are considered to be equally effective but their side effects differ.12

Non-selective alpha-blockers relax the muscles in the blood vessels and may lower blood pressure. This can cause symptoms such as dizziness, lightheadedness (especially when standing or sitting up abruptly), and fainting. These alpha-blockers may not be a good choice for men who already take medicines for high blood pressure or men with normal or low blood pressure.

Some alpha-blockers

Selective alpha-blockers like RAPAFLO® work specifically to relax muscles in the prostate and bladder neck and do not have much of an effect on blood pressure. RAPAFLO® is the newest of the selective alpha-blockers. It was designed to target just the areas of the body involved in BPH: the prostate and neck of the bladder, the urethra, and surrounding tissues.

Selective alpha-blockers

The selective action of RAPAFLO® provides rapid relief of BPH symptoms. Urine flow improves within 2 to 6 hours of taking the first dose.2,3 And improvement in symptoms can start within 3 to 4 days.3 RAPAFLO® relieves both urination problems and problems with storing urine. Talk to your doctor, and learn how RAPAFLO® can help.

Urination problems: delay or difficulty in starting the urine stream, weak urinary stream, stream that starts and stops, incomplete emptying of the bladder.

Urine storage problems: frequent urination, urge to urinate right away, waking at night to urinate

Side effects of alpha-blockers may include lightheadedness upon standing or sitting up abruptly, dizziness, tiredness, headache, and nasal congestion. With highly selective agents, it is also common for men to experience orgasm with reduced or no semen. Side effects stop if medication is stopped.

Work with your doctor.

If you stop treatment, BPH symptoms may return.

Since every man is different, you and your doctor will work together to find the right medication at the right dose. In some cases, your doctor may prescribe more than one type of drug to control BPH.12

Some plant products such as saw palmetto and Pygeum africanum have been used in other parts of the world to relieve the symptoms of BPH.13[Ref 13, Fagelman, p23, para1, para6, p25, pra5] However, there is no definitive clinical evidence that shows these natural BPH remedies are effective in the treatment of BPH, and the American Urological Association does not recommend their use.12

References
  1. Fenter TC, Naslund MJ, Shah MB, et al. The cost of treating the 10 most prevalent diseases in men 50 years of age or older. Am J Manag Care. 2006;12(4 suppl):S90-S98.
  2. RAPAFLO® (silodosin) Capsules full Prescribing Information, November 2009.
  3. Marks LS, Gittelman MC, Hill LA, Volinn W, Hoel G. Rapid efficacy of the highly selective α1A-adrenoceptor antagonist silodosin in men with signs and symptoms of benign prostatic hyperplasia: pooled results of 2 phase 3 studies. J Urol. 2009;181:2634-2640.
  4. National Institute of Diabetes and Digestive and Kidney Diseases. Prostate enlargement: benign prostatic hyperplasia. NIH Publication No. 07-3012. June 2006.
  5. Bruskewitz RC. Quality of life and sexual function in patients with benign prostatic hyperplasia. Rev Urol. 2003;5:72-80.
  6. Roberts RO, Jacobsen SJ, Rhodes T, et al. Natural history of prostatism: impaired health status in men with lower urinary tract symptoms. J Urol. 1997;157:1711-1717.
  7. http://www.dictionary.com
  8. Atlas of Human Anatomy, Frank H. Netter, MD, Ciba-Geigy Corporation, Summit, NJ, 1989.
  9. Data on file, Watson Laboratories, Inc.
  10. Marks LS, Gittelman MC, Hill LA, Volinn W, Hoel G. Silodosin in the treatment of the signs and symptoms of benign prostatic hyperplasia: a 9-month, open-label extension study. Urology. 2009;74:1318-1322.
  11. Agency for Healthcare Quality and Research (U.S. Dept Health and Human Services): Quick Tips When Talking With Your Doctor. Available at: http://www.ahrq.gov/consumer/quicktips/doctalk.htm. Accessed July 28, 2010.
  12. American Urological Association. AUA guideline on management of benign prostatic hyperplasia (2003). Chapter 1: Diagnosis and treatment recommendations. J Urol. 2003;170:530-547.
  13. Fagelman E, Lowe FC. Herbal medications in the treatment of benign prostatic hyperplasia (BPH). Urol Clin N Am. 2002;29:23-29, vii.
  14. National Institute on Aging: Talking With Your Doctor: A Guide For Older People. NIH Publication No. 05-3452. August 2005 (Reprinted April 2010). Available at: http://www.nia.nih.gov/NR/rdonlyres/90DF996C-DF5F-4245-B7CA-B2E1B993D8C7/0/TWYD_0521_web.pdf. Accessed July 29, 2010.
  15. Medline Plus Medical Encyclopedia from NIH: Enlarged Prostate. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000381.htm. Accessed July 29, 2010.
  16. Shvartzman P, Borkan JM, Stoliar L, et al. Second-hand prostatism: effects of prostatic symptoms on spouses’ quality of life, daily routines and family relationships. Family Pract. 2001;18:610-613.
  17. Kuritzky L. A primary care physician’s perspective on benign prostatic hyperplasia. Rev Urol. 2003;5(suppl 5):S42-S48.
  18. Wolters R, et al: Lower urinary tract symptoms: social influence is more important than symptoms in seeking medical care. BJU Int. 2002;90:655–661.
  19. Rosen RC, Giuliano F, Cason CC. Sexual dysfunction and lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). Eur Urol. 2005;47:824–837.
  20. Ponholzer A, Madersbacher S. Lower urinary tract symptoms and erectile dysfunction; links for diagnosis, management and treatment. Int J Impot Res. 2007;19:544-550.
  21. MacDiarmid SA, Hill LA, Volinn W, Hoel G. Lack of pharmacodynamic interaction of silodosin, a highly selective α1a-adrenoceptor antagonist, with the phosphodiesterase-5 inhibitors sildenafil and tadalafil in healthy men. Urology. 2010;75:520-525.
  22. Marks LS. Reply to editorial comment. Urology. 2009;74:1323-1324.
  23. Schwinn DA, Roehrborn CG. α1-Adrenoceptor subtypes and lower urinary tract symptoms. Int J Urol. 2008;15:193-199.
  24. Straus SM, Kors JA, De Bruin ML, et al. Prolonged QTc interval and risk of sudden cardiac death in a population of older adults. J Am Coll Cardiol. 2006;47:362-367.
  25. Carbone DJ, Hodges S. Medical therapy for benign prostatic hyperplasia: sexual dysfunction and impact on quality of life. Int J Impot Res. 2003;15:299-306.
  26. Nomiya M, Yamaguchi O. A quantitative analysis of mRNA expression of alpha 1 and beta-adrenoceptor subtypes and their functional roles in human normal and obstructed bladders. J Urol. 2003;170(2 Pt 1):649-653.
  27. Murata S, Taniguchi T, Takahashi M, et al. Tissue selectivity of KMD-3213, an α1-adrenoreceptor antagonist, in human prostate and vasculature. J Urol. 2000;164:578-583.
  28. Stafford-Smith M, Bartz R, Wilson K, et al. Alpha-adrenergic mRNA subtype expression in the human nasal turbinate. Can J Anesth. 2007;54:549-555.
  29. Wei JT, Calhoun E, Jacobsen SJ. Urologic Diseases in America Project: benign prostatic hyperplasia. J Urol. 2008;179(5 Suppl.):S75-S80.
  30. Issa MM, Regan T. Medical therapy for benign prostatic hyperplasia—present and future impact. Am J Manag Care. 2007;13:S4-S9.
  31. Berry SJ, Coffey DS, Walsh PC, et al. The development of human benign prostatic hyperplasia with age. J Urol. 1984;132:474.
  32. Nickel JC. Comparison of clinical trials with finasteride and dutasteride. Rev Urol. 2004;6 Suppl 9:S31-39.
  33. Hernández C, Estivill E, Prieto M, et al. Nocturia in Spanish patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH). Curr Med Res Opin. 2008;24:1033-1038.

RAPAFLO® is indicated for the treatment of the signs and symptoms of benign prostatic hyperplasia (BPH).

RAPAFLO® is not indicated for the treatment of hypertension.

Important Safety Information

RAPAFLO® is available only by prescription and is approved to treat male urinary symptoms due to BPH, also called an enlarged prostate. RAPAFLO® should not be used to treat high blood pressure. Only your doctor can tell if you have BPH, not a more serious condition like prostate cancer. RAPAFLO® should not be used in patients with severe liver or kidney disease as well as those taking certain antifungal or HIV drugs. Avoid driving or hazardous tasks until you know how RAPAFLO® will affect you, as a sudden drop in blood pressure may occur, rarely resulting in fainting. If considering cataract surgery, tell your eye surgeon you're currently taking RAPAFLO® or have taken it in the past. Side effects include a decrease or absence of semen during sex, dizziness, diarrhea, lightheadedness upon standing or sitting up abruptly, headache, swelling of the throat and nasal passages, and stuffy nose.

To report suspected adverse reactions, contact Watson Pharmaceuticals, Inc. at 1-800-272-5525
or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.