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Uroxatral (Alfuzosin)
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Uroxatral

Generic Uroxatral is used for treating symptoms of benign prostatic hyperplasia (BPH) in men with an enlarged prostate. It may also be used for certain conditions.

Other names for this medication:

Similar Products:
Uroxatral, Cardura, Minipress, Terazosin, Flomax

 

Also known as:  Alfuzosin.

Description

Generic Uroxatral is an alpha-blocker. It works by blocking receptors in the lower urinary tract, causing smooth muscles in the bladder neck and prostate to relax. This relaxation improves urine flow and reduces the symptoms of BPH.

Generic name of Generic Uroxatral is Alfuzosin.

Brand name of Generic Uroxatral is Uroxatral.

Dosage

Take Generic Uroxatral by mouth with food. Take with meal every day.

Swallow Generic Uroxatral whole. Do not break, crush, or chew before swallowing.

Take Generic Uroxatral on a regular schedule to get the most benefit from it.

If you want to achieve most effective results do not stop taking Generic Uroxatral suddenly.

Overdose

If you overdose Generic Uroxatral and you don't feel good you should visit your doctor or health care provider immediately.

Storage

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) away from moisture, light and heat. Throw away any unused medicine after the expiration date. Keep out of the reach of children in a container that small children cannot open.

Side effects

The most common side effects associated with Uroxatral are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

Do not take Generic Uroxatral if you are allergic to Generic Uroxatral components.

Do not take Generic Uroxatral if you're pregnant or you plan to have a baby, or you are a nursing mother. Generic Uroxatral can harm your baby.

Do not take Generic Uroxatral if you have moderate to severe liver disease.

Do not take Generic Uroxatral if you are taking an alpha-blocker (e.g., prazosin), an azole antifungal (e.g., ketoconazole), or an HIV protease inhibitor (eg, ritonavir).

Sit up or stand slowly, especially in the morning.

Avoid situations in which injury could occur due to fainting.

Avoid alcohol.

Keep Generic Uroxatral away from children and don't give it to other people for using.

Do not stop taking Generic Uroxatral suddenly.

uroxatral 10 mg uses

Benign prostatic hyperplasia (BPH) is a prevalent disease, especially in old men, and often results in lower urinary tract symptoms (LUTS). This chronic disease has important care implications and financial risks to the health care system. LUTS are caused not only by mechanical prostatic obstruction but also by the dynamic component of obstruction. The exact etiology of BPH and its consequences, benign prostatic enlargement and benign prostatic obstruction, are not identified. Various theories concerning the causes of benign prostate enlargement and LUTS, such as metabolic syndrome, inflammation, growth factors, androgen receptor, epithelial-stromal interaction, and lifestyle, are discussed. Incomplete overlap of prostatic enlargement with symptoms and obstruction encourages focus on symptoms rather than prostate enlargement and the shifting from surgery to medicine as the treatment of BPH. Several alpha antagonists, including alfuzosin, doxazosin, tamsulosin, and terazosin, have shown excellent efficacy without severe adverse effects. In addition, new alpha antagonists, silodosin and naftopidil, and phosphodiesterase 5 inhibitors are emerging as BPH treatments. In surgical treatment, laser surgery such as photoselective vaporization of the prostate and holmium laser prostatectomy have been introduced to reduce complications and are used as alternatives to transurethral resection of the prostate (TURP) and open prostatectomy. The status of TURP as the gold standard treatment of BPH is still evolving. We review several preclinical and clinical studies about the etiology of BPH and treatment options.

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Alfuzosin hydrochloride is a novel drug used in the treatment of urinary incontinency. The purpose of this research was to develop controlled release floating matrix formulations of Alfuzosin HCl. Floating matrix tablets of Alfuzosin HCl were prepared using hydroxypropyl methylcellulose (HPMC), Polyethylene oxide (PEO), Carbopol 971P NF polymer (Direct compressible) and Blend of Polyvinyl Acetate and Povidone 30 (80:19:1(0.8% sodium laury sulfate and 0.2% silica)). Combination of citric acid and sodium bicarbonate were also used as gas forming agent. Matrix formulations were prepared by direct compression method and evaluated for floating, in vitro drug release profile and swelling characteristics. The mechanism of drug release was found to follow non-Fickian or anomalous type. The data obtained from the invitro release studies demonstrated that the floating matrix tablets containing HPMC 100K CR (controlled-release) and carbopol along with sodium CMC were found to sustain the release of drug over a period of 12 hours. Formulations containing 25% PEO 303WSR was also capable of sustaining delivery the release of Alfuzosin HCl.

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Alfuzosina has a specific antagonist effect on the alfa-1-adrenergic post-junctional receptor posed at urethral laeve musculature, prostatic capsule and vesical trgonum. It's and ideal drug the symptoms of the difficult urinary flow typical of the benign prostatic hypertrophia (IPB) and of some patologies of vesical collum to attenuate. With this work we want to demonstrate the anatomic alterations of vesical collum and prostatic urethra by means of dynamic recording mictional phase with transrectal scan carried out before and after treatment. In this study, 30 patients were divided into three groups of 10 in relation to the pathology: overtone of vesical collum, little benign prostatic ipertrophia and great benign prostatic ipertrophia have included. The patients of each group have also been divided in undergroups of five (selected with the method of double-blind) of which the first treated with alfuzosina 7.5 mg/die for 30 days and the second with placebo. Considering the limits of this study, the analysis of the results have permitted to conclude that the drug has determined a subjective improvement in all patients except those with great IPB, while the objective valuation, reached comparing scan dynamic pictures before and after treatment, has made it possible to visualize an improvement on the opening of the vesical collum and the prostatic urethra after therapy with great variations of the size of che mictional funnel and same prostatic urethra. The alfuzosina is efficacious, in the cases under examination, except the third group were the compression on the urethra was of an elevated degree.

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• To evaluate the efficacy of α-blockers with respect to improving stent-related symptoms. • Ureteric stents remain a source of marked discomfort and their placement is often required after certain ureteroscopic procedures or in the acute setting. This analysis identifies and reviews the several studies that have investigated the role of α-blockers after stent placement.

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A total of 135 men, including 43 in Group A, 48 in Group B and 44 in Group C, completed the study. Relative to baseline, all groups demonstrated significant reductions in OABSS and the IPSS after eight treatment weeks (p < 0.005). The improvement of OABSS in Group C was significantly greater than Group A and B (Group A: 0.70 ± 1.94; Group B: 2.50 ± 2.98; Group C: 4.30 ± 3.40; p < 0.005). An observed improvement of Qmax and PVR in the three groups did not achieve statistical significance. Overall adverse event rates were higher in Group C but not significant compared with others.

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A total of 42,769 men with incident BPH received any selective α-1 blocker or 5-ARI. Tamsulosin and dutasteride were the most widely prescribed agents of their respective drug classes. Predicted probabilities showed that urologists were more likely to prescribe alfuzosin (24.0% vs. 7.8%; P<0.001) and silodosin (2.3% vs. 0.4%; P<0.001) when compared with primary care providers (PCPs) at 6 months after diagnosis. Urologists were more likely to prescribe 5-ARIs but less likely to prescribe older α-1 blockers (terazosin, prazosin, and doxazosin) than PCPs at 6 months postdiagnosis.

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Of the 34 patients treated with alfuzosin SR, 17 (50%) resumed voiding and of the 28 patients from placebo group, 16 (57%) voided successfully. All 33 patients were continued open labelled on alfuzosin SR 5mg BD. Out of 33 patients, 13 (43%) had TURP within first year after TWOC and three died due to various medical causes. Out of remaining 17 patients, 15 attended for follow-up. The mean peak flow rate was 8.4 ml/s and the mean residual volume was 112 ml. Six patients (40%) required TURP for severe lower urinary tract symptoms (LUTS). So out of 28 patients followed at 2 year, 19 (68%) had TURP.

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Acute urinary retention (AUR) in males is managed conventionally by hospital admission, alpha-adrenergic therapy, and trial without catheter. To reduce inpatient bed pressures, we set up a protocol to manage such patients in the community. We review our results in this paper. We performed a prospective study of male patients presenting to our acute admissions ward and Accident and Emergency department over 6 months. Patients with chronic urinary retention, macroscopic haematuria, sepsis, urinary tract infection, and/or serum creatinine >130 mmol/l were excluded from the study. Those enrolled were catheterised, commenced on alfuzosin (10 mg nocte), and discharged to the community. A trial without catheter (TWOC) was performed 5-7 days later. QoL/IPSS, peak flow rate, and residual volume assessment were performed following successful TWOC 3 months later. Thirty-one male patients with a median age of 69 years were studied and the median residual volume following catheterisation was 900 ml. The aetiology of AUR was benign prostatic hyperplasia (BPH) in 29 patients and constipation in the remaining 2 patients. TWOC was successful in 19 patients (61.3%) following first TWOC, 26 (83.9%) following second trial of voiding. The mean peak flow rate was 6.5 ml/sec and postvoid scan 165 ml, following an immediate TWOC. At 3 months follow-up, mean peak flow rate was 13.2 ml/sec, postvoid scan 26.5 ml, IPSS 4.5, and QoL score was 2. This study has shown that AUR can be managed safely and effectively in the community. Effective communication with the nurse urology specialist, general practitioner, and emergency department are crucial for the successful implementation of the protocol.

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Drug therapy with alpha blockers has become the standard treatment for patients with benign prostatic hyperplasia. Medical treatment is often preferred by patients as opposed to minimally invasive therapy or transurethral resection of the prostate. Alpha blockers reduce urethral pressure by blocking the motor sympathetic adrenergic nerve supply to the prostate. Several alpha blockers are available for treatment of benign prostatic hyperplasia, including alfuzosin, tamsulosin, terazosin, and doxazosin. Different meta-analyses have shown these agents to be comparable in terms of efficacy in improving symptom score and increasing urinary flow rates. The clinical uroselectivity of these agents differs, however, and translates into differences in side effects. Side effects that have been reported with some alpha blockers include dizziness, headache, postural hypotension, and retrograde ejaculation.

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Alpha-blockers are used in urology to treat stenosis and lithiasis. The pathophysiology is similar in salivary glands. We had for aim to assess the safety and effectiveness of an alpha-blocker (Alfuzosin) in patients with ductal stenosis, allergic pseudo-parotitis or sialolithiasis after lithotripsy.

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In mouse ureters, silodosin (a selective alpha(1A)-adrenoceptor antagonist), doxazosin (a nonselective alpha(1)-adrenoceptor antagonist), terazosin (a nonselective alpha(1)-adrenoceptor antagonist), and alfuzosin (a nonselective alpha(1)-adrenoceptor antagonist) all shifted the norepinephrine concentration-response curve to the right. The rank order of potencies (pK(B) value) was silodosin (9.47 +/- 0.16) > doxazosin (8.62 +/- 0.15) > terazosin (8.39 +/- 0.16) > alfuzosin (8.03 +/- 0.12). In hamster ureters, all four antagonists shifted the phenylephrine concentration-response curve to the right, the rank order of potencies being silodosin (10.09 +/- 0.13) > doxazosin (8.22 +/- 0.16) > terazosin (7.75 +/- 0.15) > alfuzosin (7.70 +/- 0.10). In each case, silodosin was much more potent than the other three drugs.

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Currently alpha(1)-adrenergic receptor blocking agents are first line treatment for BPH. Although all alpha-blocking compounds show similar levels of efficacy for LUTS treatment, newer agents such as alfuzosin tend to demonstrate improved selectivity for the prostate and bladder with few vasodilatory effects and they have tolerability advantages over older alpha-blocking compounds. Immediate, sustained and newer extended release alfuzosin formulations significantly improve LUTS indicative of BPH but extended release alfuzosin may be more convenient to administer and it tends to show better vasodilatory tolerability than the older immediate release formulation.

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Relevant articles were identified through MEDLINE, EMBASE, and International Pharmaceutical Abstracts searches of the English-language literature published between 1986 and September 2003 using the terms alfuzosin, alpha-adrenergic receptor antagonists, and quinazolines. The reference lists of identified articles were also searched, as were abstracts from annual meetings of the American Urological Association for the past 5 years. Data regarding the ER formulation were emphasized, and data involving the IR/SR formulations were included only when data for the ER formulation were not available or as needed for clarification.

alfuzosin uroxatral dosage

Indirect comparison of data derived from the placebo-controlled studies involving 6,333 patients and the data derived from the direct comparative studies involving 507 patients demonstrate that all alpha1-adrenoceptor antagonists (alfuzosin, terazosin, doxazosin and tamsulosin) produce comparable improvements in LUTS and urinary flow. Total symptom score is in general improved by 30-40% and Qmax by 16-25%. The difference between currently available alpha1-adrenoceptor antagonists is related to their side effect profile. Alfuzosin (especially the sustained release formulation) and tamsulosin (modified release formulation 0.4 mg) seem to be better tolerated than terazosin and doxazosin. The percentage of patients that withdrew due to bothersome side effects with alfuzosin and tamsulosin 0.4 mg was comparable to that with placebo (about 4-10%) whereas in the terazosin and doxazosin studies an additional 4-10% of patients dropped out because they did not tolerate the therapy. Tamsulosin has less effect on blood pressure than alfuzosin (especially in elderly patients) and causes less symptomatic orthostatic hypotension during orthostatic stress testing than terazosin.

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A combined, including urodynamic, study was made in 129 patients with abnormal reservoir function of the urinary bladder (UB). Of them, 82 patients had nephrotuberculosis (NT). Cystoscopy was made in 93 patients, endovesical multifocal biopsy of the bladder wall-- in 23. Correction was conducted with alpha-adrenoblocker alfusozine. In NT, sensory functional disorders of UB prevail (60%). The degree of fibrous-inflammatory involvement of the bladder wall by biopsy findings and severity of urodynamic disorders do not correlate (r < 0.03). Miction recovered in 81.5% patients with NT taking alfusozine. Ileocystoplasty (n = 20) was made in treatment failure and total UB fibrosis. Long-term pathogenic action of specific infection on the neuroreceptor system of the UB may cause defects in its activity. Complex urodynamic investigations of the lower urinary tracts in NT patients identify the type of the disorder and help in making choice of pharmacological or surgical correction. Alfusoxine is a drug of choice in UB hypersensitivity.

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Acute urinary retention is a urological emergency in men and requires urgent catheterisation. Any intervention which aims at increasing the rate of a successful trial without a catheter following an acute urinary retention episode would be considered potentially beneficial. Alpha blockers relax prostatic smooth muscle cells thereby decreasing the resistance to urinary flow and by doing so improve urinary symptoms.

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Pertinent English-language articles were identified through a search of MEDLINE (1966-week 2, May 2006) using such search terms as 5alpha-reductase inhibitor, alpha-blocker, benign prostatic hyperplasia, dutasteride, efficacy, enlarged prostate, finasteride, and safety.

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Data in the present study suggest a predominant role of the alpha 1C adrenoceptor subtype in the contractile response of the canine prostate to phenylephrine in vivo. This model therefore provides a suitable means of assessing putative prostate-selective antagonists for the treatment of benign prostatic hyperplasia.

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Thirty-three patients with symptoms of outflow obstruction due to BPH were randomized into a double-blind study for 8 weeks treatment with alfuzosine 2.5 mg x 3 or placebo. Alfuzosine blood concentrations were analysed. The residual volume was significantly reduced in the alfuzosine group, from 98 to 43 cc (p less than 0.02) and the average urinary flow as measured by timed micturition was significantly improved (p = 0.023). Subjective symptoms were reduced in both groups. However, no statistically significant differences between the groups were recorded. Side-effects were limited and without clinical importance.

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An on-line SPE-HPLC method, using a monolithic poly(glycidyl methacrylate-co-ethylene glycol dimethacrylate) (poly(GMA-EDMA)) based weak cation-exchange (WCX) column, was developed for simultaneous determination of alpha1-adrenergic receptor antagonists in human plasma. The monolithic WCX column was prepared by an in-situ polymerization protocol and modified stepwise with ethylenediamine and chloroacetic acid. On connecting this column to an injection valve, an on-line SPE protocol could be established for removal of matrices (mainly proteins and lipids) and preconcentration of four alpha1-adrenergic receptor antagonists in human plasma. This method was validated and then used for determination of terazosin, alfuzosin, prazosin, and doxazosin in clinical plasma samples. For all analytes, each calibration curve was found to be linear over a range of 0.005-5 microg/mL (R>0.997), and the limit of detection for each analyte was 0.5 ng/mL. Recovery (>80%) and precision (RSD<15%) for inter- and intra-day assay were tested at three concentration levels of each analyte and showed acceptable results for quantitative assay. Real samples from hypertensive patients were monitored and results were in agreement with those of the conventional liquid-liquid extraction-HPLC method. Furthermore, due to its good permeability and biocompatibility, the monolithic WCX sorbent could be reused more than 300 times. The proposed method was especially appropriate for multi-analyte monitoring in plasma samples.

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Alfuzosin 10 mg administered for 6 months provides a marked improvement in patients presenting symptomatic BPH not only on LUTS but also in QoL and sexual disorders.

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Relevant RCTs were identified from electronic databases. The proceedings of appropriate meetings were also searched. Seven articles on the basis of RCTs were included in our meta-analysis. Using pairwise and network meta-analyses, comparisons were made by qualitative and quantitative syntheses. Evaluation was performed with the Ureteric Stent Symptoms Questionnaire to assess the urinary symptom score (USS) and body pain score (BPS).

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Correlation between lower urinary tract dysfunction, urinary tract infection (UTI) and vesicoureteral reflux (VUR) is complex and well known. The impact of lower urinary tract dysfunction treatment on frequency of UTI in children with VUR was assessed in our study. Lower urinary tract dysfunction was diagnosed in 32 girls and 4 boys; 19 (53%) of them had VUR in 24 kidney units. All patients were on chemo-prophylaxis and were advised how to restore regular voiding and assume normal posture, in order to reach an optimal relaxation of the pelvic floor during voiding. Eight patients (42%) with signs of hyperactive bladder and/or small bladder capacity were administered anticholinergic-oxybutynin (0.2 mg/kg of body weight). Eleven patients (58%) with sign of bladder-sphincter dysfunction and/or residual urine volume over 20% were treated by alfa-blocker-alfuzosin (0.1 mg/kg of body weight). Four children with constipation were advised to use fiber-rich diet. During 12-mount follow-up, none had febrile UTI, and 7 (37%) had 1 to 3 UTI without temperature. In conclusion, conservative treatment of VUR should include chemo-prophylaxes, lower urinary tract dysfunction treatment, and treatment of constipation, what was confirmed by our study as well.

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This study provides further evidence of the importance of prostate size as a prognostic factor in determining the outcome in patients with prostatic obstruction. Whilst most men presenting with AUR will eventually have prostatic surgery, a significant minority will not. An assessment of risk factors such as prostate size may identify those who require urgent intervention after a successful TWOC. The role of continued medical therapy with alpha-blockers and/or 5alpha-reductase inhibitors after a successful TWOC merits further investigation.

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Mean age and PSA level was 63.3+/-1.6 years (45-80), and 2.1+/-0.4 ng/ml (0.16-6.3 ng/ml). IPSS and Qmax values before treatment with terazosin and alfuzosin were similar. Improvements in IPSS and Qmax values after treatments with both terazosin and alfuzosin were significant. There was no statistically significant difference between the drugs in terms of percent improvements in IPSS and Qmax with alpha-blocker treatment. No untoward effect except for transient dizziness in one case with terazosin treatment was encountered.

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uroxatral buy online 2017-08-30

In BPH there is a growth of both glandular and stromal components. Most of adrenoceptors sites are in buy uroxatral the fibromuscular stroma. So the higher is the stromal/epithelial ratio, the more effective will alpha-blockers be. There in an indirect way of stimating this ratio without performing a biopsy. Bearing in mind that PSA is produced by the prostatic epithelium, the lower PSA density (PSAd), the higher the stromal/epithelial ratio and the higher alpha-blocker activity. We pretend to study if PSAd is useful for predicting the response to alpha-blockers in BPH.

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Alfuzosin, a selective alpha-1a antagonistis is the most recently approved AARAS, with limited cardiac toxicity and exclusively used for lower urinary tract syndromes (LUTS). In order to reduce pill burden and better patient compliance modified release (MR) formulations have been developed. Alfuzosin MR tablet was developed by the use of hot-melt granulation techniques using mono- and diglycerides as rate controlling membranes to minimize health care cost and uses of costly excipients. The other purpose of the study was to evaluate in vitro-in vivo performance of the scale up batch in healthy human subjects for commercialization. The blend uniformity (mean ± RSD%), assay, cumulative percent dissolution at 24 h, hardness, and friability of the biobatch were 100.2 ± 0.05%, 100.43 ± 0.023%, 93.98%, 4.5 kg, 5 min, and 0.08%, respectively. The in vivo pharmacokinetic parameters under fasting conditions between test and reference formulations (Uroxatral 10 mg extended release tablets) were buy uroxatral comparable. The 90% CI, geometric mean ratio (%) and power of C max, AUCT, and AUCI of the fasting study for the test and reference formulation were 99.03% to 122.78%, 109%, 0.998; 92.94% to 116.71%, 104%, 1; 98.17% to 124.01%, 110% 1, respectively. The scale up biobatch showed negligible difference in in vitro properties with respect to the pilot batch. The formulation developed with these agents was safe to use as there were no serious adverse events developed during the conduction of the clinical trial on the healthy subjects. Furthermore, the developed formulation was bioequivalent with respect to rate and extends of absorption to the reference formulation.

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In order to establish accurately the exact effect of any drug therapy for symptomatic benign prostatic hyperplasia (BPH) it is important to define the effect of placebo treatment. This effect was assessed by throughly analyzing the placebo arm, which included 101 patients, from a randomized, double-blind, placebo-controlled trial of the selective alpha-blocker alfuzosin and comparing the data with those of a variety of independent studies which followed a placebo group of patients with clinical BPH. Following 16 weeks of placebo treatment a decrease of 24% (p < 0.05) in Cymbalta Pharmacy Prices Madsen-Iversen score and an increase of 14% (p < 0.05) in peak flow rate was demonstrated. The percentages of patients who reported worsening, improvement or no change in symptoms were 9.2%, 73.6% and 17.2% respectively. The maximal effect of placebo, approximately 40% reduction in symptom scores, is likely to be achieved within the first four to six months. After this, the placebo effect stabilizes and gradually wears off but is still present following 12 months of treatment. The duration of the placebo effect and the time until it has totally worn off, if ever, remains to be studied in long-term, placebo-controlled trials, including an untreated cohort. The present study emphasizes the importance of properly designed, double-blind, placebo-controlled studies in evaluating any pharmacological intervention in clinical BPH.

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Seventy males (mean age, 71 Diflucan And Alcohol Use .2 years) were randomly assigned to receive double or single dose alpha-blocker (35 patients per group). The intent-to-treat population consisted of 70 males. Twenty-seven individuals in the double dose group and 19 in the single dose group did not require re-catheterization on the day of the TWOC (77% and 54%, respectively; P = .003). Success using free-flow variables was also higher in the males who received double dose alpha-blocker compared with single dose therapy (48% vs. 40%; P = .017).

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Benign prostatic hyperplasia (BPH) is a chronic condition common in older men that can result in bothersome lower urinary tract symptoms. The molecular mechanisms and networks underlying the development and the progression of the disease are still far from being fully understood. BPH results from smooth muscle cell and epithelial cell proliferation, primarily within the transition zone of the prostate. Apoptosis and inflammation play important roles in the control of cell growth and in the maintenance of tissue homeostasis. Disturbances in molecular mechanisms of apoptosis machinery have been linked to Voltaren Suppository Dose Child BPH. Increased levels of the glycoprotein Dickkopf-related protein 3 in BPH cause an inhibition of the apoptosis machinery through a reduction in B cell lymphoma (Bcl)-2 associated X protein (Bax) expression. Inhibitors of apoptosis proteins influence cell death by direct inhibition of caspases and modulation of the transcription factor nuclear factor-κB. Current pharmacotherapy targets either the static component of BPH, including finasteride and dutasteride, or the dynamic component of BPH, including α-adrenoceptor antagonists such as tamsulosin and alfuzosin. Both these classes of drugs significantly interfere with the apoptosis machinery. Furthermore, phytotherapic supplements and new drugs may also modulate several molecular steps of apoptosis.

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A review Glucophage 1000 Mg Price was performed of pertinent studies in the literature relating to the pathophysiology of LUTS and BPH, focusing on the role of alpha1ARs, and of clinical trial and practice data evaluating the different agents that inhibit these receptors.

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An open, dose-titration study of alfuzosin, a new selective post-synaptic alpha 1-adrenoceptor antagonist with additional direct vasodilator properties has been performed. After a 3-week run-in placebo period, 12 patients with essential hypertension received alfuzosin 5 mg oral b.d., and then the dose was doubled every week, up to a maximum of 20 mg q.i.d. if the supine diastolic blood pressure was greater than 90 mm Hg. The study lasted for 4 weeks. Supine blood pressure (SBP) decreased from 160/102 (Day 0) to 148/89 mm Hg and upright blood pressure (UBP) from 151/102 (Day 0) to 137/84 mm Hg. Alfuzosin did not cause any significant change in supine or upright heart rate. In addition, after the first dose of alfuzosin, supine and upright blood pressure and heart rate (SHR and UHR) were measured every 30 min for 5 h. The fall in blood pressure was significant after 90 min and it lasted up to the 5th hour; the maximum effect was observed after 3 h: SBP decreased from 159/103 (time 0) to 137/84 mm Hg and UBP from 150/102 (time 0) to 123/79 mm Hg. SHR was increased from 72 (time 0) to 81 beats/min at the 5th hour and UHR from 87 to 101 beats/min at the 4th hour. A weak but significant correlation Benicar Tab 40mg was observed between the hypotensive effect 12 h after drug intake and the plasma concentration of the drug at that time. A 10% decrease in supine diastolic blood pressure was found at a drug plasma concentration higher than 7 ng/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

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Prostatic and bladder tissue were obtained from patients (n=20 and n=17, respectively) undergoing cystoprostatectomy for bladder cancer. Bactroban Nasal Spray Dose

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We enrolled 30 men with lower urinary tract symptom (LUTS) who visited Gyeongsang National Luvox Cr 200 Mg University Hospital between 2010 and 2012. At first visit, urinalysis, prostate specific antigen, transrectal ultrasound, and uroflowmetry were performed. The nternational Prostate Symptom Score (IPSS), quality of life (QoL), International Index of Erectile Function (IIEF), and Male Sexual Health Questionnaire Ejaculation Function Domain (MSHQ-EjFD) questionnaires were administered, and the subjects answered the same questionnaires at 1 month, 6 months, 1 year, and 2 years of follow-up.

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Trial without catheter after a short course of an alpha-blocker in men presenting with Tofranil Reviews Anxiety acute urinary retention is successful in up to 50% of cases. The ability to better predict outcome could avoid a trial without catheter for some men. Intravesical prostatic protrusion and not prostate volume has been shown to predict trial without catheter outcome in an Asian cohort. We investigated the relationship between the outcome of trial without catheter and prostate volume and intravesical prostatic protrusion in white men given alpha-blockers before a trial without catheter.

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Under urethane anaesthesia, adult male rats were implanted with a cannula into the lateral cerebral ventricle for intracerebroventricular (i.c.v.) injection, and with recording electrodes in the BS for electromyogram (EMG) monitoring. Tamsulosin (1 microg/kg) and alfusozin (10 microg/kg) were injected i.v. and 15 min later 8-OH-DPAT (20 microg) was delivered i.c Cheap Viagra Online Reviews .v. BS-EMG recording was continued for 30 min after i.c.v. 8-OH-DPAT. The area under the curve (AUC) of the BS cluster of contractions was determined as reflecting the energy of BS contractions.

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The influence of dynamic variables (International Prostate Symptom Score change and bother during treatment) and baseline variables (patient age, prior acute urinary retention Deltasone Brand Name managed conservatively, prostate specific antigen, International Prostate Symptom Score and bother severity) on the risk of acute urinary retention and benign prostatic hyperplasia related surgery was estimated using the Kaplan-Meier method and log rank test. The associated HR and 95% CI were calculated using Cox proportional hazard models.

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The effects of different alpha-1 adrenoceptor blockers on the urethra and the cardiovascular system were evaluated using an in vivo isovolumetric intra-urethral pressure model in New Zealand white rabbits. The urethra of anesthetized male rabbits was cannulated through the bladder and secured at the vesico-urethral junction. The distal side of urethra under the pubic bone was also closed to allow measurement of the intra-urethral pressure. Both the intra-urethral pressure and the femoral arterial pressure were monitored. The effects of five different alpha-1 adrenoceptor blockers on the increases in both the intra-urethral pressure and blood pressure induced by phenylephrine were then examined. The inhibition rate of the alpha-1 adrenoceptor blockers prazosin, bunazosin, terazosin, alfuzosin and tamsulosin on the increase in Mestinon 90 Mg intra-urethral pressure caused as a result of contraction by phenylephrine was 87.5 +/- 4.5% (mean +/- S.E.), 88.0 +/- 7.2%, 86.2 +/- 6.2%, 81.4 +/- 4.8% and 92.5 +/- 5.0% respectively. The potency ranking of these alpha-1 adrenoceptor blockers was tamsulosin > bunazosin > prazosin > terazosin > alfuzosin. Their inhibition rate of the arterial pressure increase induced by phenylephrine was 81.9 +/- 5.0%, 86.2 +/- 5.9%, 76.0 +/- 6.0%, 63.6 +/- 5.7% and 58.0 +/- 5.2% respectively, with a potency ranking of bunazosin > prazosin > terazosin > alfuzosin > tamsulosin. We therefore conclude that the alpha-1 adrenoceptor blockers bunazosin and prazosin have a more potent action on both the urethra and the vascular system. However, tamsulosin and alfuzosin displayed a marked blockade of the increased urethral pressure induced by phenylephrine, with much less of a blockade of arterial pressure. In the present study, tamsulosin has been shown to be the most sensitive and powerful of the alpha-1 adrenoceptor blockers on urethral smooth muscle.

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Correct Begining Viagra Dose evauation before surgery is necessary in order to anticipate the condition as its frequency and severity can be reduced by a proactive behavior which demands experience and adequate endowment.

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There has been relatively little investigation of the effect of temperature on skin permeation compared to other methods of penetration enhancement. A Half Life Cymbalta 30 Mg principal physicochemical factor which controls the passive diffusion of a solute from a vehicle into the skin arises from the skin temperature. The aim of this ex vivo study was to probe into the effect of heat on transdermal absorption of alfuzosin hydrochloride from ethyl cellulose-polyvinyl pyrrolidone (EC-PVP) based transdermal systems.

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We determined the binding affinity of tamsulosin, a selective α(1)-adrenoceptor antagonist, for human α(1)-adrenoceptor subtypes in comparison with those of other α(1)-adrenoceptor antagonists including silodosin, prazosin, 5-methylurapidil, terazosin, alfuzosin, nafopidil, urapidil and BMY7378. The association and dissociation kinetics of [(3)H]tamsulosin for recombinant human α(1)-adrenoceptor subtypes were compared with those of [(3)H]prazosin. Tamsulosin competitively inhibited [(3)H]prazosin binding to human α(1A)-, α(1B)- and α(1D)-adrenoceptors (pK(i) values were 10.38, 9.33, 9.85) indicating 11 and 3.4-fold higher affinities for human α(1A)-adrenoceptor than those for α(1B)- and α(1D)-adrenoceptors, respectively. The affinity of tamsulosin for the human α(1A)-adrenoceptor was, respectively, 5, 9.9, 38, 120, 280, 400, 1200 and 10000 fold higher than those of silodosin, prazosin, 5-methylurapidil, terazosin, alfuzosin, naftopidil, urapidil and BMY7378, respectively. [(3)H]Tamsulosin dissociated from the α(1A)-adrenoceptor slower than from the α(1B)- and α(1D)-adrenoceptors (α(1B)>α(1D)>α(1A)). Moreover, [(3)H]tamsulosin dissociated slower than [(3)H]prazosin from the α(1A)-adrenoceptor and faster from the α(1B)- and Stromectol Dosing α(1D)-adrenoceptors. In conclusion, tamsulosin potently and selectively antagonized α(1A/1D)-adrenoceptor ligand binding, and slowly dissociated from the α(1A)-adrenoceptor subtype.

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In this prospective trial, 81 patients with a first episode of AUR related to benign prostatic obstruction received either sustained-release alfuzosin (40) 5 mg twice daily or placebo (41) for 48 h. The catheter was removed after 24 h of treatment and the patient's ability to void assessed. Those who voided successfully entered an open follow-up, the defined endpoints of which were the date of recurrent AUR, date of bladder Accutane Dose Chart outlet surgery, date of last follow-up or death, and factors that influenced the long-term outcome after a successful TWOC were examined.

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This study was undertaken in order to establish the alpha1-antagonist effects of alfuzosin on phenylephrine-induced increases in urethral and arterial blood pressures at 1 and 6 hours post dosing (10 mg/kg, p.o.). At each time, plasma and prostatic concentrations of alfuzosin were measured and correlations between tissue concentrations and pharmacological effects were calculated. At one and six hours post dosing, alfuzosin markedly shifted the urethral and arterial dose response curve to phenylephrine. At one hour, prostatic concentration was 4.1 times greater than plasma concentration (363 ng/g vs 88 ng/ml) and at 6 hours this ratio reached 8.6 times (167 ng/g vs 20 ng/ml). By taking together the data points obtained at 1 and 6 hours we showed that the effects of alfuzosin on urethral pressure were correlated with prostate levels (r=0.906, p<0.01) and the effects on arterial blood pressure were correlated with plasma levels (r=0.941, p<0.01). These results suggest that a preferential distribution of alfuzosin in prostatic tissue may play a role in its functional uroselectivity.

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Both finasteride and dutasteride reduced PSA and prostate volume significantly. The comparison between groups showed a more significant reduction of PSA (p=0.020) and prostate volume (p=0.052) in the dutasteride group. Other parameters did not differ significantly between the groups.

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A systematic review of PubMed/Medline, ISI Web of Knowledge, and Scopus databases was performed in May 2015. Seventeen studies were selected for inclusion.

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The progression of benign prostatic hyperplasia (BPH) can be defined as a deterioration of clinical variables such as lower urinary tract symptoms (LUTS), health-related quality of life and peak flow rate, increased prostate size, or unfavourable outcomes such as acute urinary retention (AUR) and BPH-related surgery. The natural history of BPH is best analysed from longitudinal studies of community-dwelling men. In the Olmsted county study, which followed for 12 years a randomly selected cohort of 2115 men aged 40-79 years, there was an average increase in the International Prostate Symptom Score (IPSS) of 0.18 points per year, ranging from 0.05 for men in their fifties to 0.44 for those in their seventies. There was also a decrease in peak flow rate of 2% per year and a median prostate growth of 1.9% per year. The cumulative incidence of AUR was low (2.7% over 4 years). Information can also be collected from the placebo arms of controlled studies of men with symptomatic BPH, although the strict trial inclusion criteria and indeed the taking of a placebo itself introduce biases which limit the analysis of the natural history of the disease in this way, and its applicability to the general population. Hence, in the Medical Therapy of Prostatic Symptoms study, there is clear evidence that symptom deterioration, defined by a worsening of the IPSS of > or = 4 points, was by far the most prevalent progression event (79.5%), with a cumulative incidence of 14% over a mean follow-up of 4.5 years. As in the longitudinal community-based studies, AUR was rather uncommon (14.8% of overall progression events) with a cumulative incidence of 2%. BPH-related surgery, which was a secondary criterion in the study, was required in 5% of men. Similar conclusions can be drawn from a 2-year placebo-controlled study (ALTESS) assessing the impact of alfuzosin 10 mg once daily on LUTS/BPH progression in 1522 men with symptomatic BPH at high risk of developing AUR. Symptom deterioration was clearly the main progression event, with a cumulative incidence of 16.8%, compared to BPH-related surgery (6.5%) and AUR (2.2%). Thus, there is evidence from longitudinal studies, and to a lesser extent from the placebo arms of large controlled studies, that BPH is a progressive disease. Symptom worsening is by far the most frequently occurring progression event. Identifying those patients at risk of BPH progression is crucial to optimize their management.

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The mean (sd) detrusor LPP decreased from 68 (37) to 46 (31) cmH2O (P < 0.01), reflex volume (defined as the volume at the first uninhibited bladder contraction of > 15 cmH2O) increased from 78 (69) to 112 (118) mL (+ 44%), bladder compliance increased from 9.3 (6.1) to 19.6 (14.6) mL/cmH2O (+ 111%), maximal vesical pressure decreased from 84 (40) to 70 (47) cmH2O (- 17%), and the mean number of uninhibited bladder contractions decreased from 6.3 to 3.5 (- 44%). The therapy was well tolerated; side-effects were rare and not severe. Intermittent catheterization could be avoided in six children.

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This article reviews the structure and function of the sympathetic nervous system controlling the myogenic tone of the bladder outlet. Therefore, the sympathetic nervous system is partially responsible for urinary outflow resistance. The alpha 1-adrenoceptor antagonists alfuzosin, doxazosin, tamsulosin, or terazosin are able to reduce bladder outflow resistance, which leads to significant relief of LUTS (20-65%) and improvement of urinary flow (1-4.3 ml/s) in patients with symptomatic BPH. Alpha 1-blocker treatment works irrespective of the severity of symptoms, degree of subvesical obstruction, or prostate size. A significant reduction of residual urine was observed only occasionally, but at least alfuzosin is able to reduce the incidence of acute urinary retention. This article presents the results of 39 randomized, placebo-controlled trials with 14,924 patients as well as trials with alpha 1-blockers and plant extracts or finasteride. The results of these trials indicate that all alpha 1-blockers are equally effective. However, tolerability of alfuzosin or tamsulosin is superior to doxazosin or terazosin. Furthermore, treatment of hypertension with doxazosin or terazosin is no longer recommended due to the increased frequency of cardiovascular side effects seen in the ALLHAT Study. As alpha 1-blockers can relieve symptoms and improve urinary flow more effectively than plant extracts or finasteride, alpha 1-blockers are the treatment of first choice in patients with symptomatic BPH without or with a minor degree of subvesical obstruction.

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Growing evidence suggest that BPH is a risk factor for ED. Since alfuzosin is a cornerstone in the treatment of BPH patients, we assessed the effect of alfuzosin on erectile function in rats when combined with a pro-erectile drug such as apomorphine.

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Alfuzosin 10 mg once daily prevents the overall clinical progression of BPH, defined by the occurrence of a deterioration in IPSS of > or = 4 points and/or AUR and/or BPH-related surgery, but does not reduce the primary occurrence of AUR. Alfuzosin significantly improves LUTS and quality of life over 2 years, and is well tolerated.

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A total of 180 males who underwent elective urologic surgery were included in this study. The patients were randomly allocated into three Groups. The Group I received placebo. Patients in Group II were given 0.4mg of tamsulosin orally 14 and 2 hours before surgery. Patients in Group III were given 10mg of alfuzosin ER orally 10 and 2 hours before surgery. All patients were closely followed for 24 hours postoperatively and their episodes of urinary retentions were recorded.

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Benign prostatic hyperplasia (BPH) is a common condition among elderly men. The aim of therapy is to improve lower urinary tract symptoms (LUTS) and quality of life (QoL) and to prevent complications.

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To perform a systematic review and meta-analysis of studies evaluating the ABs urodynamic outcomes in patients with LUTS/BPE. The primary endpoint was variation in bladder outlet obstruction index (BOOI). Secondary endpoints were the maximum urinary flow rate (Qmax) and detrusor pressure at Qmax (PdetQmax). A meta-analysis of placebo-controlled randomized clinical trials (RCTs) was performed to compare ABs with placebo.

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The search strategy identified 11 trials involving 3901 men with a mean age of 64 years. Eight trials were placebo-controlled studies, two were alfuzosin versus alternative alpha-blockers, and one was alfuzosin versus finasteride and combination alfuzosin/finasteride therapy. The study durations were short term, 4 to 26 weeks. The mean baseline symptom scores and peak urinary flow rates were indicative of moderate BPH. Alfuzosin (7.5 or 10 mg) improved lower urinary tract symptoms assessed by the International Prostate Symptom Score compared with placebo. The mean absolute change from baseline was -5.4 points for alfuzosin compared with -3.6 points for placebo, a weighted mean difference of 1.8 points (three studies). Alfuzosin increased the peak urinary flow more than did placebo, although the improvement varied across the eight studies. Symptom and flow improvements were generally comparable to that with combination therapy and with other alpha1-blockers. Alfuzosin had good short-term tolerability, and the numbers of study withdrawals were comparable to those with placebo and controls. Efficacy and short-term safety were similar across the various (immediate-release, sustained, and once-daily) formulations.

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• To evaluate the efficacy of α-blockers with respect to improving stent-related symptoms. • Ureteric stents remain a source of marked discomfort and their placement is often required after certain ureteroscopic procedures or in the acute setting. This analysis identifies and reviews the several studies that have investigated the role of α-blockers after stent placement.

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• There is evidence that α-blockers provide an improvement in discomfort after placement of a ureteric stent.

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LUTS are an independent risk factor for sexual dysfunction in aging men, even after controlling for age and comorbidities. Although surgery, minimally invasive therapies, and pharmacologic therapies can all improve LUTS and the peak urinary flow rate, some can cause or exacerbate ED (incidence rates: surgery, 10%; minimally invasive therapies, 1%-3%; pharmacologic monotherapy or combination therapy, 3%-10%) and EjD (incidence rates: surgery, 65%; minimally invasive therapies, 4%-16%; pharmacologic monotherapy or combination therapy, 0%-10%). Among pharmacologic therapies for BPH, the frequency of EjD appears to be greater with tamsulosin (10%) than with other alpha(1)-blockers (0%-1%) or the 5alpha-reductase inhibitor finasteride (4%), based on data from a single-arm meta-analysis conducted by the AUA.

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Alpha1-receptor blockers have become first-line therapy for the medical management of lower urinary tract symptoms associated with benign prostatic hyperplasia. However, adverse effects such as cardiovascular intolerance can limit their use. This article focuses on alfuzosin, a clinically uroselective, alpha1-adrenergic antagonist that is available as a novel once-daily formulation that does not require dose titration. Alfuzosin is less vasoactive than other non-subtype selective alpha1-receptor blockers. In addition to effects on lower urinary tract symptoms, it is also used as an adjunct to urethral catheterisation in patients with acute urinary retention related to benign prostatic hyperplasia, and can improve sexual function and health-related quality of life in benign prostatic hyperplasia sufferers.

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A comprehensive electronic search was conducted in October 2010 using the Medline database to identify all publications relating to ED and BPH and treatment with sildenafil, vardenafil, tadalafil, udenafil, UK-369003, and combination therapy with alfuzosin and tamsulosin.

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The incidence of hypotension differs between α-blockers. It is greatest with doxazosin or terazosin, but others including tamsulosin can also lead to hypotension especially upon treatment initiation. Concomitant antihypertensive medication increases the incidence of hypotension with some α-blockers. Use of α(1A)-selective blockers, evening dosing and drug intake after a meal can reduce the risk of hypotension. IFIS can occur with all drugs exerting α(1)-adrenoceptor antagonist properties and has especially been reported for tamsulosin. It makes cataract surgery more challenging but does not constitute a health risk to patients. IFIS seems to result from inhibition of iris dilator muscle contraction and occurs in men or women, even after α-blockers have been discontinued. To reduce the risk of IFIS, the authors suggest taking a careful drug history, postponing α-blocker treatment for patients with scheduled cataract surgery and careful counseling of patients taking α-blockers.

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Incidence of benign prostatic hyperplasia (BPH), one of the most common conditions affecting adult men, increases dramatically after the age of 50. The various symptoms of BPH, which include lower urinary tract symptoms (LUTS), can adversely affect quality of life (QoL) and sexuality and 1-Blockers are the most frequently prescribed oral medications as first-line treatment.

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5-α Reductase inhibitors for BPH treatment reduced PSA and prostate volume significantly when the patients were treated for 1 year. Administration of dutasteride is considered to be more effective in reducing PSA and prostate volume. Therefore, dutasteride should not be considered equivalent to finasteride in the reduction rate of PSA. The intensity of dutasteride must be reevaluated in comparison with finasteride.