Alpha-Blockers Treatment For Benign Prostatic Hypertrophy (BPH)
Terazosin (Blavin): Approved in 1993.
- Life 1 / 2 12hrs. Should be given 1mg x 3 then 2mg x12 and then 5mg/day.
- 40% is eliminated by the kidney and 60% in feces.
- Deterioration of renal function does not change the dose.
- Produces decreased total and LDL cholesterol <5%.
- Lower BP in hypertension but with minimal effect in normotensives.
- 70% improvement in symptoms: 60% obstructive, 30% and 35% flow irritant.
- RAM: dizziness 9%, fatigue 7%, orthostatic 4%, drowsiness 3%.
Doxazosin (Cardura): Approved in 1995.
- Life 1 / 2 22hrs. Should be given 1 mg for 1 to 2 weeks and then 2mg.
- Very similar to the previous in terms of renal function and lipid profile.
- 70% improvement in symptoms.
- RAM: syncope 15% (give it at night when lying down), rest well.
Tamsulosin (Secotex): Approved in 1997.
- Dosage 0.4 to 0.8 mg / day. 1st is an alpha blocker, 12 times more selective.
- Rapid decrease in symptoms after the first shot.
- Significant increase in urinary flow 5hrs after the first dose.
- RAM: abnormal ejaculation 5%.
Inhibitors of 5 alpha reductase
- Finasteride (Proscar). Adopted in 1992.
- Life 1 / 2 8hrs. Increased utility in prostates> 40grs.
- PSA decreases by 50%, so after 6 months of PSA obtained el.valor multiply by two.
- Minimal effects on sex drive.
- Does not meet the dose in renal failure.
- RAM: 4% impotence libido decreased 3%.