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%.