Discontinuation of alpha-blockade after initial treatment with finasteride and doxazosin for bladder outlet obstruction.

Abstract

OBJECTIVES:

Patients with symptomatic bladder outlet obstruction and moderately enlarged prostates can receive durable relief from finasteride. However, the delayed onset of action has led many clinicians to prescribe an alpha-blocker in addition to finasteride early in therapy for more rapid symptom relief. Our goal was to determine when to discontinue the alpha-blocker in this group of patients.

METHODS:

We enrolled 100 consecutive men with an estimated prostate size of >40 g and an AUA symptom score of > or =20, who reported an initially favorable response to combination therapy with 5 mg finasteride and 2 mg doxazosin daily. The average symptom score reduction at 1 month was 3.3. We discontinued the doxazosin at 3, 6, 9, or 12 months, while continuing finasteride, then reevaluated patients 1 month later to determine if the patients reported any worsening of symptoms.

RESULTS:

Twenty-five patients discontinued doxazosin at 3 months. Five (20%) were successfully discontinued, reporting no change in symptom score. Twenty reported worsening symptoms. Twenty-five patients discontinued doxazosin at 6 months. Twelve (48%) were successfully discontinued, reporting no change in symptom scores. Thirteen (52%) reported worsening symptoms. Twenty-five patients discontinued doxazosin at 9 months. Twenty-one (84%) were successfully discontinued, reporting no change in symptom scores. Four (16%) reported worsening symptoms. Twenty-five patients discontinued doxazosin at 12 months. Twenty-one (84%) were successfully discontinued, reporting no change in symptom scores. Four (16%) reported worsening symptoms.

CONCLUSION:

Patients with symptomatic bladder outlet obstruction and moderately enlarged prostates who are placed initially on combination therapy using finasteride and an alpha-blocker are likely to tolerate discontinuation of the alpha-blocker after 9 months of combination therapy.

• Authors: K C Baldwin, P C Ginsberg, R C Harkaway
• Journal: Urologia internationalis (Urol Int) Vol. 66 Issue 2 Pg. 84-8 ( 2001) ISSN: 0042-1138 [Print] Switzerland
• PMID: 11223749 (Publication Type: Clinical Trial, Journal Article)
• Copyright: Copyright 2001 S. Karger AG, Basel

Chemical References

• Adrenergic alpha-Antagonists
• Enzyme Inhibitors
• Finasteride
• Doxazosin

Topics

• Adrenergic alpha-Antagonists (therapeutic use)
• Doxazosin (therapeutic use)
• Enzyme Inhibitors (therapeutic use)
• Finasteride (therapeutic use)
• Humans
• Male
• Prostatic Hyperplasia (complications, drug therapy)
• Urinary Bladder Neck Obstruction (drug therapy, etiology)