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.
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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)
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Copyright | Copyright 2001 S. Karger AG, Basel |
Chemical References |
- Adrenergic alpha-Antagonists
- Enzyme Inhibitors
- Finasteride
- Doxazosin
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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)
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