alpha-Blockers for benign prostatic hyperplasia: the new era

作者：Lepor Herbert^*; Kazzazi Amir; Djavan Bob

来源：Current Opinion in Urology, 2012, 22(1): 7-15.

DOI：10.1097/MOU.0b013e32834d9bfd

• alpha-blockers
• benign prostatic hyperplasia
• lower urinary tract symptoms
• quality of life

Purpose of review
alpha 1-Adrenoceptor blockers are the most frequently prescribed medical therapy in the treatment of lower urinary tract symptom suggestive of benign prostatic hyperplasia (LUTS/BPH). The purpose of this review is to highlight the evolution of adrenoceptor blockers with emphasis on newly approved drugs.
Recent findings
Over the past years new formulations of several alpha 1-adrenoceptor blockers were introduced to the market. Five long-acting alpha 1-blockers are currently approved by the Food and Drug Administration for treatment of symptomatic LUTS/BPH: terazosin, doxazosin, tamsulosin, alfuzosin and silodosin. Silodosin is the only adrenoceptor blocker that exhibits true selectivity for the alpha 1-adrenoceptor subtypes. This unique adrenoceptor selectivity profile likely accounts for the very favorable cardiovascular safety profile.
Summary
Tamsulosin, alfuzosin slow release and silodosin do not require dose titration. Alfuzosin, terazosin, doxazosin and silodosin have all been shown to be effective in relieving LUTS/BPH independent of prostate size. Low incidence of orthostatic hypotension has been reported for silodosin, but abnormal ejaculation is the most commonly reported adverse effect.

• 出版日期2012-1