From the Guidelines
Alpha adrenergic blockers that are recommended for the treatment of lower urinary tract symptoms (LUTS) attributed to benign prostatic hyperplasia (BPH) include alfuzosin, doxazosin, silodosin, tamsulosin, and terazosin. These medications are primarily used to treat hypertension and BPH by blocking alpha-adrenergic receptors in the body, preventing norepinephrine and epinephrine from binding to these receptors 1.
Key Points
- Alpha-1 selective blockers like tamsulosin are particularly useful for BPH as they relax smooth muscle in the prostate and bladder neck, improving urinary symptoms with fewer cardiovascular side effects.
- The choice of alpha blocker should be based on patient age and comorbidities, and different adverse event profiles, such as ejaculatory dysfunction and changes in blood pressure 1.
- Common side effects of alpha blockers include orthostatic hypotension, dizziness, headache, and nasal congestion.
- Patients should take the first dose at bedtime and rise slowly from sitting or lying positions to minimize dizziness.
Medication Options
- Alfuzosin (Uroxatral)
- Doxazosin (Cardura)
- Silodosin (Rapaflo)
- Tamsulosin (Flomax)
- Terazosin (Hytrin) These medications have been shown to be relatively equally effective in terms of improving LUTS and BPH symptoms, with a moderate recommendation and evidence level of Grade A 1.
From the FDA Drug Label
The patient’s ophthalmologist should be prepared for possible modifications to their surgical technique, such as the utilization of iris hooks, iris dilator rings, or viscoelastic substances. There does not appear to be a benefit of stopping alpha-1 blocker therapy prior to cataract surgery 5.1 Orthostasis The signs and symptoms of orthostasis (postural hypotension, dizziness, and vertigo) were detected more frequently in Tamsulosin Hydrochloride Capsules -treated patients than in placebo recipients. As with other alpha adrenergic blocking agents there is a potential risk of syncope [ see Adverse Reactions (6. 1) ]. Tamsulosin Hydrochloride Capsules should not be used in combination with other alpha adrenergic blocking agents [ see Drug Interactions (7.2) and Clinical Pharmacology (12. 3)].
- Alpha adrenergic blockers mentioned are:
- Terazosin
- Tamsulosin These medications are alpha-1 blockers.
From the Research
Alpha Adrenergic Blockers
The following medications are classified as alpha adrenergic blockers:
- Terazosin 2, 3, 4, 5, 6
- Doxazosin 2, 3, 4, 5
- Alfuzosin 2, 4, 5
- Tamsulosin 2, 4, 5, 6
- Prazosin 3, 6
- Silodosin 5
Characteristics of Alpha Adrenergic Blockers
These medications have different characteristics, such as:
- Efficacy in treating benign prostatic hyperplasia (BPH) 2, 3, 4, 5, 6
- Adverse event profiles, including vasodilatatory, cardiovascular side effects (dizziness, fatigue, and hypotension) 2, 4
- Selectivity for alpha1-adrenoceptor subtypes, with silodosin exhibiting true selectivity 5
- Requirement for dose titration, with tamsulosin, alfuzosin slow release, and silodosin not requiring dose titration 5