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After ALLHAT: doxazosin for the treatment of benign prostatic hyperplasia

Sheila A Doggrell1

  • 1School of Biomedical Sciences, The University of Queensland, QLD 4072, Australia. s_doggrell@yahoo.com

Expert Opinion on Pharmacotherapy
|August 28, 2004
PubMed

Insights

Doxazosin mesylate, an alpha1-adrenoceptor antagonist, is now used for benign prostatic hyperplasia (BPH). While effective, its controlled-release formulation (GITS) offers easier titration and potentially fewer side effects for BPH symptom management.

Area of Science:

  • Pharmacology
  • Urology

Background:

  • Doxazosin mesylate, an alpha1-adrenoceptor antagonist, was previously used for hypertension but is now indicated for benign prostatic hyperplasia (BPH).
  • Noradrenaline-induced contraction of prostate and bladder smooth muscle, mediated by alpha1-adrenoceptors, is counteracted by doxazosin, offering therapeutic benefits in BPH.
  • Doxazosin also demonstrates an effect on prostate apoptosis.

Purpose of the Study:

  • To review the efficacy and tolerability of doxazosin, particularly its controlled-release gastrointestinal therapeutic system (GITS) formulation, in the management of benign prostatic hyperplasia (BPH).
  • To compare the benefits and side effect profiles of standard doxazosin preparations with the GITS formulation in BPH patients.

Main Methods:

  • Review of clinical studies and trial data concerning doxazosin's use in BPH.
  • Analysis of doxazosin's mechanism of action on alpha1-adrenoceptors in prostate and bladder smooth muscle.
  • Evaluation of symptom improvement, urinary flow rates, and adverse events associated with standard and GITS doxazosin formulations.

Main Results:

  • Standard doxazosin effectively reduced obstructive and irritative BPH symptoms and improved peak urinary flow rate.
  • The controlled-release gastrointestinal therapeutic system (GITS) formulation of doxazosin simplifies titration to a single step and may offer a better side effect profile.
  • Doxazosin's blood pressure-lowering effects are less pronounced in normotensive individuals compared to hypertensive patients.

Conclusions:

  • Doxazosin is a beneficial treatment for BPH symptoms, with the GITS formulation providing enhanced convenience and potentially improved tolerability.
  • Combination therapy with doxazosin and finasteride may offer additive benefits, especially in men with larger prostates.
  • Further research is needed to establish the superiority of doxazosin GITS over other alpha1-adrenoceptor antagonists for BPH treatment.

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