DRUGS THAT RELAX THE PROSTATE: TERAZOSIN
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In a recent multi-center study, terazosin was given in various doses, ranging from two to ten milligrams daily, to more than 200 men. (Men who had “absolute indications” for prostatectomy—the conditions mentioned above—were not included in the study, and should not be considered eligible for this treatment. ) Only the men receiving 10 milligrams, the largest dose, had a significant improvement in urinary flow rate and obstructive and irritative symptoms, and the study suggested that larger doses could be given to bring about even greater results. The study proved the drug to be safe and effective in most men. It also found that some of the side effects, such as dizziness, were less of a problem if the drug was taken at night—which might be best anyway, as bedtime is often when BPH is at its most annoying. In another study, symptoms improved in 72 percent of men with BPH for at least two years of treatment with terazosin.
The change in symptoms and improvement in urinary flow with alpha blockers isn’t as dramatic as it is after prostatectomy, and alpha blockers aren’t recommended for men with severe symptoms. On the other hand, alpha blockers create fewer side effects than prostatectomy—and they’re all reversible when men stop taking the drug. One advantage of alpha blockers is that they work almost immediately, unlike finasteride, which must be taken for months before any change is noticeable. A drawback is that alpha blockers don’t change the course of BPH—they work like cold pills, just treating the symptoms, not the underlying cause of the illness. If your doctor prescribes an alpha blocker, you’ll probably be checked regularly over the first few weeks to fine-tune the dosage of the drug. Then you should be seen every few months to have your prescription refilled and your symptoms checked.
Side Effects. Alpha blockers improve urine flow by relaxing clenched smooth muscle tissue. Because their effect is not limited simply to the prostate, they may not be best for men with a history of significant heart disease or blood pressure problems. But they don’t seem to have any adverse effects on blood pressure or heart rate in men who are otherwise healthy. They are vasodilators —they open up blood vessels, making a wider channel for blood to go through, which means they reduce blood pressure. Their side effects can include dizziness, heart palpitations, lightheadedness or even fainting, nasal congestion, and fatigue, especially during the first few doses. These symptoms tend to improve over time as the body adjusts to the drug. They also seem to be diminished in men who take the drug at night.
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Tags: Erectile Dysfunction, Men’s Health
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