Alfuzosin Hydrochloride for the Treatment of Benign Prostatic Hyperplasia

Mary Lee

Disclosures

Am J Health Syst Pharm. 2003;60(14) 

In This Article

Combination Therapy with Finasteride

Alpha-1 adrenergic antagonists produce greater improvement in voiding symptoms and urinary flow rates than finasteride alone. No additive or synergistic effects have been proven when terazosin was used with finasteride.[68]

Similar to terazosin, alfuzosin is more effective than finasteride, and an alfuzosin-finasteride combination does not appear to be more effective than alfuzosin alone. Debruyne et al.[69] conducted a multicenter, randomized study of 1051 patients with BPH. Patients received ER alfuzosin 5 mg twice daily, finasteride 5 mg daily, or both drugs for six months. Alfuzosin alone and alfuzosin-finasteride combination therapy significantly improved symptoms when compared with finasteride alone, as assessed with the International Prostate Symptom Score. Increases in peak urinary flow rates were greater with alfuzosin and alfuzosin-finasteride than with finasteride alone after one month of therapy, but after six months, peak urinary flow rates were similar among the three treatment groups. In patients with peak urinary flow rates less than 10 mL/sec, the mean increases in peak urinary flow rates were significantly higher with alfuzosin alone and with the alfuzosin-finasteride combination. Finasteride alone and in combination with alfuzosin significantly impaired sexual function; the frequency of erectile dysfunction and ejaculatory disorder increased. The number of postural symptoms was comparable and low in all treatment groups. Thus, in this clinical trial, alfuzosin was more effective than finasteride, and no additional benefit was observed when both drugs were combined.

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