Terazosin and doxazosin in the treatment of BPH: results of a randomized study with crossover in non-responders.
OBJECTIVE
To compare the effects of the doxazosin and terazosin on total International Prostate Symptom Score (IPSS) and maximum urinary flow rate (Qmax) in treating patients with lower urinary tract symptoms (LUTS) and compare this effectivity by switching the drugs in the patients who did not benefit from either the first or the second drug.


METHODS
This is a prospective randomized study of the patients with LUTS suggestive of benign prostatic hyperplasia (BPH). Fifty male patients (mean age 59.4 +/- 7.6 years) received either doxazosin (n = 25) or terazosin (n = 25) once daily every night. The patients were evaluated in the 1st, 2nd and 3rd months of treatment. Minimum 20% improvement in IPSS and Qmax in the 3rd month was considered as improvement. The patients with no improvement in any of the parameters switched the drugs, and they were followed up in the next 3 months. The patients whose only one parameter improved were excluded from the study.


RESULTS
Eleven (44%) out of 25 patients using doxazosin and 10 (40%) out of 25 patients using terazosin showed improvement in both IPSS and Qmax at the end of the 3rd month and continued using the drug. After 3 months of treatment, increase in Qmax (p < 0.001) and decrease in IPSS (p < 0.01) was significant for both doxazosin and terazosin. Nineteen patients, who did not show improvement in any of the parameters, switched the drug. Of the patients who switched the drug, 2 (4%) showed improvement both in IPSS and in Qmax, while 2 (4%) showed improvement only in IPSS but not in Qmax. The remaining 15 (30%) patients did not show improvement in any of the parameters.


CONCLUSIONS
The results of the study suggest that alpha-blockade with either doxazosin or terazosin is effective in males with LUTS. The two alpha-blocking drugs showed equal effectiveness in the treatment of LUTS. If one of the drugs is ineffective in the treatment of LUTS, then the other drug will probably be ineffective.
Samli
M Murat
MM
Department of Urology, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey. msamli@tr.net
Dincel
Cetin
C
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000368:Aged; D018592:Cross-Over Studies; D017292:Doxazosin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011224:Prazosin / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D011446:Prospective Studies; D011470:Prostatic Hyperplasia / Q000188:drug therapy*
D000317:Adrenergic alpha-Antagonists; C041226:Terazosin; D017292:Doxazosin; D011224:Prazosin