No abstract available.
Doxazosin* ; Hypertension*

No abstract available.
*Antihypertensive Agents ; *Doxazosin ; Humans ; Liver Cirrhosis

PURPOSE: An economic analysis of pharmacological therapy and transurethral resection of the prostate (TURP) for patients with benign prostatic hyperplasia (BPH) was conducted. MATERIALS AND METHODS: Twenty six patients had undergone TURP from January to June 2000 were enrolled in this study. The costs associated with this group of patients were compared with those of 7 patients treated with medication (doxazosin, terazosin, tamsulosin, and finasteride only and alpha-blocker with finasteride). RESULTS: The mean cost for TURP was 1,900,000 won. The most expensive medical therapy was finasteride, which was followed by tamsulosin, terazosin, and doxazosin, with an estimated 12-month cost of 817,000won, 695,000won, 396,000won, and 372,000won respectively. The costs associated with doxazosin remained lower than those associated with TURP for approximately 5.3 years (the corresponding break-even point was 2.4 years for finasteride vs. TURP). CONCLUSIONS: Among the pharmacological therapies, doxazosin is the most cost effective. TURP was more cost effective than doxazosin therapy after 5.3 years. In view of the cost-effectiveness, TURP may be considered as the mode of primary therapy for the patients with severe symptoms of BPH.
Doxazosin ; Finasteride ; Humans ; Prostate* ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate

BACKGROUND AND OBJECTIVES: Doxazosin GITS (Gastrointestinal Therapeutic System) greatly minimizes the need for titration by changing the drug-delivery rate and pharmacokinetic profile. No data are available on the safety and efficacy of Doxazosin GITS among Korean hypertensive patients. This study was designed to evaluate the effectiveness and safety of Doxazosin GITS as an add-on therapy, under standard usage conditions, through a multi center study in patients with hypertension. SUBJECTS AND METHODS: A total of 595 hypertensive patients, not adequately controlled with a single agent, were enrolled into this study. The demographic profiles were gathered at the baseline, and the patients followed up at 4 and 8 week intervals for dose adjustment and for final assessment of the efficacy, respectively. The blood pressure, heart rate, fasting glucose and lipid profiles were assessed at each visit and any adverse events also observed. RESULTS: A total of 595 patients, in whom Doxazosin GITS had been administered, and evaluated at least once according to its related parameters, were analyzed to assess its safety. Of the 595 patients 534 completed this study and fulfilled the requirements for the efficacy analysis. Eight weeks after treatment, the responders (BP<140/90 mmHg or BP<130/85 mmHg in patients with diabetes) were 68.5% of the total patients and 71.3% of the hypertensive patients without diabetes. The blood pressure was significantly improved, with a mean change from the baseline of -18.9+/-19.5/-1 0.6+/-11.8 mmHg (mean+/-standard deviation expressed as SBP/DBP)(p<0.05). In addition, Doxazosin GITS showed a change in the heart rate of -1.5+/-6.8 bpm (p<0.05), and brought favorable metabolic effects, such as improved glucose metabolism and reductions in the total cholesterol and triglyceride. A total of 18 adverse events were reported among the 595 patients (3.0%), with mild to moderate severity. CONCLUSION: Doxazosin GITS as an add-on therapy significantly improved the blood pressure and heart rate, with favorable metabolic effects. Doxazosin GITS could be a safe and effective drug for hypertension not adequately controlled with a single agent.
Blood Pressure ; Cholesterol ; Doxazosin* ; Fasting ; Glucose ; Heart Rate ; Humans ; Hypertension* ; Metabolism ; Triglycerides

The antihypertensive efficacy and safety of doxazosin, a selective alpha1-inhibitor, were assessed in 20 patients with essential hypertension. Doxazosin induced a clinically significant reduction in blood pressure(26.0mmHg in systolic blood pressure and 21.7mmHg in diastolic blood pressure) with similar heart rates after 12 weeks therapy. The efficacy of doxazosin therapy was successful in 17 patients(89.5%) and failed in 2 patients(10.5%). The mean dose of the efficacy evaluable patients was 4.4mg/day. most of all patients completed for 12 weeks therapy except one patients who experienced side effects sych as vertigo, dizziness and fatigue. There were no clinically significant laboratory changes before and after the doxazosin therapy. The overall lipid profile indicated a decrease in total cholesterol with increases in HDL-cholesterol. This results indicated that doxazosin given once daily is and effective antihypertensive agent with the additional action of favorably affecting blood lipid level in the treatment of mild-to-moderate hypertension.
Blood Pressure ; Cholesterol ; Dizziness ; Doxazosin* ; Fatigue ; Heart Rate ; Humans ; Hypertension* ; Vertigo

PURPOSE: The purpose of this study was to investigate the pro-erectile potential of various urethral alpha blockers using pharmacological or electrical induction of erection in anesthesized rats. MATERIALS AND METHODS: To evaluate the influence on centrally mediated erection, intravenous administeration of terazosin, doxazosin(3, 10, 30microgram/kg), and tamsulosin (0.3, 1, 3microgram/kg), followed by submaximal subcutaneous apomorphine(50microgram/kg) administration, mean arterial pressure(MAP) and intracavernosal pressure(ICP) were recorded over 30 minutes in male anesthesized rats. The time to first response, peaks within 30 minutes, maximal ICP, area under the curve, percentage of ICP/MAP were compared. To evaluate the influence on peripherally induced erections, various doses of alpha antagonists and submaximal cavernous nerve stimulation(0.5ms, 2V, 10Hz) were combined. The ICP increase and ICP/MAP percentage were also compared. RESULTS: Although various dose response relationships were shown, all three alpha blockers enhanced erectile activity triggered by apomorphine. In terms of time to first response and peaks within 30 minutes, the proerectile effects of terazosin was most prominent whereas those of tamsulosin was minimal, requiring larger doses. In combining with cavernous nerve stimulation, doxazosin and tamsulosin showed moderate proerectile activity, but the highest dose of terazosin was required to enhance ICP increase induced by cavernous nerve stimulation. Despite their pressure lowering effects, all tested alpha adrenergic blockers significantly enhanced the ICP/MAP percentage. CONCLUSIONS: The present finding clearly indicated that alpha 1 selective antagonists can enhance erectile capacity when combined with central or peripheral stimuli for erection.
Adrenergic alpha-Antagonists ; Adrenergic Antagonists ; Animals ; Apomorphine ; Doxazosin ; Humans ; Male ; Models, Animal* ; Rats*

PURPOSE: Bethanechol enhances detrusor contraction and alpha1-blockers reduce bladder outlet resistance. We evaluated the effects of bethanechol with doxazosin in patients with impaired detrusor contractility. MATERIALS AND METHODS: Fifty-six patients that had confirmed detrusor underactivity with at least 150ml of postvoid residual urine volume(PVR) based on a urodynamic study were enrolled. The initial dosage of bethanechol given was 75mg/day, and the dosage was gradually increased to 150mg/day if necessary. Doxazosin gastro-intestinal therapeutic system(GITS)(4mg) was also given. The effect of the treatment was evaluated by a urine flow test, the amount of PVR, and frequency of clean intermittent catheterization(CIC). RESULTS: The mean follow-up period was 6 months(range, 1 to 9 months). After treatment, the mean PVR decreased from 251.8+/-149.6ml to 136.4+/-153.2ml(p<0.001) and was less than 100ml in 22(39%) of the 38 patients that showed a decrease. The maximum flow rate(Qmax) increased from 8.7+/-4.7ml/s to 11.1+/-5.6ml/s(p=0.024) and was more than 5ml/s in 13 patients(23%). Five of the 18 patients that previously required CIC could discontinue this treatment and another nine patients showed a decrease in the frequency. The mean daily frequency of CIC was reduced from 3.2 to 1.5(p=0.004). Ten of the 12 patients that were not able to void became capable of voluntary voiding. Five patients(9%) complained of adverse reactions and four of them were taken off the medication. CONCLUSIONS: The combination therapy of bethanechol with doxazosin improved emptying ability in patients with impaired detrusor contractility.
Adrenergic alpha-Antagonists ; Bethanechol* ; Doxazosin ; Follow-Up Studies ; Humans ; Urinary Bladder ; Urinary Bladder, Neurogenic ; Urodynamics

Doxazosin is an adrenergic alpha-1 receptor antagonist used to treat lower urinary tract symptoms that are common in prostatic hyperplasia. To our knowledge, few cases of gynecomastia and mastodynia, as a complication of adrenergic alpha-1 receptor antagonist, have been reported to date; no cases have been reported in Korea. We describe a case involving a 78-year-old man treated for prostatic hyperplasia with 13 months of doxazosin. He complained about unilateral gynecomstia and mastodynia. Five months after the discontinuation of doxazosin, the gynecomastia was significantly improved. This is the first reported case of gynecomastia and mastodynia associated with doxazosin use in Korea.
Aged ; Doxazosin* ; Gynecomastia* ; Humans ; Korea ; Lower Urinary Tract Symptoms ; Male ; Mastodynia ; Prostatic Hyperplasia

PURPOSE: Doxazosin has gained wide acceptance as a pharmacotherapeutic agents for the treatment of BPH. As a selective alpha-1 blocker, it is known to reduce symptom scores and improve flow rates. However, the correlation not been fully established. in this study we investigated that improvements of clinical parameters, such as the symptom score, storage symptom score, voiding symptom score, bother score, peak flow, post-voiding residuals and prostate volume, are statistically related to the subjective satisfaction in patients receiving doxazosin pharmacotherapy for the management of BPH. MATERIALS AND METHODS: Forty nine symptomatic BPH patients were evaluated prior to and at 3 months after the administration of recommended dose of doxazosin. The parameters evaluated were total symptom, storage symptom, voiding symptom and bother scores, peak flow rate (Qmax), post-voiding residuals (PVR) and prostate volume. The patients satisfaction to the treatment was determined by subjective responses to the questionnaires, and each response was categorized into one of the two groups; good (much improved, improved) or poor (slightly improved, no changes or getting worse). The subjective responses and the clinical parameters were compared and statistically analyzed. RESULTS: The total symptom, storage symptom, voiding symptom and bother scores decreased, and the Qmax increased significantly in all patients after doxazosin therapy. There was also significant mean posttherapeutic improvement for all individual questions. However, according to the patients subjective satisfaction for the treatment, patients with good result (23 patients) score then those with poor result group (26 patients; p<0.01). The changes of storage symptom score, Qmax, PVR and prostate volume were not significantly different in both groups. CONCLUSIONS: Doxazosin was effective in reducing symptoms and improving peak flow rates in the patients diagnosed clinically with BPH. Although the clinical parameters show significant improvements after doxazosin therapy, the patient satisfaction is more dependent on the severity of pre-treatment total and voiding symptom score. These findings suggest that pre-selecting patients prior to the initiation of doxazosin therapy could result in better treatment responses.
Doxazosin* ; Drug Therapy ; Humans ; Patient Satisfaction ; Patient Selection* ; Prostate ; Surveys and Questionnaires

PURPOSE: The doxazosin-gastrointestinal therapeutic system (GITS) greatly minimizes the need for titration by changing the drug-delivery rate and pharmacokinetic profiles. This multi-center study was designed to evaluate the efficacy and safety of doxazosin GITS in patients with BPH when used under the standard usage conditions. MATERIALS AND METHODS: A total of 487 men, aged 40 years or over, with clinical evidence of BPH were enrolled. Demographic profiles were gathered at the baseline and the patients followed up at 4 and 8 weeks for dose adjustment and final assessment of the efficacy, respectively. The efficacy, measured in terms of the International Prostate Symptom Score (IPSS), quality of life (QOL), maximum urinary flow rate (Qmax) and post-voiding residual volume were assessed on each visit. RESULTS: On completion of the study, the mean change in the IPSS and QOL from the baseline were -6.9+/-5.7 (p<0.01) and -1.4+/-1.1 (p<0.01), respectively. The Qmax and post-voiding residual volume were significantly improved compared to the baseline (p<0.01). Decreases in the mean systolic and diastolic blood pressures from the baseline in hypertensive patients (n=139) were significantly greater than in normotensive patients (n=309). There were 25 cases (5.1%) among 487 patients in which adverse events, such as dizziness, impotence, dryness of mouth and postural hypotension, were reported. CONCLUSIONS: In treating BPH, doxazosin GITS significantly improved the IPSS, QOL, Qmax and post-voiding residual volume. Doxazosin GITS is a safe and effective drug for the treatment of BPH in Korean men when used in a standard clinical setting.
Dizziness ; Doxazosin* ; Erectile Dysfunction ; Humans ; Hypotension, Orthostatic ; Male ; Mouth ; Prostate ; Prostatic Hyperplasia* ; Quality of Life ; Residual Volume