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

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: This study aimed at evaluating the expected additive blood pressure (BP) lowering effect of vardenafil when administered in the background of chronic alpha1-blocker therapy. Materials and Methods: Patients (n=90) with symptomatic benign prostatic hypertrophy (BPH) and erectile dysfunction (ED) took vardenafil 20mg in the morning following repeated doxazosin gastrointestinal therapeutic system (GITS) 4mg (n=60) or tamsulosin 0.2mg (n=30) HS a day for 30 days. The standing and sitting BP at baseline, before taking the vardenafil and 30 minutes and 1 hour post vardenafil were measured 3 consecutive times. The data were analyzed by Student's t-test (paired), repeated measures of two-way ANOVA, chi-square tests and Pearson correlation analysis. Results: Doxazosin produced a significant reduction in systolic/diastolic BP ( 12.3/ 6.7mmHg), but tamsulosin did not. In the doxazosin group, the average reductions in BP from baseline ( 24.7/ 15.8mmHg) were significantly higher than that for the tamsulosin group ( 14.6/ 7.5mmHg). However, the average BP change was not different in both group ( 12.4/ 9.1mmHg in the doxazosin group and 11.3/ 6.4mmHg in the tamsulosin group) following a single dose of 20mg vardenafil. The higher the BP was at baseline, the more the reduction in BP was in both the doxazosin and tamsulosin groups. Two patients of tamsulosin showed a sitting systolic BP <85mmHg, but they didn't experience dizziness. Conclusions: We recommend starting Vardenafil treatment in the background of chronic aalpha1 blocker therapy, including tamsulosin, with a low dose and to increase the dose by monitoring the BP, particularly for the patients with hypertension.
Blood Pressure* ; Dizziness ; Doxazosin* ; Drug Interactions* ; Erectile Dysfunction* ; Humans ; Hypertension ; Male ; Prostatic Hyperplasia* ; Vardenafil Dihydrochloride

PURPOSE: We administered doxazosin gastrointestinal therapeutic system (GITS) to women with non-neurogenic voiding dysfunction to evaluate its therapeutic effects. MATERIALS AND METHODS: Women who had voiding dysfunctions for at least 3 mo were included. Inclusion criteria were age > or =18yr, an International Prostate Symptom Score (IPSS) > or =15, and a maximum flow rate (Qmax) <15mL/sec and/or postvoid residual (PVR) > or =150mL. Patients with neurogenic voiding dysfunction or anatomical bladder outlet obstruction were excluded. All patients were classified according to the Blaivas-Groutz nomogram. After 4 weeks, treatment outcomes were evaluated. RESULTS: Sixty-two patients were evaluated of mean age 53.8 (32-78)yr. According to the Blaivas-Groutz nomogram, 24 patients had no or mild obstruction (group A) and 38 had moderate or severe obstruction (group B). After treatment, mean IPSS decreased significantly and by more than 5 points in 42 (67.7%). Mean bother scores, Qmax, and PVR also changed significantly. Thirty-seven (59.7%) showed Qmax increases of more than 50%. No significant difference were observed between the groups in terms of IPSS, bother score, Qmax, PVR, micturition frequencies, or functional bladder capacity changes. Adverse effects related to medication were de novo stress urinary incontinence (SUI) (1 case) and underlying SUI aggravation (1 case). By satisfaction assessments, 16 patients (25.8%) were 'mainly satisfied', 31 (50%) were 'slightly satisfied', and 15 (24.2%) were 'dissatisfied'. CONCLUSION: Doxazosin GITS was found to be effective in female patients with voiding dysfunction regardless of obstruction grade. The alpha-adrenoceptor antagonists should be viewed as initial treatment option for women with a non-neurogenic voiding dysfunction.
Doxazosin* ; Female ; Humans ; Nomograms ; Prostate ; Urinary Bladder ; Urinary Bladder Neck Obstruction ; Urinary Incontinence ; Urination

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 goal of this study is to estimate the effect of doxazosin GITS on sexual function of patients with benign prostatic hyperplasia using the validated international index of erectile function (IIEF). MATERIALS AND METHODS: We prospectively examined a total of 60 patients with benign prostatic hyperplasia who were treated with doxazosin by using the IIEF questionnaires prior to treatment and after 3 months of medication. The patients whose total IIEF scores were under 21 and treated with finasteride were excluded. RESULTS: The mean total IIEF scores after treatment with doxazosin increased from 41.4+/-10 to 44.2+/-9.3 (p<0.001). The mean scores of IIEF according to the patient's age for the men in their fifties, sixties, and seventies were 48.6+/-8.3, 41.5+/-9.5, and 36.6+/-9.7, respectively, and the mean scores decreased as the patient's age increased. Among the mean scores of each IIEF domain, the erectile function scores increased from 16.4+/-4.8 to 18.2+/-4.2 (p<0.001), the intercourse satisfaction scores increased from 6.9+/-2.3 to 7.3+/-2.2 (p<0.001), the orgasm function scores increased from 6.4+/-1.7 to 6.5+/-1.8 (p=0.038), the sexual desire scores increased from 6.6+/-1.3 to 6.8+/-1.3 (p=0.164), and the overall satisfaction scores increased from 5.4+/-1.9 to 5.8+/-1.7 (p<0.001). CONCLUSIONS: According to the IIEF questionnaire, the generalized sexual function increased after doxazosin treatment in patients with benign prostatic hyperplasia, especially, in the erectile function and intercourse satisfaction domain.
Doxazosin* ; Finasteride ; Humans ; Male ; Orgasm ; Prospective Studies ; Prostatic Hyperplasia* ; Surveys and Questionnaires

BACKGROUND: Exercise-induced coronary spasm is occasionally recognized in patients with variant angina, but the patterns of exercise-induced coronary spasm and its relation to clinical features are still not clear. METHODS: Eight consecutive patients with variant angina without significant stenosis of the coronary artery performed serial treadmill exercise tests during early morning, late morning, and in the afternoon. The subjects repeated the tests after administration of atropine and doxazosin or phentolamine. RESULTS: (Upon drug administration), anginal episodes with ST-segment changes (elevation 5, depression 1) Occurred repeatedly in 6 of the 8 patients during early morning; the episodes occurred in only 2 patients during the afternoon exercise test. Four patients showed exercise-induced angina and ST-segment changes during early morning but not in the afternoon, and 2 of them showed mild episodes of exercise-induced angina and ST-segment changes during late morning. Three of the four patients had the characteristic clinical history of angina in early morning during usual activities but not during daytime activities despite the activities being more strenuous. Another 2 patients showed both exercise-induced ST-segment elevation and angina in early morning and afternoon, and they had the characteristic history of more episodes at night and in early morning but only occasionally in the daytime with or without relation to activity. One of the two patients showed intermittent ST-segment elevation during the exercise test. The other two patients had exercise-induced episodes neither in the early morning nor in the afternoon; they had a characteristic history of episodes only at night during sleep but never in the early morning nor in the daytime. Atropine did not suppress the exercise-induced angina in 4 of 5 patients studied. Doxazosin or phentolamine suppressed the exercise-induced episodes in 3 of 5 patients studied but aggravated spontaneous episodes in 3 patients. CONCLUSION: These data suggest that there's possibility of presence of different patterns of exercise-induced coronary spasm, which may be induced by different mechanisms from those in spontaneous episodes in patients with variant angina.
Atropine ; Constriction, Pathologic ; Coronary Vessels ; Depression ; Doxazosin ; Exercise Test ; Humans ; Phentolamine ; Spasm*

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