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

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

PURPOSE: This study set out to investigate the safety and efficacy of doxazosin treatment in symptomatic patients with benign prostatic hyperplasia(BPH) in Korea. MATERIALS AND METHODS: A total of 237 male patients aged 50 or over with clinical evidence of BPH were enrolled into this 12-week, open, baseline-controlled, dose-response study. A run-in period of 2 weeks placebo treatment was followed by 10 weeks of doxazosin treatment. The initial dose was 1mg per day which, at 2-week intervals, could have been titrated up to 2, 4, or 8mg per day. Efficacy, in terms of International Prostate Symptom Score(I-PSS) and blood pressure(BP), was assessed from Week 6 onwards. RESULTS: A total of 180 patients(mean age 65.3 years) completed the study, with the most common reason for withdrawal being lost to follow-up(35 cases); four patients were withdrawn due to adverse events. Mean I-PSS score was reduced by 48.8%(from 21.5 at baseline to 11 at completion). Subset analysis of normo- or hypertensive patients showed that in the 26 hypertensive patients mean systolic BP was reduced by 12.3%(-19mmHg) and mean diastolic BP by 13.7%(-14mmHg), whereas in normotensive patients the reductions were 4.0%(-5mmHg) and 1.9%(-1.5mmHg), respectively. No differences in I-PSS improvements were seen between these two groups. The effects of age were also investigated and showed no significant differences in the changes in blood pressure for older patients(> or =65 years; n=91 ) compared with younger patients(7.5/5.8mmHg compared with 6.5/5.0mmHg). There were no differences in I-PSS improvement. Twenty eight adverse events were reported by 16 patients, the most commomly reported events being dizziness, postural hypotension, and headache. CONCLUSIONS: The effectiveness and safety of doxazosin in the treatment of BPH was confirmed in this Korean population, with significant improvements in I-PSS regardless of patient age and blood pressure at baseline. The baseline I-PSS was higher than is commonly seen in European populations, indicating a greater disease severity.
Blood Pressure ; Dizziness ; Doxazosin* ; Headache ; Humans ; Hypotension, Orthostatic ; Korea ; Male ; Prostate ; Prostatic Hyperplasia*

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

An arterialized venous flap has the advantages of being thin and pliable, utilizing a large-caliber vein with a pedicle of almost any length, as well as obviating the need to sacrifice a donor artery. However, the main disadvantage of this flap is the partial necrosis of the large flap. The aim of this study was to investigate the efficacy of a surgical delay procedure and a combined surgical and chemical delay procedure on the survival of arterialized venous flaps. Ninety New Zealand white rabbits were divided into three groups: control group, a surgical delay group and a combined surgical and chemical delay group. These groups were further divided into subgroups depending on the delay period and the chemical agents. One arterialized venous flap was made from only one ear of each rabbit due to operative mortality, and 10 rabbits were distributed to each subgroup. The arterialized venous flap had an arterial inflow by anastomosis of the central auricular artery to the anterior branch of the central auricular vein and a venous outflow through the anterior marginal vein. The results were as follows ; 1. Control group : The arterialized venous flaps without any delay procedure showed complete necrosis of all flaps. 2. Surgical delay group : The mean percentages of survival areas of arterialized venous flaps were 36.6% in the 4-day delay group, 59.7% in the 7-day delay group. 3. Combined surgical and chemical delay group: a. A 3-day chemical delay in a continuation of a 4-day simultaneous surgical and chemical delay group: The mean percentages of survival areas of the arterialized venous flaps were 81.1% in the doxazosin mesylate group, 72.8% in the nitroglycerine patch group and 92.9% in a combination group of doxazosin mesylate and nitroglycerine patch. b. A 3-day chemical delay in a continuation of a 7-day simultaneous surgical and chemical delay group : The mean percentages of survival areas of the arterialized venous flaps were 94% in the doxazosin mesylate group, 90.2% in the nitroglycerine patch group and 99% in a combination group of doxazosin mesylate and nitroglycerine patch. In conclusion, the surgical delay procedure increases the percentage of survival areas of the arterialized venous flap in proportion to the delay period. The combination group of surgical and chemical delay procedure had a significant increase of the percentage of survival areas than that of the surgical delay group(p < 0.001). The best survival of the flap was obtained from the subgroup which had a 3-day chemical delay in a continuation of a 7-day simultaneous surgical and chemical delay with combined chemical agents.
Arteries ; Doxazosin ; Ear ; Humans ; Mortality ; Necrosis ; Nitroglycerin ; Rabbits* ; Tissue Donors ; Veins

An arterialized venous flap has the advantages of being thin and pliable, utilizing a large-caliber vein with a pedicle of almost any length, as well as obviating the need to sacrifice a donor artery. However, the main disadvantage of this flap is the partial necrosis of the large flap. The aim of this study was to investigate the efficacy of a surgical delay procedure and a combined surgical and chemical delay procedure on the survival of arterialized venous flaps. Ninety New Zealand white rabbits were divided into three groups: control group, a surgical delay group and a combined surgical and chemical delay group. These groups were further divided into subgroups depending on the delay period and the chemical agents. One arterialized venous flap was made from only one ear of each rabbit due to operative mortality, and 10 rabbits were distributed to each subgroup. The arterialized venous flap had an arterial inflow by anastomosis of the central auricular artery to the anterior branch of the central auricular vein and a venous outflow through the anterior marginal vein. The results were as follows ; 1. Control group : The arterialized venous flaps without any delay procedure showed complete necrosis of all flaps. 2. Surgical delay group : The mean percentages of survival areas of arterialized venous flaps were 36.6% in the 4-day delay group, 59.7% in the 7-day delay group. 3. Combined surgical and chemical delay group: a. A 3-day chemical delay in a continuation of a 4-day simultaneous surgical and chemical delay group: The mean percentages of survival areas of the arterialized venous flaps were 81.1% in the doxazosin mesylate group, 72.8% in the nitroglycerine patch group and 92.9% in a combination group of doxazosin mesylate and nitroglycerine patch. b. A 3-day chemical delay in a continuation of a 7-day simultaneous surgical and chemical delay group : The mean percentages of survival areas of the arterialized venous flaps were 94% in the doxazosin mesylate group, 90.2% in the nitroglycerine patch group and 99% in a combination group of doxazosin mesylate and nitroglycerine patch. In conclusion, the surgical delay procedure increases the percentage of survival areas of the arterialized venous flap in proportion to the delay period. The combination group of surgical and chemical delay procedure had a significant increase of the percentage of survival areas than that of the surgical delay group(p < 0.001). The best survival of the flap was obtained from the subgroup which had a 3-day chemical delay in a continuation of a 7-day simultaneous surgical and chemical delay with combined chemical agents.
Arteries ; Doxazosin ; Ear ; Humans ; Mortality ; Necrosis ; Nitroglycerin ; Rabbits* ; Tissue Donors ; Veins