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INTERACTION BETWEEN THE PHOSPHODIESTERASE 5 INHIBITOR, TADALAFIL AND 2 α-BLOCKERS, DOXAZOSIN AND TAMSULOSIN IN HEALTHY NORMOTENSIVE MEN

2004; Lippincott Williams & Wilkins; Volume: 172; Issue: 5 Linguagem: Inglês

10.1097/01.ju.0000142687.75577.e4

1527-3792

Robert A. Kloner, Graham Jackson, Jeffrey T. Emmick, Malcolm I. Mitchell, Alun Bedding, Margaret R. Warner, Álvaro R. Pereira,

Pharmacology and Obesity Treatment

No AccessJournal of UrologyAdult Urology: Sexual Function/Infertility1 Nov 2004INTERACTION BETWEEN THE PHOSPHODIESTERASE 5 INHIBITOR, TADALAFIL AND 2 α-BLOCKERS, DOXAZOSIN AND TAMSULOSIN IN HEALTHY NORMOTENSIVE MEN ROBERT A. KLONER, GRAHAM JACKSON, JEFFREY T. EMMICK, MALCOLM I. MITCHELL, ALUN BEDDING, MARGARET R. WARNER, and ALVARO PEREIRA ROBERT A. KLONERROBERT A. KLONER , GRAHAM JACKSONGRAHAM JACKSON , JEFFREY T. EMMICKJEFFREY T. EMMICK , MALCOLM I. MITCHELLMALCOLM I. MITCHELL , ALUN BEDDINGALUN BEDDING , MARGARET R. WARNERMARGARET R. WARNER , and ALVARO PEREIRAALVARO PEREIRA View All Author Informationhttps://doi.org/10.1097/01.ju.0000142687.75577.e4AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Tadalafil, a phosphodiesterase type 5 inhibitor, is effective therapy for erectile dysfunction (ED). Men with ED have a high incidence of comorbid conditions including cardiovascular disease, diabetes mellitus and benign prostatic hyperplasia. Although phosphodiesterase type 5 inhibitors are safe when administered with most medications, sildenafil given with doxazosin and vardenafil given with terazosin evoke orthostatic hypotension in some patients. We examined the hemodynamic interactions of tadalafil with the α-blockers doxazosin and tamsulosin. Materials and Methods: In separate double-blind, placebo controlled, randomized crossover studies (18 patients in each study) we evaluated the hemodynamic effects of doxazosin 8 mg with tadalafil 20 mg, and tamsulosin 0.4 mg with tadalafil 10 and 20 mg. Blood pressure (BP) and heart rate were recorded before dosing and for 24 hours after dosing. Results: Tadalafil 20 mg augmented the hypotensive effect of doxazosin by producing a mean maximal decrease in standing systolic BP (SBP) that was significantly greater than placebo (a mean difference of 9.8 mm Hg). Analysis of BP outliers showed that the number of subjects with a standing SBP of less than 85 mm Hg was greater after doxazosin plus tadalafil (28%) versus doxazosin plus placebo (6%). In subjects on tamsulosin, tadalafil 10 and 20 mg produced mean maximal decreases in standing SBP that were similar to placebo (mean difference of 1.7 and 2.3 mm Hg, respectively). No subject taking tamsulosin had a decrease in standing SBP less than 85 mm Hg. Conclusions: Tadalafil augmented the hypotensive effects of doxazosin but had little hemodynamic interaction with tamsulosin. In patients taking tadalafil for ED, tamsulosin 0.4 mg may be given for the treatment of benign prostatic hyperplasia. References 1 : Oral sildenafil in the treatment of erectile dysfunction. 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Link, Google Scholar From The Heart Institute, Good Samaritan Hospital, Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California (RAK), Guy's and St. Thomas Hospital, London, United Kingdom (GJ), Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana (JTE, MRW), Windlesham, United Kingdom (MIM, AB), and Mont-Saint-Guibert, Belgium (AP)© 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byNg C, Wong A, Cheng C, Chan E, Wong H and Hou S (2018) Effect of Vardenafil on Blood Pressure Profile of Patients With Erectile Dysfunction Concomitantly Treated With Doxazosin Gastrointestinal Therapeutic System for Benign Prostatic HyperplasiaJournal of Urology, VOL. 180, NO. 3, (1042-1046), Online publication date: 1-Sep-2008.Andersson K (2018) How Many Drugs for LUTS Due to BPH are Too Many?Journal of Urology, VOL. 180, NO. 3, (811-812), Online publication date: 1-Sep-2008.Nieminen T, Tammela T, Kööbi T and Kähönen M (2018) The Effects of Tamsulosin and Sildenafil in Separate and Combined Regimens on Detailed Hemodynamics in Patients With Benign Prostatic EnlargementJournal of Urology, VOL. 176, NO. 6, (2551-2556), Online publication date: 1-Dec-2006. Volume 172Issue 5November 2004Page: 1935-1940 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordsdoxazosinprostatic hyperplasiaphosphodiesterase inhibitorsadrenergic alpha-antagonistsMetricsAuthor Information ROBERT A. KLONER Financial interest and/or other relationship with Pfizer, Lilly ICOS, Bayer GSK and Merck (Germany) More articles by this author GRAHAM JACKSON More articles by this author JEFFREY T. EMMICK Financial interest and/or other relationship with Eli Lilly & Co More articles by this author MALCOLM I. MITCHELL Financial interest and/or other relationship with Eli Lilly & Co More articles by this author ALUN BEDDING Financial interest and/or other relationship with Eli Lilly & Co More articles by this author MARGARET R. WARNER Financial interest and/or other relationship with Eli Lilly & Co More articles by this author ALVARO PEREIRA Financial interest and/or other relationship with Eli Lilly & Co More articles by this author Expand All Advertisement PDF downloadLoading ...