Tamsulosin shows edge in improving BPH symptoms

Patients receiving tamsulosin hydrochloride (Flomax) experienced significantly greater improvement in symptoms associated with BPH than patients who received terazosin hydrochloride (Hytrin) after 4 days of treatment, according to a study appearing in The Journal of Applied Research in Clinical and Experimental Therapeutics (2005; 5:231-45). The study also showed that treatment with terazosin was associated with significantly more side effects, including dizziness and sleepiness.

"Unlike terazosin, tamsulosin does not have to be titrated and patients receive a therapeutically effective dose on day 1," said principal author Perinchery Narayan, MD, of the North Florida Urology Association. "Because side effects, including dizziness and reduced blood pressure, were more common in men treated with terazosin, these findings also indicate that tamsulosin may be a more appropriate treatment option for men with BPH who might also be taking medications for hypertension."

In the study, 1,993 BPH patients were randomized to receive tamsulosin (.4 mg/day) or terazosin (5 mg/day). Patients taking tamsulosin experienced a statistically and clinically significant improvement—25%—in BPH symptoms after 4 days of treatment, while patients taking terazosin had an 18% improvement. In patients with severe BPH symptoms, the adjusted mean change in total AUA-Symptom Index score after 4 days of therapy was -6.6 for tamsulosin patients versus -4.8 for terazosin patients (p>.001).