Alpha1-Blockers για τη χρόνια προστατίτιδα

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Εμένα γνωστός ουρολόγος που πρότεινε να πάρω OMNIC TOKAS. Βλέπω μάλιστα αποτελέσματα. Τα φάρμακα αυτά έχουν σημαντική θέση στη θεραπεία της χρόνιας προστατίτιδας- χρόνιου πυελικού άλγους. Σύμφωνα με τις παγκόσμιες ιατρικές οδηγίες από το καλύτερο συνδρομητικό ιατρικό site
http://www.chronic-prostatitis.com/index.php?topic=244.0
όλοι οι α1 αποκλειστές (Οmnic ή Xatral) λαμβάνονται μία φορά την ημέρα μετά το φαγητό. εσείς έχετε πάρει ποτέ;;;;;
από κάτω οδηγίες πρώτα για το Οmnic tocas (Tamsulosin) και έπειτα για το δέυτερο α1 αποκλειστή Xatral OD (Alfuzosin)

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Tamsulosin: Drug information (OMNIC)
For abbreviations and symbols that may be used in Lexicomp (show table)
Brand Names: U.S.
•   Flomax®
Brand Names: Canada
•   Ava-Tamsulosin CR;
•   Flomax® CR;
•   JAMP-Tamsulosin;
•   Mylan-Tamsulosin;
•   RAN™-Tamsulosin;
•   ratio-Tamsulosin;
•   Sandoz-Tamsulosin;
•   Sandoz-Tamsulosin CR;
•   Teva-Tamsulosin
Pharmacologic Category
•   Alpha 1 Blocker
Dosing: Adult
Benign prostatic hyperplasia (BPH): Oral: 0.4 mg once daily ~30 minutes after the same meal each day; dose may be increased after 2-4 weeks to 0.8 mg once daily in patients who fail to respond. If therapy is interrupted for several days, restart with 0.4 mg once daily.
Bladder outlet obstruction symptoms (unlabeled use): Oral: 0.4 mg once daily (Rossi, 2001)
Ureteral stones, expulsion (unlabeled use): Oral: 0.4 mg once daily, discontinue after successful expulsion (average time to expulsion was 1-2 weeks) (Agrawal, 2009; Ahmed, 2010). Note: Patients with stones >10 mm were excluded from studies.
Dosing: Geriatric
Refer to adult dosing.
Dosing: Renal Impairment
Clcr ≥10 mL/minute: No adjustment needed.
Clcr <10 mL/minute: Not studied.
Dosing: Hepatic Impairment
Mild-to-moderate impairment: No adjustment needed
Severe impairment: Not studied
Dosage Forms: U.S.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Capsule, oral, as hydrochloride: 0.4 mg
Flomax®: 0.4 mg
Generic Equivalent Available: U.S.
Yes
Administration
Administer 30 minutes after the same meal each day. Capsules should be swallowed whole; do not crush, chew, or open.
Use
Treatment of signs and symptoms of benign prostatic hyperplasia (BPH)
Use - Unlabeled
Symptomatic treatment of bladder outlet obstruction or dysfunction; facilitation of expulsion of ureteral stones
Medication Safety Issues
Sound-alike/look-alike issues:
Flomax® may be confused with Flonase®, Flovent®, Foltx®, Fosamax®
Tamsulosin may be confused with tacrolimus, tamoxifen, terazosin
International issues:
Flomax [U.S., Canada, and multiple international markets] may be confused with Flomox brand name for cefcapene [Japan]; Volmax brand name for salbutamol [multiple international markets]
Flomax: Brand name for tamsulosin [U.S., Canada, and multiple international markets], but also the brand name for morniflumate [Italy]
Adverse Reactions Significant
>10%:
Cardiovascular: Orthostatic hypotension (6% to 19%)
Central nervous system: Headache (19% to 21%), dizziness (15% to 17%)
Genitourinary: Abnormal ejaculation (8% to 18%)
Respiratory: Rhinitis (13% to 18%)
Miscellaneous: Infection (9% to 11%)
1% to 10%:
Cardiovascular: Chest pain (4%)
Central nervous system: Somnolence (3% to 4%), insomnia (1% to 2%), vertigo (≤1%)
Endocrine & metabolic: Libido decreased (1% to 2%)
Gastrointestinal: Diarrhea (4% to 6%), nausea (3% to 4%), gum pain, toothache
Neuromuscular & skeletal: Weakness (8% to 9%), back pain (7% to 8%)
Ocular: Blurred vision (≤2%)
Respiratory: Pharyngitis (5% to 6%), cough (3% to 5%), sinusitis (2% to 4%)
<1% (Limited to important or life-threatening): Allergic reactions (angioedema, pruritus, rash, urticaria, respiratory symptoms); constipation, hypotension, intraoperative floppy iris syndrome, lightheadedness, orthostasis (symptomatic), palpitation, priapism, skin desquamation, syncope, vomiting
Contraindications
Hypersensitivity to tamsulosin or any component of the formulation
Warnings/Precautions
Concerns related to adverse effects:
• Angina: Discontinue if symptoms of angina occur or worsen.
• Floppy iris syndrome: Intraoperative floppy iris syndrome has been observed in cataract surgery patients who were on or were previously treated with alpha1-blockers; causality has not been established and there appears to be no benefit in discontinuing alpha-blocker therapy prior to surgery. Instruct patients to inform ophthalmologist of tamsulosin use when considering eye surgery.
• Orthostatic hypotension/syncope: May cause significant orthostatic hypotension and syncope, especially with first dose; anticipate a similar effect if therapy is interrupted for a few days, if dosage is rapidly increased, or if another antihypertensive drug (particularly vasodilators) or a PDE-5 inhibitor (eg, sildenafil, tadalafil, vardenafil) is introduced. "First-dose" orthostatic hypotension may occur 4-8 hours after dosing; may be dose related. Patients should be cautioned about performing hazardous tasks when starting new therapy or adjusting dosage upward.
• Priapism: Priapism has been associated with use (rarely).
• Sulfonamide allergy: Rarely, patients with a sulfa allergy have also developed an allergic reaction to tamsulosin; avoid use when previous reaction has been severe.
Disease-related concerns:
• Prostate cancer: It is recommended to rule out prostatic carcinoma before beginning therapy.
Other warnings/precautions:
• Antihypertensive use: Not intended for use as an antihypertensive drug.
Metabolism/Transport Effects
Substrate of CYP2D6 (minor), CYP3A4 (major); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential
Drug Interactions
(For additional information: Launch Lexi-Interact™ Drug Interactions Program)
Alpha1-Blockers: May enhance the antihypertensive effect of other Alpha1-Blockers. Risk X: Avoid combination
Beta-Blockers: May enhance the orthostatic hypotensive effect of Alpha1-Blockers. The risk associated with ophthalmic products is probably less than systemic products. Exceptions: Levobunolol; Metipranolol. Risk D: Consider therapy modification
Calcium Channel Blockers: Alpha1-Blockers may enhance the hypotensive effect of Calcium Channel Blockers. Risk C: Monitor therapy
CYP3A4 Inducers (Strong): May increase the metabolism of CYP3A4 Substrates. Risk C: Monitor therapy
CYP3A4 Inhibitors (Moderate): May decrease the metabolism of CYP3A4 Substrates. Risk C: Monitor therapy
CYP3A4 Inhibitors (Strong): May increase the serum concentration of Tamsulosin. Risk X: Avoid combination
Dasatinib: May increase the serum concentration of CYP3A4 Substrates. Risk C: Monitor therapy
Deferasirox: May decrease the serum concentration of CYP3A4 Substrates. Risk C: Monitor therapy
Herbs (CYP3A4 Inducers): May increase the metabolism of CYP3A4 Substrates. Risk C: Monitor therapy
Ivacaftor: May increase the serum concentration of CYP3A4 Substrates. Risk C: Monitor therapy
MAO Inhibitors: May enhance the orthostatic hypotensive effect of Orthostatic Hypotension Producing Agents. Risk C: Monitor therapy
Mifepristone: May increase the serum concentration of CYP3A4 Substrates. Management: Minimize doses of CYP3A4 substrates, and monitor for increased concentrations/toxicity, during and 2

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weeks following treatment with mifepristone. Avoid cyclosporine, dihydroergotamine, ergotamine, fentanyl, pimozide, quinidine, sirolimus, and tacrolimus. Risk D: Consider therapy modification
Peginterferon Alfa-2b: May decrease the serum concentration of CYP2D6 Substrates. Risk C: Monitor therapy
Phosphodiesterase 5 Inhibitors: May enhance the hypotensive effect of Alpha1-Blockers. Management: Ensure patient is stable on one agent prior to initiating the other, and always initiate combination using the lowest possible dose of the drug being added. When tadalafil is used for treatment of BPH, concurrent alpha 1-blockers are not recommended. Risk D: Consider therapy modification
Tocilizumab: May decrease the serum concentration of CYP3A4 Substrates. Risk C: Monitor therapy
Ethanol/Nutrition/Herb Interactions
Food: Fasting increases bioavailability by 30% and peak concentration 40% to 70%. Management: Administer 30 minutes after the same meal each day.
Herb/Nutraceutical: St John's wort may decrease the levels/effects of tamsulosin. Some herbal medications have hypotensive properties or may increase the hypotensive effect of tamsulosin. Limited information is available regarding combination with saw palmetto. Management: Avoid St John's wort, black cohosh, California poppy, coleus, golden seal, hawthorn, mistletoe, periwinkle, quinine, and shepherd's purse. Avoid saw palmetto.
Pregnancy Risk Factor
B (show table)
Pregnancy Implications
Teratogenic effects were not observed in animal studies.
Dietary Considerations
Take once daily, 30 minutes after the same meal each day.
Pricing: U.S. (www.drugstore.com)
Capsules (Flomax)
0.4 mg (30): $153.99
Capsules (Tamsulosin HCl)
0.4 mg (30): $122.99
International Brand Names
•   Alna (AT, DE);
•   Comadex (EC);
•   Flomax (NZ, TR);
•   Flomaxtra (AU, NZ);
•   Flomaxtra XL (GB);
•   Harnal (CL, HK, JP, PH, TH);
•   Harnal D (ID);
•   Harnal OCAS (ID, MY, PH, SG);
•   Harnalidge D (TW);
•   Harusin SR (KP);
•   Josir (FR);
•   Lutsnal (KP);
•   Mecir LP (FR);
•   Omexel LP (FR);
•   Omic (BE, LU);
•   Omix Ocas (CH);
•   Omnexel (IE);
•   Omnic (AR, CN, CO, CZ, DE, DK, EE, ES, FI, GR, HU, IL, IT, NL, NO, PE, PL, PT, PY, RU);
•   Omnic OCAS (IL);
•   Omnic Tocas (BG);
•   Pimax (PH);
•   Pradif (PT);
•   Promnix (IL);
•   Prozelax (PH);
•   Secotex (AR, CN, CO, CR, DO, GT, HN, MX, NI, PA, PE, PY, SV, UY, VE);
•   Secotex OCAS (CR, DO, EC, GT, HN, NI, PA, SV);
•   Sulosin (KP);
•   Sulosin D (KP);
•   Tabphyn MR (GB);
•   Tamlosin (TW);
•   Tamlosin SR (KP);
•   Tamsulin (IL);
•   Tamsulo (KP);
•   Tamsulon (CR, DO, EC, GT, HN, NI, SV);
•   Tamunal (KP);
•   Tarunal (KP);
•   Urimax (IN);
•   Urnal (TW);
•   Urotams SR (KP);
•   Zotan (TW)
Mechanism of Action
Tamsulosin is an antagonist of alpha1A-adrenoreceptors in the prostate. Smooth muscle tone in the prostate is mediated by alpha1A-adrenoreceptors; blocking them leads to relaxation of smooth muscle in the bladder neck and prostate causing an improvement of urine flow and decreased symptoms of BPH. Approximately 75% of the alpha1-receptors in the prostate are of the alpha1A subtype.
Pharmacodynamics/Kinetics
Absorption: >90%
Distribution: Vd: 16 L
Protein binding: 94% to 99%, primarily to alpha1 acid glycoprotein (AAG)
Metabolism: Hepatic (extensive) via CYP3A4 and 2D6; metabolites undergo extensive conjugation to glucuronide or sulfate
Bioavailability: Fasting: 30% increase
Steady-state: By the fifth day of once-daily dosing
Half-life elimination: Healthy volunteers: 9-13 hours; Target population: 14-15 hours
Time to peak: Fasting: 4-5 hours; With food: 6-7 hours
Excretion: Urine (76%, <10% as unchanged drug); feces (21%)
Use of UpToDate is subject to the Subscription and License Agreement.
REFERENCES
1.   Agrawal M, Gupta M, Gupta A, et al, "Prospective Randomized Trial Comparing Efficacy of Alfuzosin and Tamsulosin in Management of Lower Ureteral Stones," Urology, 2009, 73(4):706-9. [PubMed 19193417]
2.   Ahmed AF and Al-Sayed AY, "Tamsulosin versus Alfuzosin in the Treatment of Patients with Distal Ureteral Stones: Prospective, Randomized, Comparative Study," Korean J Urol, 2010, 51(3):193-7. [PubMed 20414396]
3.   Chang DF and Campbell JR, "Intraoperative Floppy Iris Syndrome Associated With Tamsulosin," J Cataract Refract Surg, 2005, 31(4):664-73. [PubMed 15899440]
4.   Goldman HB and Zimmern PE, "The Treatment of Female Bladder Outlet Obstruction," BJU Int, 2006, 98(Suppl 1):17-23. [PubMed 16911596]
5.   Pischedda A, Pirozzi Farina F, Madonia M, et al, "Use of Alpha1-Blockers in Female Functional Bladder Neck Obstruction," Urol Int, 2005, 74(3):256-61. [PubMed 15812214]
6.   Rossi C, Kortmann BB, Sonke GS, et al, "Alpha-Blockade Improves Symptoms Suggestive of Bladder Outlet Obstruction But Fails to Relieve It," J Urol, 2001, 165(1):38-41. [PubMed 11125359]

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Alfuzosin: Drug information (XATRAL)

For abbreviations and symbols that may be used in Lexicomp (show table)
Brand Names: U.S.
•   Uroxatral®
Brand Names: Canada
•   Apo-Alfuzosin®;
•   Sandoz-Alfuzosin;
•   Teva-Alfuzosin PR;
•   Xatral
Pharmacologic Category
•   Alpha 1 Blocker
Dosing: Adult
Benign prostatic hyperplasia (BPH): Oral: 10 mg once daily
Ureteral stones, expulsion (unlabeled use): Oral: 10 mg once daily, discontinue after successful expulsion (average time to expulsion 1-2 weeks) (Agrawal, 2009; Ahmed, 2010; Gurbuz, 2011). Note: Patients with stones >10 mm were excluded from studies.
Dosing: Geriatric
Refer to adult dosing.
Dosing: Renal Impairment
Bioavailability and maximum serum concentrations are increased by ~50% with mild (Clcr 60-80 mL/minute), moderate (Clcr 30-59 mL/minute), or severe (Clcr <30 mL/minute) renal impairment.
Note: Safety data is limited in patients with severe renal impairment (Clcr <30 mL/minute). Use with caution.
Dosing: Hepatic Impairment
Mild hepatic impairment: Use has not been studied; use caution.
Moderate or severe hepatic impairment (Child-Pugh class B or C): Clearance is decreased 1/3 to 1/4 and serum concentration is increased three- to fourfold; use is contraindicated.
Dosage Forms: U.S.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Tablet, extended release, oral, as hydrochloride: 10 mg
Uroxatral®: 10 mg
Generic Equivalent Available: U.S.
Yes
Administration
Tablet should be swallowed whole; do not crush or chew. Administer once daily (immediately following a meal); should be taken at the same time each day.
Use
Treatment of the functional symptoms of benign prostatic hyperplasia (BPH)
Use - Unlabeled
Facilitation of expulsion of ureteral stones
Adverse Reactions Significant
1% to 10%:
Central nervous system: Dizziness (6%), fatigue (3%), headache (3%), pain (1% to 2%)
Gastrointestinal: Abdominal pain (1% to 2%), constipation (1% to 2%), dyspepsia (1% to 2%), nausea (1% to 2%)
Genitourinary: Impotence (1% to 2%)
Respiratory: Upper respiratory tract infection (3%), bronchitis (1% to 2%), pharyngitis (1% to 2%), sinusitis (1% to 2%)
<1% (Limited to important or life-threatening): Angina pectoris (pre-existing CAD), angioedema, atrial fibrillation, chest pain, cholestatic liver injury, diarrhea, edema, flushing, hepatocellular injury, intraoperative floppy iris syndrome (with cataract surgery), jaundice, priapism, pruritus, rash, rhinitis, tachycardia, urticaria
Contraindications
Hypersensitivity to alfuzosin or any component of the formulation; moderate or severe hepatic insufficiency (Child-Pugh class B and C); concurrent use with potent CYP3A4 inhibitors (eg, itraconazole, ketoconazole, ritonavir) or other alpha1-blocking agents
Warnings/Precautions
Concerns related to adverse effects:
• Angina: Discontinue if symptoms of angina occur or worsen.
• Floppy iris syndrome: Intraoperative floppy iris syndrome has been observed in cataract surgery patients who were on or were previously treated with alpha1-blockers; causality has not been established and there appears to be no benefit in discontinuing alpha-blocker therapy prior to surgery.
• Orthostatic hypotension/syncope: May cause significant orthostatic hypotension and syncope, especially with first dose; anticipate a similar effect if therapy is interrupted for a few days, if dosage is rapidly increased, or used with antihypertensives (particularly vasodilators), PDE-5 inhibitors, nitrates or other medications which may result in hypotension. Patients should be cautioned about performing hazardous tasks when starting new therapy or adjusting dosage upward.
• Priapism: Priapism has been associated with use (rarely).
Disease-related concerns:
• Hepatic impairment: Use with caution in patients with mild hepatic impairment; contraindicated in moderate-to-severe impairment.
• Prostate cancer: Rule out prostatic carcinoma before beginning therapy (many symptoms of BPH and prostate cancer are similar).
• QT prolongation: Alfuzosin has been shown to prolong the QT interval alone (minimal) and with other drugs with comparable effects on the QT interval (additive). Use with caution in patients with known QT prolongation (congenital or acquired).
• Renal impairment: Use with caution in patients with severe renal impairment (Clcr <30 mL/minute).
Concurrent drug therapy issues:
• High potential for interactions: Contraindicated in patients receiving strong CYP3A4 inhibitors or other alpha1-blockers.
Other warning/precautions:
• Antihypertensive agent: Not intended for use as an antihypertensive drug.
Metabolism/Transport Effects
Substrate of CYP3A4 (major); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential
Drug Interactions
(For additional information: Launch Lexi-Interact™ Drug Interactions Program)
Alpha1-Blockers: May enhance the antihypertensive effect of other Alpha1-Blockers. Risk X: Avoid combination
Antihypertensives: Alfuzosin may enhance the hypotensive effect of Antihypertensives. Risk C: Monitor therapy
Beta-Blockers: May enhance the orthostatic hypotensive effect of Alpha1-Blockers. The risk associated with ophthalmic products is probably less than systemic products. Exceptions: Levobunolol; Metipranolol. Risk D: Consider therapy modification
Calcium Channel Blockers: Alpha1-Blockers may enhance the hypotensive effect of Calcium Channel Blockers. Risk C: Monitor therapy
CYP3A4 Inducers (Strong): May increase the metabolism of CYP3A4 Substrates. Risk C: Monitor therapy
CYP3A4 Inhibitors (Moderate): May decrease the metabolism of CYP3A4 Substrates. Risk C: Monitor therapy
CYP3A4 Inhibitors (Strong): May increase the serum concentration of Alfuzosin. Risk X: Avoid combination
Deferasirox: May decrease the serum concentration of CYP3A4 Substrates. Risk C: Monitor therapy
Herbs (CYP3A4 Inducers): May increase the metabolism of CYP3A4 Substrates. Risk C: Monitor therapy
Ivacaftor: May increase the serum concentration of CYP3A4 Substrates. Risk C: Monitor therapy
MAO Inhibitors: May enhance the orthostatic hypotensive effect of Orthostatic Hypotension Producing Agents. Risk C: Monitor therapy
Mifepristone: May increase the serum concentration of CYP3A4 Substrates. Management: Minimize doses of CYP3A4 substrates, and monitor for increased concentrations/toxicity, during and 2 weeks following treatment with mifepristone. Avoid cyclosporine, dihydroergotamine, ergotamine, fentanyl, pimozide, quinidine, sirolimus, and tacrolimus. Risk D: Consider therapy modification
Nitroglycerin: Alfuzosin may enhance the hypotensive effect of Nitroglycerin. Risk C: Monitor therapy
Phosphodiesterase 5 Inhibitors: May enhance the hypotensive effect of Alpha1-Blockers. Management: Ensure patient is stable on one agent prior to initiating the other, and always initiate combination using the lowest possible dose of the drug being added. When tadalafil is used for treatment of BPH, concurrent alpha 1-blockers are not recommended. Risk D: Consider therapy modification
Protease Inhibitors: May increase the serum concentration of Alfuzosin. Risk X: Avoid combination
QTc-Prolonging Agents: Alfuzosin may enhance the QTc-prolonging effect of QTc-Prolonging Agents. Risk C: Monitor therapy
Telaprevir: May increase the serum concentration of Alfuzosin. Risk X: Avoid combination
Tocilizumab: May decrease the serum concentration of CYP3A4 Substrates. Risk C: Monitor therapy
Ethanol/Nutrition/Herb Interactions
Food: Food increases the extent of absorption. Management: Administer immediately following a meal at the same time each day.
Herb/Nutraceutical: St John's wort may decrease alfuzosin levels. Management: Avoid St John's wort.
Pregnancy Risk Factor
B (show table)
Pregnancy Implications
Teratogenic effects were not observed in animal studies.

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Dietary Considerations
Take immediately following a meal at the same time each day.
Pricing: U.S. (www.drugstore.com)
Tablet, 24-hour (Alfuzosin HCl)
10 mg (30): $45.99
Tablet, 24-hour (Uroxatral)
10 mg (30): $142.99
Monitoring Parameters
Urine flow, blood pressure, PSA
International Brand Names
•   Alfsin XL (KP);
•   Alfu-Kal XL (IL);
•   Alfurix XL (KP);
•   Alfusin (IN);
•   Alfuzo XL (TW);
•   Alfuzon XL (KP);
•   Azosin SR (TW);
•   Bearxat XL (KP);
•   Benestan (PT);
•   Benestan OD (PT);
•   Dalfaz (AR, ES, PL, RU);
•   Flotral (PE);
•   Fozal (PH);
•   Lafuzo (TW);
•   Profuzosin (PH);
•   Ranfuzosin (SG);
•   Uroxatral (CN);
•   Uroxatral OD (AR, UY);
•   Uroxatral uno (CH, DE);
•   Xatosin XL (KP);
•   Xatral (AT, BE, BF, BJ, CH, CI, CL, CZ, DK, ET, FI, FR, GB, GH, GM, GN, GR, IE, IL, IT, KE, LR, MA, ML, MR, MU, MW, NE, NG, NL, NO, PH, SC, SD, SE, SL, SN, TN, TR, TZ, UG, ZA, ZM, ZW);
•   Xatral LP (BG, FR, HK);
•   Xatral OD (BR, CO, CR, DO, EC, GT, HN, MX, NI, PA, PE, PH, PY, SE, SV, VE);
•   Xatral SR (AU, EE, EG, HK, IL, PK, SG);
•   Xatral XL (ID, IL, KP, TH, TW);
•   Xatral XR 10 (SG);
•   Zapros XL (KP)
Mechanism of Action
An antagonist of alpha1-adrenoreceptors in the lower urinary tract. Smooth muscle tone is mediated by the sympathetic nervous stimulation of alpha1-adrenoreceptors, which are abundant in the prostate, prostatic capsule, prostatic urethra, and bladder neck. Blockade of these adrenoreceptors can cause smooth muscles in the bladder neck and prostate to relax, resulting in an improvement in urine flow rate and a reduction in BPH symptoms.
Pharmacodynamics/Kinetics
Absorption: Decreased 50% under fasting conditions
Distribution: Vd: 3.2 L/kg
Protein binding: 82% to 90%
Metabolism: Hepatic, primarily via CYP3A4; metabolism includes oxidation, O-demethylation, and N-dealkylation; forms metabolites (inactive)
Bioavailability: 49% following a meal
Half-life elimination: 10 hours
Time to peak, plasma: 8 hours following a meal
Excretion: Feces (69%); urine (24%; 11% as unchanged drug)
Use of UpToDate is subject to the Subscription and License Agreement.
REFERENCES
1.   Agrawal M, Gupta M, Gupta A, et al, "Prospective Randomized Trial Comparing Efficacy of Alfuzosin and Tamsulosin in Management of Lower Ureteral Stones," Urology, 2009, 73(4):706-9. [PubMed 19193417]
2.   Ahmed AF and Al-Sayed AY, "Tamsulosin versus Alfuzosin in the Treatment of Patients with Distal Ureteral Stones: Prospective, Randomized, Comparative Study," Korean J Urol, 2010, 51(3):193-7. [PubMed 20414396]
3.   Gurbuz MC, Polat H, Canat L, et al, "Efficacy of Three Different Alpha 1-Adrenergic Blockers and Hyoscine N-butylbromide for Distal Ureteral Stones," Int Braz J Urol, 2011, 37(2):195-202. [PubMed 21557836]
Topic 9105 Version 31.0

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Πουθενά παραπάνω δεν γράφει για παλίνδρομη εκσπερμάτωση. Όμως και εγώ το έπαθα και άλλος ένας χρήστης του φόρουμ. Συμφέροντα παγκόσμια, αλλιώς πως θα τα πουλούσαν στην καλοήθη υπερπλασία του προστάτη.
Μου είπε ο ουρολόγος ότι με την συνέχιση της αγωγής με α-αποκλειστές μπορεί να υποχωρήσει η παλινδρόμηση. Ξέρει κανένας τίποτε για αυτό;
Επίσης ένας άλλος ότι το xatral κάνει λιγότερο την παρενέργεια της μη ορατής εκσπερμάτισης. Πάντως υπάρχει μεγάλο κενό γνώσης στην ιατρική για την πάθησή μας
Άμα το πιο αναγνωρισμένο συνδρομητικό ιατρικό site δεν τα λέει καλά, τότε τι να περιμένουμε

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Το alpha blocker δεν είναι η βασική θεραπεία αλλά είναι βοηθητικό. Προσέξτε όμως εάν πάρετε alpha blocker έχει μια πολύ δυσάρεστη παρενέργεια η οποία (ευτυχώς) όταν το σταματήσετε περνάει σε 48 ώρες. Επειδή χαλαρώνει την περιοχή (άρα και τον προστάτη) δεν δουλεύει η εκτόξευση κατά την εκσπερμάτωση. Δηλαδή εκσπερματώνεις και δεν βγαίνει τίποτα!!!! Το σπέρμα που βγαίνει πηγαίνει στην κύστη (αφού η περιοχή δεν μπορεί να το σπρώξει προς τα έξω) και βγαίνει με τα ούρα κατά την ούρηση. Εάν το πάθει κανείς από alpha blocker να μην τρομάξει δεν είνα κάτι και περνάει αμέσως μόλις σταματήσεις το φάρμακο.

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Πάντως τελικά η παλίνδρομη εκσπερμάτιση που είχα με το omnic υποχώρησε πλήρως όταν το αντικατέστησα με το άλλο a-blocker το xatral. Οπότε να ξέρετε και εσείς ότι μπορείτε να πάρετε και το δεύτερο

[Giannik]

Καλησπέρα,

Τα τελευταία χρόνια ταλαίπωρουμαι απο οξείες προστατιτιδες,έχω νοσηλευτεί πριν δυο χρόνια με ενδοφλέβια αντιβίωση..
Έχω υπερπλασία προστάτη και ο γιατρός μετα τις αντί βιώσεις μου σύστησε a blocker αλλά μου ρίχνει την πίεση και έχω πέσει πολλές φορές το βράδυ πηγαίνοντας τουαλέτα..
Σαν εναλλακτική μου συνταγογράφησε το avodart αλλά διαβάζω οτι ενεργεί στις ορμόνες ,μείωση τεστοτερόνης,ρίχνει λίμπιντο και προκαλεί και γυναικομαστία..
Ποιά είναι η γνώμη σας;
Ευχαριστώ πολύ!

[ZEFIROS]

Έπαιρνα XATRAL για περίπου 12 χρόνια λόγω  Προστατίτιδας μάλιστα το έπινα πρωί, και μολονότι έχω χαμηλή πίεση 10,5-11 δεν είχα θέμα, στην τουαλέτα στο σπίτι φυσικά ουρώ καθιστός για να μην λερώνω τριγύρω αλλά και για καμιά ζαλάδα (κυρίως στου μετά τα 60).
Επειδή το XATRAL δεν με βοηθούσε πλέον, δεν ξέρω γιατί, το άλλαξα εδώ και δύο χρόνια με omnic tocas και είμαι ευχαριστημένος νομίζω γράφει ότι υπάρχει περίπτωση το σπέρμα να πάει στην κύστη, σε εμένα δεν συμβαίνει, και με την πίεση δεν έχω θέμα τώρα το πίνω βράδυ. Για την ζαλάδα πάντως πρέπει να μην σηκώνεσαι απότομα από το κρεββάτι και να παραμένεις ένα λεπτό καθιστός.