Our library of drug research abstracts drawn from the medical literature is updated on a regular schedule, and you can be assured that new tamsulosin research articles will be listed here shortly after becoming available to us.
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Medical research on tamsulosin
[Treatment with tamsulosin. Should the cataract be operated before?]
Arch Esp Urol. 2008 Oct; 61(8): 921-2
González Martín-Moro J, Martínez Silva V
OBJECTIVE: Recently, intraoperative floppy-iris syndrome (IFIS) has been related to tamsulosin treatment. This review evaluates the epidemiological evidence of the association of tamsulosin with IFIS and the necessity of a prior ophthalmolo-gic examination in this group of patients. METHOD: Systematic review of the literature. RESULTS: Since 2005, when the syndrome was described, some studies have confirmed this association. Tamsulosin is the most clearly involved drug. No prospective studies have been published, but some authors consider that the syndrome affects, at least, half of the patients receiving this drug. No medical treatment has demonstrated its usefulness in the prevention of this syndrome. CONCLUSION: Considering the high prevalence of this syndrome, all the patients who are going to start this treatment should receive previous ophthalmologic examination, to evaluate the convenience of performing early cataract surgery in order to avoid intraoperative complications.
ASCRS White Paper: Clinical review of intraoperative floppy-iris syndrome.
J Cataract Refract Surg. 2008 Dec; 34(12): 2153-62
Chang DF, Braga-Mele R, Mamalis N, Masket S, Miller KM, Nichamin LD, Packard RB, Packer M,
Intraoperative floppy-iris syndrome (IFIS) is associated with the use of systemic alpha(1)-antagonists, and tamsulosin in particular. The incidence and severity of IFIS are variable; however, the syndrome is associated with a higher rate of cataract surgical complications, especially when the condition is not recognized or anticipated. Questioning cataract patients preoperatively about current or previous use of alpha(1)-antagonists is therefore important. Intraoperative floppy-iris syndrome surgical management strategies include pharmacologic measures, the use of high-viscosity ophthalmic viscosurgical devices, and mechanical dilating devices. However, sphincterotomies and pupil stretching are ineffective. Whether used alone or in combination, these small-pupil techniques improve the surgical success rate in these cases. Stopping the alpha(1)-antagonist preoperatively is of questionable value.
Eur Urol. 2008 Nov 6;
Roehrborn CG, Siami P, Barkin J, Damião R, Becher E, Miñana B, Mirone V, Castro R, Wilson T, Montorsi F,
BACKGROUND: Knowledge of baseline factors that influence outcomes for men with benign prostatic hyperplasia (BPH) receiving medical therapy may help to improve outcomes and cost effectiveness. OBJECTIVES: To examine the influence of baseline parameters on changes in International Prostate Symptom Score (IPSS) and maximum urinary flow rate (Q(max)) in men with BPH receiving dutasteride, tamsulosin, or a combination of the two using 2-yr Combination of Avodart and Tamsulosin (CombAT) study data. DESIGN, SETTING, AND PARTICIPANTS: CombAT is an ongoing, 4-yr, multicentre, randomised, double-blind study in 4844 men aged >/=50 yr with clinical diagnosis of BPH, IPSS >/=12, prostate volume >/=30cm(3), prostate-specific antigen (PSA) 1.5-10ng/ml, and Q(max) >5 and /=125ml. INTERVENTION: Daily tamsulosin 0.4mg, dutasteride 0.5mg, or the combination. MEASUREMENTS: Post hoc analyses of mean IPSS and Q(max) changes from baseline by treatment group and by baseline prostate volume, PSA, age, body mass index (BMI), IPSS, IPSS quality of life (QoL) score, BPH Impact Index score, Q(max), and previous BPH medical therapy. RESULTS AND LIMITATIONS: Combination therapy was more effective than either monotherapy after 24 mo in improving IPSS in all baseline subgroups, with benefit onset varying by baseline prostate volume. Combination therapy was also more effective in improving Q(max) versus tamsulosin in all subgroups and versus dutasteride in 10 of 18 subgroups. At 24 mo, dutasteride monotherapy resulted in significantly greater IPSS improvements versus tamsulosin in men with lower age, worse symptoms, worse QoL, less bother, higher BMI, greater Q(max), higher prostate volume, and higher PSA at baseline. Post hoc analyses, the lack of placebo control, and the exclusion of men with unsuccessful medical BPH treatment are study limitations. CONCLUSIONS: Combination therapy with tamsulosin and dutasteride affords the greatest and the most rapid symptomatic benefit among men with higher baseline prostate volume and is effective regardless of previous BPH medical therapy. Dutasteride monotherapy is more effective than tamsulosin in men with higher baseline prostate volume or PSA and worse symptoms.
The role of combination medical therapy in benign prostatic hyperplasia.
Int J Impot Res. 2008 Dec; 20 Suppl 3: S33-43
Greco KA, McVary KT
To review key trials of monotherapy and combination therapy of alpha(1)-adrenergic receptor antagonists (alpha(1)-ARAs), 5alpha-reductase inhibitors (5alphaRIs) and anti-muscarinic agents in the treatment of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). To assess the safety and efficacy of combination therapies for LUTS associated with BPH, a search of the MEDLINE and Cochrane databases (1976-2008) was conducted for relevant trials and reviews using the terms benign prostatic hyperplasia, lower urinary tract symptoms, alpha(1)-adrenergic receptor antagonists, 5alpha-reductase inhibitors, anti-muscarinics, anticholinergics, combination therapy, alfuzosin, doxazosin, tamsulosin, terazosin, dutasteride, finasteride, tolterodine, flavoxate, propiverine, oxybutynin, erectile dysfunction, sildenafil, vardenafil and tadalafil. Data from the Medical Therapy of Prostatic Symptoms (MTOPS) study indicated a role for long-term use of alpha(1)-ARAs and 5alphaRIs in combination. In the MTOPS study, combination therapy with the alpha(1)-ARA doxazosin and the 5alphaRI finasteride was significantly more effective than either component alone in reducing symptoms (P=0.006 vs doxazosin monotherapy; P
The involvement of urothelial alpha1A adrenergic receptor in controlling the micturition reflex.
Biomed Res. 2008 Oct; 29(5): 239-44
Yanase H, Wang X, Momota Y, Nimura T, Kawatani M
The current study was undertaken in an attempt to characterize the functional properties of urothelial alpha1A adrenergic receptors, especially in modulating the micturition reflex. The expression of alpha1A receptors in rat bladder was analyzed by immunohistochemistry and Western blotting. As a functional study, we obtained continuous infusion cystometrograms in conscious rats using noradrenaline (NA) and subtype selective alpha1 adrenergic receptor antagonists, tamsulosin (alpha1A/alpha1D selective) and silodosin (alpha1A superselective). Alpha1A receptors were immunohistochemically detected in rat urothelium. Intravesical infusion of NA (60 microM) significantly shortened the intercontraction interval (ICI). Pretreatment with tamsulosin at a dose of 0.4 microg/kg i.v. abolished intravesical NA infusioninduced reduction of ICI. Neither intravesical infusion of tamsulosin (20 microM) nor that of silodosin (0.2 microM) significantly altered ICI. After intravesical infusion of silodosin, intravesical NA infusion did not affect ICI. Urothelial alpha1A receptors might modulate bladder afferent activity under pathophysiological conditions with augmented concentrations of NA in blood or urine.
Voltammetric investigation of Tamsulosin.
Talanta. 2003 Oct 17; 61(2): 147-56
Ozkan SA, Uslu B, Aboul-Enein HY
The electrooxidative behavior and determination of Tamsulosin HCl (TAM), one of the alpha(1)-adrenoceptor antagonist, on a glassy carbon disc electrode were investigated for the first time by using cyclic, linear sweep, differential pulse (DPV) and square wave voltammetry (SWV). TAM showed an irreversible oxidation behavior at all pH values and buffers studied. From the electrochemical response, the main oxidation step was found to be related to the methoxy group on the phenyl ring. DPV and SWV were used to generate peak current versus concentration curves for TAM. A linear response was obtained in the range comprised between 2x10(-6) and 4x10(-4) M for both techniques with detection limit of 3.34x10(-7) M for DPV and 2.45x10(-7) M for SWV. The methods were proposed for the determination of TAM in dosage forms adopting both DPV and SWV modes. The methods were extended to the in vitro determination of TAM in spiked serum samples.
Neurourol Urodyn. 2008 Oct 6;
Chen Z, Ishizuka O, Imamura T, Aizawa N, Igawa Y, Nishizawa O, Andersson KE
AIMS: alpha(1)-Adrenergic receptors (ARs) are involved in micturition control both centrally and peripherally. alpha(1)-AR antagonists improve not only voiding but also storage symptoms in patients with bladder outlet obstruction. We investigated the role of alpha(1)-AR mechanisms involved in detrusor overactivity induced by cold stress in conscious rats. METHODS: Continuous cystometry was performed at room temperature (RT, 28 +/- 2 degrees C) and for 40 min at cold temperature (CT, 4 +/- 2 degrees C). Voiding interval (VI), micturition volume (MV), and bladder capacity (BC) were evaluated before and after intravenous administration of KMD-3213 (selective alpha(1A)-AR antagonist), naftopidil (selective alpha(1D)-AR antagonist), tamsulosin (selective alpha(1A/1D)-AR antagonist), and prazosin (non-selective alpha(1)-AR antagonist). Blood pressure (BP), cumulative voided volume and body temperature were also evaluated. RESULTS: At RT, none of the AR antagonists caused significant change in the cystometric parameters. During 40 min of cold stress cumulative voided volume and body temperature did not change, but there were significant decreases in VI, MV, and BC. Low doses of the AR antagonists had no effect on CT-induced decreases of these variables. However, high doses of KMD-3213, tamsulosin, naftopidil and prazosin significantly inhibited the CT-induced decreases in VI, MV, and BC. CT caused a significant increase in BP, and this was not affected by low doses of the AR antagonists. However, high doses of prazosin significantly lowered the CT-induced increase of BP. CONCLUSIONS: Cold stress induces detrusor overactivity and increases BP in conscious rats. These effects are mediated, at least in part, by alpha(1A)-AR and alpha(1D)-AR subtypes and can be prevented/reduced by alpha(1)-AR antagonists. Neurourol. Urodynam. (c) 2008 Wiley-Liss, Inc.
Dutasteride (Avodart) with tamsulosin (Flomax) for benign prostatic hyperplasia.
Med Lett Drugs Ther. 2008 Oct 6; 50(1296): 79-80
J Clin Pharmacol. 2008 Oct 2;
Modi NB, Kell S, Aquilina J, Rivas D
The tolerability of dapoxetine, a short-acting selective serotonin reuptake inhibitor being developed for premature ejaculation, was evaluated when coadministered with tamsulosin. Adult men on a stable dose of tamsulosin were randomized to also receive dapoxetine 30 or 60 mg, or placebo, in a crossover design. Supine and standing vital signs were measured on days 1 and 7. Plasma samples were collected for measurement of tamsulosin, dapoxetine, and dapoxetine metabolites. Coadministration of dapoxetine with tamsulosin did not alter orthostatic profiles or affect the incidence of orthostatic hypotension. Tamsulosin and dapoxetine pharmacokinetics were not altered. Adverse events were reported by 5.4%, 10.9%, and 23.2% of participants receiving tamsulosin with placebo, dapoxetine 30 mg, and dapoxetine 60 mg, respectively. The most common adverse events were diarrhea, dizziness, headache, and nausea. Therefore, dapoxetine had no clinically important effects on the pharmacokinetics or orthostatic profile of tamsulosin in men on a stable tamsulosin regimen.
Int J Clin Pract. 2008 Oct; 62(10): 1547-59
Nickel JC, Sander S, Moon TD
OBJECTIVES: To evaluate the safety profile and efficacy of alpha1-adrenergic receptor blockers (A1Bs) currently prescribed for benign prostatic hyperplasia (BPH). DATA SOURCES: A systematic literature search of MEDLINE, the Cochrane Database and the Food and Drug Administration Web site through December 2006 identified double-blinded, prospective, placebo-controlled trials, evaluating agents commercially available by prescription for the symptomatic treatment of BPH. REVIEW METHODS: Data were reviewed by two investigators with the use of a standardised data abstraction form. Studies were evaluated for methodological quality using the Jadad scale. Studies with a score of < 3 were considered of weaker methodology. RESULTS: Of 2389 potential citations, 25 were usable for evaluation of safety data, 26 for efficacy. A1B use was associated with a statistically significant increase in the odds of developing a vascular-related event [odds ratio (OR) 2.54; 95% confidence interval (CI): 2.00-3.24; p < 0.0001]. The odds of developing a vascular-related adverse event were: alfuzosin, OR 1.66, 95% CI: 1.17-2.36; terazosin, OR 3.71, 95% CI: 2.48-5.53; doxazosin, OR 3.32, 95% CI: 2.10-5.23 and tamsulosin, OR 1.42, 95% CI: 0.99-2.05. A1Bs increased Q(max) by 1.32 ml/min (95% CI: 1.07-1.57) compared with placebo. Difference from placebo in American Urological Association symptom index/International Prostate Symptom Score was -1.92 points (95% CI: -2.71 to -1.14). CONCLUSIONS: Alfuzosin, terazosin and doxazosin showed a statistically significant increased risk of developing vascular-related events compared with placebo. Tamsulosin showed a numerical increase that was not statistically significant. All agents significantly improved Q(max) and symptom signs compared with placebo.