Doxazosin in the treatment of lower urinary tract symptoms associated with benign prostatic hyperplasia. Current clinical evidence and a case report Case report

Abstract

Lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia are among the most common conditions affecting ageing men and have a significant impact on quality of life. α1-adrenoceptor antagonists remain the cornerstone of pharmacological treatment for patients with moderate to severe LUTS, providing rapid improvement in both storage and voiding symptoms. The European Association of Urology guidelines consider the currently available α-adrenoceptor antagonists to have comparable efficacy and do not specify a preferred agent for routine clinical use. Non-selective α-adrenoceptor antagonists such as doxazosin demonstrate efficacy comparable to that of tamsulosin in reducing storage and voiding LUTS and improving uroflowmetry parameters. However, doxazosin appears to be associated with a lower risk of ejaculatory dysfunction compared with tamsulosin. Recent evidence from a network meta-analysis suggests that doxazosin 4 mg administered as a gastrointestinal therapeutic system (GITS) formulation has a favourable safety profile and may be associated with a lower risk of treatment discontinuation due to adverse events compared with tamsulosin 0.4 mg administered as an oral controlled absorption system (OCAS) formulation. Treatment selection should therefore take into account not only symptom control but also comorbidities, adverse effects, and patient expectations regarding quality of life.