Silodosin therapy for lower urinary tract symptoms in men with suspected benign prostatic hyperplasia: Results of an international, randomized, double-blind, placebo- and active-controlled clinical trial performed in Europe (2023)

Abstract

Background: Silodosin is a new selective therapy with a high pharmacologic selectivity for the α1A-adrenoreceptor. Objective: Our aim was to test silodosin's superiority to placebo and noninferiority to tamsulosin and discuss the findings in the context of a comprehensive literature review of the new compound silodosin. Design, setting, and participants: We conducted a multicenter double-blind, placebo- and active-controlled parallel group study. A total of 1228 men ≥50 yr of age with an International Prostate Symptom Score (IPSS) ≥13 and a urine maximum flow rate (Qmax) >4 and ≤15 ml/s were selected at 72 sites in 11 European countries. The patients were entered into a 2-wk wash-out and a 4-wk placebo run-in period. A total of 955 patients were randomized (2:2:1) to silodosin 8 mg (n = 381), tamsulosin 0.4 mg (n = 384), or placebo (n = 190) once daily for 12 wk. Measurements: We calculated the change from baseline in IPSS total score (primary), storage and voiding subscores, quality of life (QoL) due to urinary symptoms, and Q max. Responders were defined on the basis of IPSS and Qmax by a decrease of ≥25% and an increase of ≥30% from baseline, respectively. Results and limitations: The change from baseline in the IPSS total score with silodosin and tamsulosin was significantly superior to that with placebo (p <0.001): difference active placebo of -2.3 (95% confidence interval [CI], -3.2, -1.4) with silodosin and -2.0 (95% CI,-2.9, -1.1) with tamsulosin. Responder rates according to total IPSS were significantly higher (p <0.001) with silodosin (66.8%) and tamsulosin (65.4%) than with placebo (50.8%). Active treatments were also superior to placebo in the IPSS storage and voiding subscore analyses, as well as in QoL due to urinary symptoms. Of note, only silodosin significantly reduced nocturia versus placebo (the change from baseline was -0.9, -0.8, and -0.7 for silodosin, tamsulosin, and placebo, respectively; p = 0.013 for silodosin vs placebo). An increase in Q max was observed in all groups. The adjusted mean change from baseline to end point was 3.77 ml/s for silodosin, 3.53 ml/s for tamsulosin, and 2.93 ml/s for placebo, but the change for silodosin and tamsulosin was not statistically significant versus placebo because of a particularly high placebo response (silodosin vs placebo: p = 0.089; tamsulosin vs placebo: p = 0.221). At end point, the percentage of responders by Qmax was 46.6%, 46.5%, and 40.5% in the silodosin, tamsulosin, and placebo treatment groups, respectively. This difference was not statistically significantly (p = 0.155 silodosin vs placebo and p = 0.141 tamsulosin vs placebo). Active treatments were well tolerated, and discontinuation rates due to adverse events were low in all groups (2.1%, 1.0%, and 1.6% with silodosin, tamsulosin, and placebo, respectively). The most frequent adverse event with silodosin was a reduced or absent ejaculation during orgasm (14%), a reversible effect as a consequence of the potent and selective α1A-adrenoreceptor antagonism of the drug. The incidence was higher than that observed with tamsulosin (2%); however, only 1.3% of silodosin-treated patients discontinued treatment due to this adverse event. Conclusions: Silodosin is an effective and well-tolerated treatment for the relief of both voiding and storage symptoms in patients with lower urinary tract symptoms suggestive of bladder outlet obstruction thought to be associated with benign prostatic hyperplasia. Its overall efficacy is not inferior to tamsulosin. Only silodosin showed a significant effect on nocturia over placebo. Trial registration: ClinicalTrials.gov Identifier NCT00359905.

Original languageEnglish
Pages (from-to)342-352
Number of pages11
JournalEuropean Urology
Volume59
Issue number3
DOIs
Publication statusPublished - Mar 2011

Keywords

  • BPH
  • LUTS
  • Silodosin
  • Tamsulosin

ASJC Scopus subject areas

  • Urology

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Chapple, C. R., Montorsi, F., Tammela, T. L. J., Wirth, M., Koldewijn, E., & Fernández Fernández, E. (2011). Silodosin therapy for lower urinary tract symptoms in men with suspected benign prostatic hyperplasia: Results of an international, randomized, double-blind, placebo- and active-controlled clinical trial performed in Europe. European Urology, 59(3), 342-352. https://doi.org/10.1016/j.eururo.2010.10.046

Silodosin therapy for lower urinary tract symptoms in men with suspected benign prostatic hyperplasia : Results of an international, randomized, double-blind, placebo- and active-controlled clinical trial performed in Europe. / Chapple, Christopher R.; Montorsi, Francesco; Tammela, Teuvo L J et al.

In: European Urology, Vol. 59, No. 3, 03.2011, p. 342-352.

Research output: Contribution to journalArticlepeer-review

Chapple, CR, Montorsi, F, Tammela, TLJ, Wirth, M, Koldewijn, E & Fernández Fernández, E 2011, 'Silodosin therapy for lower urinary tract symptoms in men with suspected benign prostatic hyperplasia: Results of an international, randomized, double-blind, placebo- and active-controlled clinical trial performed in Europe', European Urology, vol. 59, no. 3, pp. 342-352. https://doi.org/10.1016/j.eururo.2010.10.046

Chapple CR, Montorsi F, Tammela TLJ, Wirth M, Koldewijn E, Fernández Fernández E. Silodosin therapy for lower urinary tract symptoms in men with suspected benign prostatic hyperplasia: Results of an international, randomized, double-blind, placebo- and active-controlled clinical trial performed in Europe. European Urology. 2011 Mar;59(3):342-352. https://doi.org/10.1016/j.eururo.2010.10.046

(Video) Male LUTS - Evaluation and Medical Management, Literature on Medications. Episode 154

Chapple, Christopher R. ; Montorsi, Francesco ; Tammela, Teuvo L J et al. / Silodosin therapy for lower urinary tract symptoms in men with suspected benign prostatic hyperplasia : Results of an international, randomized, double-blind, placebo- and active-controlled clinical trial performed in Europe. In: European Urology. 2011 ; Vol. 59, No. 3. pp. 342-352.

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title = "Silodosin therapy for lower urinary tract symptoms in men with suspected benign prostatic hyperplasia: Results of an international, randomized, double-blind, placebo- and active-controlled clinical trial performed in Europe",

abstract = "Background: Silodosin is a new selective therapy with a high pharmacologic selectivity for the α1A-adrenoreceptor. Objective: Our aim was to test silodosin's superiority to placebo and noninferiority to tamsulosin and discuss the findings in the context of a comprehensive literature review of the new compound silodosin. Design, setting, and participants: We conducted a multicenter double-blind, placebo- and active-controlled parallel group study. A total of 1228 men ≥50 yr of age with an International Prostate Symptom Score (IPSS) ≥13 and a urine maximum flow rate (Qmax) >4 and ≤15 ml/s were selected at 72 sites in 11 European countries. The patients were entered into a 2-wk wash-out and a 4-wk placebo run-in period. A total of 955 patients were randomized (2:2:1) to silodosin 8 mg (n = 381), tamsulosin 0.4 mg (n = 384), or placebo (n = 190) once daily for 12 wk. Measurements: We calculated the change from baseline in IPSS total score (primary), storage and voiding subscores, quality of life (QoL) due to urinary symptoms, and Q max. Responders were defined on the basis of IPSS and Qmax by a decrease of ≥25% and an increase of ≥30% from baseline, respectively. Results and limitations: The change from baseline in the IPSS total score with silodosin and tamsulosin was significantly superior to that with placebo (p <0.001): difference active placebo of -2.3 (95% confidence interval [CI], -3.2, -1.4) with silodosin and -2.0 (95% CI,-2.9, -1.1) with tamsulosin. Responder rates according to total IPSS were significantly higher (p <0.001) with silodosin (66.8%) and tamsulosin (65.4%) than with placebo (50.8%). Active treatments were also superior to placebo in the IPSS storage and voiding subscore analyses, as well as in QoL due to urinary symptoms. Of note, only silodosin significantly reduced nocturia versus placebo (the change from baseline was -0.9, -0.8, and -0.7 for silodosin, tamsulosin, and placebo, respectively; p = 0.013 for silodosin vs placebo). An increase in Q max was observed in all groups. The adjusted mean change from baseline to end point was 3.77 ml/s for silodosin, 3.53 ml/s for tamsulosin, and 2.93 ml/s for placebo, but the change for silodosin and tamsulosin was not statistically significant versus placebo because of a particularly high placebo response (silodosin vs placebo: p = 0.089; tamsulosin vs placebo: p = 0.221). At end point, the percentage of responders by Qmax was 46.6%, 46.5%, and 40.5% in the silodosin, tamsulosin, and placebo treatment groups, respectively. This difference was not statistically significantly (p = 0.155 silodosin vs placebo and p = 0.141 tamsulosin vs placebo). Active treatments were well tolerated, and discontinuation rates due to adverse events were low in all groups (2.1%, 1.0%, and 1.6% with silodosin, tamsulosin, and placebo, respectively). The most frequent adverse event with silodosin was a reduced or absent ejaculation during orgasm (14%), a reversible effect as a consequence of the potent and selective α1A-adrenoreceptor antagonism of the drug. The incidence was higher than that observed with tamsulosin (2%); however, only 1.3% of silodosin-treated patients discontinued treatment due to this adverse event. Conclusions: Silodosin is an effective and well-tolerated treatment for the relief of both voiding and storage symptoms in patients with lower urinary tract symptoms suggestive of bladder outlet obstruction thought to be associated with benign prostatic hyperplasia. Its overall efficacy is not inferior to tamsulosin. Only silodosin showed a significant effect on nocturia over placebo. Trial registration: ClinicalTrials.gov Identifier NCT00359905.",

keywords = "BPH, LUTS, Silodosin, Tamsulosin",

author = "Chapple, {Christopher R.} and Francesco Montorsi and Tammela, {Teuvo L J} and Manfred Wirth and Evert Koldewijn and {Fern{\'a}ndez Fern{\'a}ndez}, Eldiberto",

year = "2011",

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doi = "10.1016/j.eururo.2010.10.046",

language = "English",

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journal = "European Urology",

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(Video) 016 Nuevos enfoques en el tratamiento de la hiperplasia benigna de próstata 1

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TY - JOUR

T1 - Silodosin therapy for lower urinary tract symptoms in men with suspected benign prostatic hyperplasia

T2 - Results of an international, randomized, double-blind, placebo- and active-controlled clinical trial performed in Europe

AU - Chapple, Christopher R.

AU - Montorsi, Francesco

AU - Tammela, Teuvo L J

AU - Wirth, Manfred

AU - Koldewijn, Evert

AU - Fernández Fernández, Eldiberto

PY - 2011/3

Y1 - 2011/3

N2 - Background: Silodosin is a new selective therapy with a high pharmacologic selectivity for the α1A-adrenoreceptor. Objective: Our aim was to test silodosin's superiority to placebo and noninferiority to tamsulosin and discuss the findings in the context of a comprehensive literature review of the new compound silodosin. Design, setting, and participants: We conducted a multicenter double-blind, placebo- and active-controlled parallel group study. A total of 1228 men ≥50 yr of age with an International Prostate Symptom Score (IPSS) ≥13 and a urine maximum flow rate (Qmax) >4 and ≤15 ml/s were selected at 72 sites in 11 European countries. The patients were entered into a 2-wk wash-out and a 4-wk placebo run-in period. A total of 955 patients were randomized (2:2:1) to silodosin 8 mg (n = 381), tamsulosin 0.4 mg (n = 384), or placebo (n = 190) once daily for 12 wk. Measurements: We calculated the change from baseline in IPSS total score (primary), storage and voiding subscores, quality of life (QoL) due to urinary symptoms, and Q max. Responders were defined on the basis of IPSS and Qmax by a decrease of ≥25% and an increase of ≥30% from baseline, respectively. Results and limitations: The change from baseline in the IPSS total score with silodosin and tamsulosin was significantly superior to that with placebo (p <0.001): difference active placebo of -2.3 (95% confidence interval [CI], -3.2, -1.4) with silodosin and -2.0 (95% CI,-2.9, -1.1) with tamsulosin. Responder rates according to total IPSS were significantly higher (p <0.001) with silodosin (66.8%) and tamsulosin (65.4%) than with placebo (50.8%). Active treatments were also superior to placebo in the IPSS storage and voiding subscore analyses, as well as in QoL due to urinary symptoms. Of note, only silodosin significantly reduced nocturia versus placebo (the change from baseline was -0.9, -0.8, and -0.7 for silodosin, tamsulosin, and placebo, respectively; p = 0.013 for silodosin vs placebo). An increase in Q max was observed in all groups. The adjusted mean change from baseline to end point was 3.77 ml/s for silodosin, 3.53 ml/s for tamsulosin, and 2.93 ml/s for placebo, but the change for silodosin and tamsulosin was not statistically significant versus placebo because of a particularly high placebo response (silodosin vs placebo: p = 0.089; tamsulosin vs placebo: p = 0.221). At end point, the percentage of responders by Qmax was 46.6%, 46.5%, and 40.5% in the silodosin, tamsulosin, and placebo treatment groups, respectively. This difference was not statistically significantly (p = 0.155 silodosin vs placebo and p = 0.141 tamsulosin vs placebo). Active treatments were well tolerated, and discontinuation rates due to adverse events were low in all groups (2.1%, 1.0%, and 1.6% with silodosin, tamsulosin, and placebo, respectively). The most frequent adverse event with silodosin was a reduced or absent ejaculation during orgasm (14%), a reversible effect as a consequence of the potent and selective α1A-adrenoreceptor antagonism of the drug. The incidence was higher than that observed with tamsulosin (2%); however, only 1.3% of silodosin-treated patients discontinued treatment due to this adverse event. Conclusions: Silodosin is an effective and well-tolerated treatment for the relief of both voiding and storage symptoms in patients with lower urinary tract symptoms suggestive of bladder outlet obstruction thought to be associated with benign prostatic hyperplasia. Its overall efficacy is not inferior to tamsulosin. Only silodosin showed a significant effect on nocturia over placebo. Trial registration: ClinicalTrials.gov Identifier NCT00359905.

AB - Background: Silodosin is a new selective therapy with a high pharmacologic selectivity for the α1A-adrenoreceptor. Objective: Our aim was to test silodosin's superiority to placebo and noninferiority to tamsulosin and discuss the findings in the context of a comprehensive literature review of the new compound silodosin. Design, setting, and participants: We conducted a multicenter double-blind, placebo- and active-controlled parallel group study. A total of 1228 men ≥50 yr of age with an International Prostate Symptom Score (IPSS) ≥13 and a urine maximum flow rate (Qmax) >4 and ≤15 ml/s were selected at 72 sites in 11 European countries. The patients were entered into a 2-wk wash-out and a 4-wk placebo run-in period. A total of 955 patients were randomized (2:2:1) to silodosin 8 mg (n = 381), tamsulosin 0.4 mg (n = 384), or placebo (n = 190) once daily for 12 wk. Measurements: We calculated the change from baseline in IPSS total score (primary), storage and voiding subscores, quality of life (QoL) due to urinary symptoms, and Q max. Responders were defined on the basis of IPSS and Qmax by a decrease of ≥25% and an increase of ≥30% from baseline, respectively. Results and limitations: The change from baseline in the IPSS total score with silodosin and tamsulosin was significantly superior to that with placebo (p <0.001): difference active placebo of -2.3 (95% confidence interval [CI], -3.2, -1.4) with silodosin and -2.0 (95% CI,-2.9, -1.1) with tamsulosin. Responder rates according to total IPSS were significantly higher (p <0.001) with silodosin (66.8%) and tamsulosin (65.4%) than with placebo (50.8%). Active treatments were also superior to placebo in the IPSS storage and voiding subscore analyses, as well as in QoL due to urinary symptoms. Of note, only silodosin significantly reduced nocturia versus placebo (the change from baseline was -0.9, -0.8, and -0.7 for silodosin, tamsulosin, and placebo, respectively; p = 0.013 for silodosin vs placebo). An increase in Q max was observed in all groups. The adjusted mean change from baseline to end point was 3.77 ml/s for silodosin, 3.53 ml/s for tamsulosin, and 2.93 ml/s for placebo, but the change for silodosin and tamsulosin was not statistically significant versus placebo because of a particularly high placebo response (silodosin vs placebo: p = 0.089; tamsulosin vs placebo: p = 0.221). At end point, the percentage of responders by Qmax was 46.6%, 46.5%, and 40.5% in the silodosin, tamsulosin, and placebo treatment groups, respectively. This difference was not statistically significantly (p = 0.155 silodosin vs placebo and p = 0.141 tamsulosin vs placebo). Active treatments were well tolerated, and discontinuation rates due to adverse events were low in all groups (2.1%, 1.0%, and 1.6% with silodosin, tamsulosin, and placebo, respectively). The most frequent adverse event with silodosin was a reduced or absent ejaculation during orgasm (14%), a reversible effect as a consequence of the potent and selective α1A-adrenoreceptor antagonism of the drug. The incidence was higher than that observed with tamsulosin (2%); however, only 1.3% of silodosin-treated patients discontinued treatment due to this adverse event. Conclusions: Silodosin is an effective and well-tolerated treatment for the relief of both voiding and storage symptoms in patients with lower urinary tract symptoms suggestive of bladder outlet obstruction thought to be associated with benign prostatic hyperplasia. Its overall efficacy is not inferior to tamsulosin. Only silodosin showed a significant effect on nocturia over placebo. Trial registration: ClinicalTrials.gov Identifier NCT00359905.

KW - BPH

(Video) Eficacia de la Silodosina, en tratamiento de los STUI, en pacientes con HPB

KW - LUTS

KW - Silodosin

KW - Tamsulosin

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FAQs

Is silodosin better than Flomax? ›

The study found that silodosin improved urinary symptoms and quality of life in patients with BPH who did not respond to tamsulosin (Flomax).

Can silodosin cause erectile dysfunction? ›

Patients in Group 1 were informed that although silodosin is an effective therapeutic agent for the treatment of LUTS, it might cause side effects such as low semen volume, anejaculation, loss of libido, and ED.

What happens if you stop taking silodosin? ›

It comes with serious risks if you don't take it as prescribed. If you don't take it at all or stop taking it: If you don't take or stop taking this drug, you may have increased symptoms of BPH. If you stop or forget to take this medication for several days, talk with your doctor before starting again.

What is silodosin 8 mg used for? ›

Silodosin is used to treat signs and symptoms of an enlarged prostate gland, which is also known as benign enlargement of the prostate (benign prostatic hyperplasia or BPH). Benign enlargement of the prostate is a problem that can occur in men as they get older. The prostate gland is located below the bladder.

Does silodosin reduce prostate size? ›

Silodosin is used by men to treat the symptoms of an enlarged prostate (benign prostatic hyperplasia-BPH). It does not shrink the prostate, but it works by relaxing the muscles in the prostate and the bladder.

What drug shrinks the prostate? ›

5-alpha reductase inhibitors.

These medications shrink your prostate by preventing hormonal changes that cause prostate growth. These medications — which include finasteride (Proscar) and dutasteride (Avodart) — might take up to six months to be effective. Side effects include retrograde ejaculation.

How long can the average man stay erect? ›

Erections typically last a few minutes or, in some cases, up to about a half hour. If you have an erection that lasts more than a four hours (priapism) or one that's unrelated to sex, talk to your doctor right away or seek emergency care.

How long does it take silodosin to start working? ›

Silodosin has rapid onset of effect (3-4 days after the start of treatment); it can be used in all patients suffering from BPH and having indications to the administration of alpha-blockers, and does not require correction of doses of antihypertensive drugs in the case of combined appointment.

Who should not take silodosin? ›

Silodosin is not for use in women, and the effects of this medicine during pregnancy or in breastfeeding women are unknown. Not approved for use by anyone younger than 18 years old.

Does silodosin stop sperm? ›

There was no sperm in urine after ejaculation under silodosin administration in any volunteer. All volunteers on silodosin had anejaculation and did not show post-ejaculate sperm in their urine. The mechanism of ejaculatory dysfunction caused by silodosin is a loss of seminal emission.

Does silodosin increase testosterone? ›

001). Conclusion: In patients with benign prostatic hyperplasia, treatment with silodosin significantly increased testosterone secretion, and improvements in objective symptoms such as BOO were found to be the factors that influenced testosterone secretion.

Does silodosin work immediately? ›

2. How long does Silodosin take to work? Most people who take Silodosin consistently report that they start to feel better after a month or more of taking the medication. Silodosin does not completely cure the condition of an enlarged prostate.

Does silodosin make you sleepy? ›

you should know that silodosin may make you drowsy or dizzy, especially when you first start taking it. Do not drive a car or operate machinery until you know how this medication affects you.

Are silodosin side effects permanent? ›

Some side effects of silodosin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Does silodosin cause insomnia? ›

Examples: alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), silodosin (Rapaflo), terazosin (Hytrin) and tamsulosin (Flomax). How they can cause insomnia: Alpha-blockers are linked to decreased REM (rapid eye movement) sleep — the stage of sleep when people dream — and daytime sedation or sleepiness.

How can I reduce my prostate size fast? ›

You can take alpha-blockers such as terazosin (Hytrin) or tamsulosin (Flomax) to help relax the prostate and bladder muscles. You can also take dutasteride (Avodart) or finasteride (Proscar), a different kind of medication for reducing BPH symptoms. These block the hormones that cause the prostate to grow.

How can I normalize my prostate size? ›

Can Lifestyle Changes Help?
  1. Do exercises to strengthen your pelvic floor muscles.
  2. Limit how much caffeine and alcohol you take in; they make you pee more and can irritate your bladder.
  3. Lower the amount of fluids you drink, especially before you go out or go to bed.
19 Nov 2020

Can an enlarged prostate shrink back to normal size? ›

While it's difficult to completely reverse an enlarged prostate, there are several treatments that can relieve symptoms, reduce the size of the prostate and help restore normal urine flow. In fact, many men with prostate enlargement are able to achieve a positive quality of life with non-surgical treatments.

What is the latest treatment for enlarged prostate 2022? ›

Entadfi is expected to be available in early 2022. Credit: Getty Images. The Food and Drug Administration (FDA) has approved Entadfi (finasteride and tadalafil) for the treatment of the signs and symptoms of benign prostatic hyperplasia (BPH) in men with an enlarged prostate for up to 26 weeks.

What is the best treatment for a very large prostate? ›

Options include changing certain eating and drinking habits and urinating less often. Patients can take medications that relax the prostate, such as tamsulosin, or shrink the prostate, such as finasteride or dutasteride. Patients also may try supplements like saw palmetto to help their symptoms.

What drug can improve urine flow in males? ›

Tamsulosin is in a class of medications called alpha blockers. It works by relaxing the muscles in the prostate and bladder so that urine can flow easily.

How long does it take for a man to be ready for Round 2? ›

The male refractory period varies with some men ready for sexual stimulation within a few minutes, while others may require hours to days. There is no definite duration a guy must wait for the second round of sexual intercourse following an orgasm.

How many times a man gets hard? ›

The average man has 11 erections each day, as well as many more when they are asleep. On average, a healthy man has three to five erections during a full night's sleep.

How many times a day does the average man erect? ›

People with penises have an average of 11 erections per day and three to five more each night, but everyone is different. There are numerous factors that can affect how often you get hard, like your age, hormone levels, and lifestyle.

Does silodosin affect blood pressure? ›

Blood pressures did not change, and none of the patients needed to adjust their antihypertensive medication. New development of orthostatic hypotension was observed in one (2.5%) patient. Among the six patients who had orthostatic hypotension before silodosin treatment, none of the patients showed symptom aggravation.

Does silodosin affect heart rate? ›

There were no clinically significant differences in systolic/diastolic blood pressure or heart rate between the silodosin and tamsulosin groups. In addition, the incidence of side effects relating to hypotension (such as dizziness) for silodosin was similar to that for tamsulosin and placebo.

Why do you have to take silodosin with a meal? ›

Taking silodosin with food can reduce the risk and/or severity of side effects. Therefore, silodosin should be administered with or immediately after a meal.

Can silodosin cause kidney problems? ›

decreased kidney function. severe renal impairment. cataract surgery. floppy iris during eye surgery.

Can you take viagra with silodosin? ›

Talk to your doctor before using sildenafil together with silodosin. Combining these medications can lower your blood pressure and increase the risk of dizziness, lightheadedness, fainting, flushing, headache, and nasal congestion.

Is there an alternative to silodosin? ›

There are other alpha blockers that are FDA approved to treat BPH: Cardura (doxazosin), Hytrin (terazosin), Uroxatral (alfuzosin), and Rapaflo (silodosin). There are two other drug classes FDA approved to treat BPH–5-alpha reductase inhibitors and phosphodiesterase inhibitors.

Does tamsulosin and silodosin has any effect on prostate size? ›

There was a significant impact on sexual function (assessed by IPSS sexual function score) in silodosin arm compared with tamsulosin. Prostate size and uroflowmetry parameters did not change. Both treatments were well-tolerated.

How long does silodosin stay in system? ›

The terminal half-life of silodosin is about 11 hours. As the metabolism of silodosin involves cytochrome P450 3A4, it should not be used with strong inhibitors of this enzyme system, such as ketoconazole and ritonavir.

Does silodosin cause dementia? ›

Except for the recent debate on the association of dementia with tamsulosin, there appears to be no evidence that the remaining α-blockers (alfuzosin, doxazosin, terazosin, and silodosin) cause cognitive impairment.

How much silodosin can I take? ›

For oral dosage form (capsules): For benign prostatic hyperplasia (BPH): Adults—8 milligrams (mg) once a day. Children—Use is not recommended.

Can you drink alcohol while taking silodosin? ›

Avoid drinking alcohol, which could make you dizzy while you are taking silodosin (Rapaflo).

Can silodosin cause heart palpitations? ›

tamsulosin silodosin

The risk of other side effects such as dizziness, lightheadedness, fainting, headache, flushing, nasal congestion, heart palpitations, and priapism (prolonged and painful erection unrelated to sexual activity) may also increase.

Can silodosin cause urinary retention? ›

Results: Both group A (tamsulosin) and group B (silodosin) had similar results of trial without catheter (group A: 67.50%, group: B 60%). In follow up, three patients in group A and four patients in group B had retention of urine, requiring recatheterization.

What can you take in place of Flomax? ›

Doctors also prescribe four other drugs in this class to treat the symptoms of BPH:
  • alfuzosin (Uroxatral)
  • doxazosin (Cardura)
  • silodosin (Rapaflo)
  • terazosin (Hytrin)

Which is better alfuzosin or silodosin? ›

Silodosin is the most efficacious AB with rapid onset of action. Silodosin also improves the quality of life in patients with LUTS due to BPH and objectively improves maximum flow rate. However, silodosin has more adverse events when compared to tamsulosin and alfuzosin.

Can you take Flomax and silodosin together? ›

Using tamsulosin together with silodosin is not recommended. Combining these medications may cause blood pressure to fall excessively and heart rate to increase, especially when you rise from a sitting or lying position.

Does tamsulosin stop you ejaculating? ›

Meanwhile, with respect to ejaculation, tamsulosin has inhibitory effects such as reduced ejaculatory volume and delayed ejaculation.

What is the latest treatment for enlarged prostate? ›

Some of the newest treatment options, such as water vapor thermal therapy and prostatic urethral lift, can be done in the office without putting the patient to sleep, though these still employ medications to diminish discomfort with these relatively shorter procedures.

How do I shrink my prostate Mayo Clinic naturally? ›

Advertising & Sponsorship
  1. Avoid liquids a few hours before bedtime or before going out.
  2. Limit caffeine and alcohol as these may stimulate the urge to urinate.
  3. Eat a low-fat diet.
  4. Eat a large variety of vegetables each day.
  5. Eat a few servings of fruit daily, and be sure to include citrus fruits.

What is the safest medication for enlarged prostate? ›

Medicine choices include: Alpha-blockers, such as tamsulosin (Flomax) or terazosin (Hytrin), which relax muscle tissue. 5-alpha reductase inhibitors, such as dutasteride (Avodart) and finasteride (Proscar), which shrink the prostate.

Can you take Viagra with silodosin? ›

Talk to your doctor before using sildenafil together with silodosin. Combining these medications can lower your blood pressure and increase the risk of dizziness, lightheadedness, fainting, flushing, headache, and nasal congestion.

Do you pee more with Flomax? ›

Does Flomax make you pee more? Taking Flomax should cause you to more completely empty the bladder each time you pee.

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