Indian Medicine

NEW YORK (Reuters Health) - In men with an enlarged prostate who fail to respond to tamsulosin (brand name Flomax), treatment with the drug naftopidil may help alleviate common bothersome symptoms, such as having to make frequent nightly trips to the bathroom to urinate, research shows.

Enlargement of the prostate -- a common condition among older men known as benign prostate hyperplasia (BPH) -- often causes a persistent need or urge to urinate. Nighttime urination is a common symptom, for which doctors may prescribe an "alpha1A blocker" such as tamsulosin. However, these drugs may only help some men.

Naftopidil is an "alpha1D blocker" and recent reports have shown that the alpha1D receptors are the main type found in bladder muscle.

Dr. Hitoshi Oh-oka from Kobe Medical Center, Japan, assessed BPH-related symptoms in 122 men who were treated with naftopidil (75 milligrams) for 6 weeks after experiencing no improvement with tamsulosin. The two treatments were separated by a placebo "washout" period of over 1 week.

Treatment with naftopidil led to significant improvement in daytime and nighttime urinary frequency, urinary flow rate and quality of life, the investigator reports in the medical journal Urology.

Naftopidil was particularly helpful in reducing nighttime trips to the bathroom to urinate. Naftopidil therapy also eliminated overactivity of the detrusor muscle, which controls bladder function, in 31 of 40 patients who had this finding.

Based on predefined criteria for symptoms, quality of life, and maximal urine flow, roughly 70 percent of patients were successfully treated with naftopidil.

SOURCE: Urology, November 2008.

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