I've been taking alfuzosin for about six weeks and it's less effective at night when there is much more retention. I like that alfuzosin doesn't have sexual side effects but it seems very mild. Is there a better medication for BPH with little or no side effects?
Alfuzosin worked pretty well for me for about 2 years, then it just didn’t.
I have found that Alfuzosin is the best one by far according to your parameters.
John
There are other’s that you can check into but most come with side effects. It all depends what you are looking for. Cialis is good and so is Vesicare. Ask your doctor but if what your taking now may be go to stay on for a little while..
Ken
I know many are unhappy with finasteride or dutasteride for reducing the size of the prostate. I have been taking dutasteride for almost 6 months. I am fairly happy with the results so far. A transabdominal ultrasound (TAUS) before starting and after 5 months showed a decreased in size of 30 to 50% (from 140/100 grams to 70 grams). The starting size was 140 with TAUS and 100 with TRUS (which is more accurate). It seems likely that my prostate has been reduced by about 30%, which is expected. For over a year, I have been religiously recording virtually every urination and my average daytime urination per visit has increased by around 40 to 50 mL since taking dutasteride. I get up once or twice a night. I am concerned about estrogen production but I am trying some natural supplements to reduce estrogen and they seem to be working as tests show my estrogen levels are very low. I prefer dutasteride over finaseride because it inhibits not only the major pathway but a minor pathway for the production of DHT, a hormone that causes enlargement of the prostate. Also, dutasteride has a half life of 5 weeks in the body whereas finasteride is less than 1 day. To me that suggests that, in the future, I can to reduce the dosage of dutasteride to maybe every other day or maybe even once a week. I need to discuss this with my uro.
At any rate, things have improved substantially for me. I’m considering a more lengthy detailed post on my results. I just hope I haven’t jinxed myself by writing this post :).
rdemyan I’ve had similar results with finasteride. I don’t know how big my prostate is now but it was 125 gr according to Dr. K reading of my ct scan. I pee very well but would love to get off it.
uncle: Talk to your uro about dutasteride and its half life. I’m going to discuss it with mine as well.
The way I see it, dutasteride/finasteride do most of their magic in the first 6 to 12 months. After that it seems to me to be mostly maintenance, which I take to mean that you continue to take the pills to keep the prostate from growing but don’t expect much further reduction. If that’s the case, dustasteride might allow for just “maintenance” doses because of its longer half life. If I am right, that would mean we wouldn’t have to take it every day, which would be a good thing.
Johnny,
To address the “least side effects” part of your question:
Unfortunately, the side effect profiles for dutasteride/finasteride are very bad. Check them out. I also saw it on a list of 10 worst drugs.
It also, after 9 months, had not helped me at all.
I’m very happy for those for whom it has helped! Good to have all info. before making this decision.
Best of luck!
Hello All
Just be careful when taking these medicine. They can both cause impotence , decreased sex drive and ejaculation problem.
There has to be something else that will not cause to much. Some doctor do not know all the side effects of the medicine that they give out.
Take care Ken
johnny, i am taking Doxasozin 2mg morning & evening, my GP split the 4mg dose into two doses as i was having similar night time problems. works well for me
Arlington
Sorry that it did not help you. I read up on it again today and it did say it does not help everyone. You said that it has not helped you. Are you trying anything else. It does take time to get out of your symptom.
Anything to make the prostate smaller will cause sexual side effect. Doctors give them out because they feel the side effect are nothing and he is trying to help you go to the bathroom Most men don’t went that. If you do not need to make the prostate smaller and just want help to pee. Try Cialis or Vasicare. Less side effects
Ken
I’ve been taking alfuzosin for over 15 years now and find it essential for my BPH. You might try taking it with food at dinner time rather than alone before bedtime. This seems to potentiate it several fold. Please avoid the 5-alpha reductase inhibitors like Avodart and Proscar. They work for awhile but they will ruin your life after a few years.
I went in to total urinary retention in 2014 and have yet to get out of it.
I had a PAE in Sept '15 that didn’t help (it has been found to be much less effective for those like me w/ enlarged median lobes).
I’ve tried seveal drugs w/ little effect. The one thing that I initially said I’d never do has become the best thing for me - without side effects and is allowing me to take a several year wait and see approach while i wait for a procedure that has good clinical results and low side effects:
That is CIC or intermittent catheterization. It is easy and takes about 10 minutes to learn (I said no way at first!). I find the coloplast speedicath male compact to be the best ones.
But does alfuzosin shrink the prostate?
Alfuzosin relaxes the prostate. And, in my experience, works best if you take at dinner hour and then strictly no fluids 3 hrs before bedtime.
I know your question is rhetorical as it clearly does not. It will only delay the inevitable. That’s probably true of finasteride and dutasteride as well, but it will provide a longer delay.
With regards to sexual side effects, I have none worth mentioning. I don’t have RE. The amount ejaculated is about the same, perhaps a bit less. And my sex drive is there and I don’t have any issues with getting aroused when the time is right. But as I said, I am actively trying to reduce estradiol and perhaps that is helping (although it is difficult to find anything beyond anecdotal support for this idea; and urologists are not telling me to do this, I’m doing it on my own).
I also want to mention that 6 years ago I kept a urination diary because I was peeing every hour during the daytime. I knew that I had issues with my prostate but thought they were due to prostatitis. The journal clearly showed that I was urinating 3 to 3.5 liters per day. Once I reduced that to around 2 liters of fluid intake, the frequent urination dissipated. My urination amounts per trip to the bathroom are now very similar to what they were 6 years ago. So, I am hoping I have bought myself 6 additional years of time (fingers crossed). Having said that, I hate taking medications in general and as I’ve indicated in my posts above, I am looking for ways to reduce the dosage. I don’t want to take dutasteride long term.
Thus far, 30 years into this urinary frequency hassle, I can’t say that I believe there is an “inevitable” outcome to this condition – as many on this web site seem to feel. Different men will have different experiences, of course, but in my experience so much of this is about fluids consumed and when they are consumed. Drink a lot, pee a lot. Drink before bed, and suffer consequences at 1 in the a.m. and beyond. (Just as I did a moment ago. I had a late dinner around 8:30 and can’t eat dinner without a glass – or two – of milk. I knew the consequences. To bed an hour later and my bladder is now demanding attention 3 hours later. Had I not had the milk I might have lasted 'til 3 a.m. Before this strategy, I was a routine 3x per night pee’er. (And with prostatitis, which visits now and then, up to pee every 90 minutes or so.)
Bottom line for me: I am thankful for a status quo that after 30 years of BPH that has not required surgery or any other “procedure”. But, for me. it’s all about 1) restricting fluids well before bed; 2) avoiding bp meds at night and taking the med in the morning instead; 3) alfuzosin with dinner. (I tried eliminating the alfuzosin a month or so ago and the benefits of that drug were clear. Tension in the prostate, to say the very least. It works against that for me with no sexual side effect three years running.)
I am, btw, happily married. Age 73 in body but age 33 or so in mind . With all the urges that come with it. (Which brings to mind: prostate cancer – believed to be avoided, at least in part, by routine flushing of the orgasmic pipeline. All of the above worth a try, yes?? If there was ever a case for using it or losing it.)
I believe Alfuzosin is an alpha-adrenergic blocker used to treat benign prostatic hyperplasia (BPH). It works by relaxing the muscles in the prostate and bladder neck, making it easier to urinate. Dutasteride and Finasteride are 5ARI drugs that are supposed to reduce prostate volume by preventing the conversion of Testosterone to a more potent form that prevents the normal loss of prostate cells. As new, supposedly replacement, cells naturally form the gland grows.
These drugs are prescribed under many names which I think is meant to confuse the issue. The more I read forum posts the more concerned I am at how I was treated.. BPH 1990, Alpha Blockers (4mg a day) 2006>2015, 5ARI Duodart 2013>2014, 3+4 PCa and Open RP 2015.
Since 1995 urologists had known Alpha Blockers would need an increase above 4mg a day after 2 years but by 2013 no one had bothered to do the research. They would therefore not increase the dose but prescribed Duodart which included 5mg Dutasteride (5ARI) + 4mg Alpha Blocker. I was therefore on 8mg of alphas a day anyway plus risky 5ARI I did not need or want which possibly had an increased risk of PCa..
As mentioned all over BPH/PCa posts on this forum there are so many treatments for both but in Australia I had only medications and TURPS/RP or Radiation. In 2015 our Federal Government was still pushing Ultrasound Guided Biopsies (failed since 1990) to detect PCa without the necessary MRI to show them where to hit. My RP surgeon was an expert in RARP but Newcastle NSW did not have the equipment.
No real research is attempted or data being collected on sufferers of BPH or PCa and it seems they don’t want to be forced into more expensive treatments that would adversely affect the Budget. All I hear is that more men die with PCa rather than from it but our forum site tells us 3300 Australian men die from PCa each year. For me post- op complications and ongoing incontinence is worse than BPH. I suspect 9 years of relaxing bladder neck muscles has not helped post-RP. All these medications have side effects they know of and likely some they will never find out without proper research and data collection.Barrie Heslop
For me over the years the best “medication” for BPH with little side effects has been self-cathing or CIC. I’ve tried most of the drugs and several of the procedures and all of them have adverse side effects which often are worse than the BPH itself. I’ve had BPH for over 20 years and if I had to do it over again I would just have started CIC. Yes it is inconvenient to a degree but that “side effect” is a walk in the park compared to what the uros and IRs have put me through over the years. Maybe some day a benign treatment will come available but until then CIC is the way to go for me! Good luck. Howard
I’ve been taking Tamsulosin for about a year now and it does help my inability to pee as needed. I also take daily 5mg Tadalafil as a way to counteract the decreased sex drive/libido caused by Tamsulosin. So with this combination, if and when I’m in the mood, I can perform, but I find that I’m not in the mood as much as I used to be. Still looking for alternatives.