Hi all. based on replies to my thread about PAE, I wanted to start another arond combo drug therapies. This is all fairly new to me so I am trying to find the right med, or combo of meds, before going down the surgical route.
54 years old, recently started having retention issues. Urologist has me on flomax, hated the side effects (retrograde ejaculation and loss of libido), Now trying Uroxatrol (alfuzosin). While it mostly works, without the bad side effects, I suspect that I may not be fully emptying my bladder as even after urinating I feel like I should have to go. I can sleep through the night, it is more of a general discomfort during the day. Another interesting note is that when I first started either of the two the results had me peeing like a 20 year old but after a week more like a 40 year old.
Anyway, this had me thinking about combo type therapies. Perhaps adding cialis daily into the mix as it has a diferent mechanism of action. Perhaps swithcing off daily betweek the flowmax and the alfuzosin. I want to stay away from Proscar (Finasteride) as that seems to have a lot of side effects.
Wondering if anyone has any experience with using more than one med?
Mike..... many of us start on drugs with reasonable results, but the bottom line is that the prostate keeps growing, and what can happen is that the bladder becomes overextended and damaged, so that eventually, and almost certainly, wI hen surgery is necessary, the reliance on drugs over a long period is damaging.
I'd strongly recommend you think about the drugs as temporary, and start researching the various more permanent treatments/surgeries. I had HoLep after several years on drugs, and am very happy with the results, even including retro, etc.
Best of luck with what you choose!
HI mike. I'm still takin flomax and avordart,and still have retention.I'm a lot older than you i"m 87.stil lhanging in there. I was on alfusosin ,also .seems like their all the same.
FWIW I have almost no side effects from fernasteride. I also take Flowmax
FWIW
I'm 70 yrs old, started with retention issues about 3 years ago. Doc started me on flowmax. Two years later after trying several different drugs, all helped for a short period of time. The doc put me on the max dose of flowmax and finasteride, worked great at first but soon was back to horable retention issues. 11/08/16 I had TURP surgery. Now 23 days later I am peeing like I was 25 again. The first two weeks after surgery were uncomfortable and at times scared when seeing blood when I pee. I am still passing some small scabs and clots, none painful. TURP is just one of many procedures that can be done, see your uro, talk to your uro about what is best for you. Knowing what I know now I would have TURP procedure again. Good luck Mike, let us know how things work out for you.
Joe, Have you had sex after your TURP? Maybe too soon I don't know
Not yet but it won't be long. Since TURP I woke two mornings a week apart with an erection, that has not happened in years. My wife was as surprised as I was. Penis still a bit sensitive, I'll try manual stimulation first.
I gave up on finasteride. The list of possible side effects had me worried and it did nothing. Not to mention the cost. Flomax did nothing as well.
fernasteride takesmonths to work. Its supposed to shrink or at least slow growth of the prostate. tamsulosin ( flowmax ) should work in a short time. You mention cost, not sure where you live but I pay very little because they're both generic. Maybe try daily Cialis instead of tamsulosin, but thats is expensive.
I was on daily Cialis for 1 month it worked ok but it is so expensive. My insurance would not cover it.
Did you find it any more it less effective than other meds? Side effects any better or worse. Thx.
Cialis was just as effective as flowmax when the flowmax was first started. When the flowmax started to lose it's effectiveness and the dose was increased flowmax worked good again for awhile. I did not stay on the cialis long enough to know if it would lose it's effectiveness. I took the cialis in combo with max dose of flowmax and finasteride.
Drugs are usually a short term fix at best and for some (me included) none really helped all that much. There are three good, not all that invasive procedures now that weren't available even a few years ago - they are Urolift, Rezum and PAE. If the drug regimen stops working, I would investigate those. The side effect profile is very low, recovery is quick and no anesthesia is required for any of them.
Your urologist can do a quick scan to see if you're emptying fully, or he can set you up to self cath, which is a good thing to have in your back pocket if retension is a risk anyway as it will save you a trip to the ER and having to wear a foley catheter. You can pee then self cath and see how much is left.
The 2 had a $75 co pay for me. Finasteride takes 4 -6 months to work and just as long to get out of your system. Tamsulosin is a works right away. Stops working when you stop taking it thing. According to my uros practitioner anyway. I asked if I had to taper off them.
My younger brother has been taking flomax a while. It works great for him even at a low dose. I was hoping the same for me. But it didn't help at all
Hi Mike,
Be very careful about increasing dosage or mixing these types of drugs up. In addition to relaxing the prostate, they also control blood pressure which has to be controlled and supervised. As to the quickly waning benefits, I had the same both with flomax and daily cialis. Perhaps higher dosages would have made up the difference but higher doses tend to come with more side effects which I didn't want.
How much retention do you have? Do you know your International Prostate Sympton Score (IPSS)?
Have you considered self catherization (CIC)? That was my choice when drugs didn't work and surgery wasn't to my taste. Three years later and CIC has rehabiltated my bladder to the extent that I have resolved my retention problem and only have to cath once a week, if that.
Jim
This is all fairly new to me.
Flomax or alfuzosin seem to be working, but they definitely have impact in the sex side. That is why I was asking about experience with Cialis daily as combo or substitute.
At some point I will consider PAE or urolift. I figure if I can hold off on the surgical type options they will only improve and / or I will only need to do it once in my lifetime! Crappy insurance and benefits make a couple weeks downtime all that less appealing at the moment.
Thanks for all the replies.