BPH Medication Comparison Tool
Class: Alpha-1 blocker
Dosage: 10 mg once daily after a meal
Onset: 3-5 days
Cost: NZ$12/month
Best For: Patients wanting once-daily dosing with minimal blood-pressure impact
Side Effects:
- • Mild dizziness
- • Headache
- • Rare cardiac arrhythmia
Class: Alpha-1A blocker
Dosage: 0.4 mg once daily
Onset: Within 24 hours
Cost: NZ$18/month
Best For: Those needing fast relief and tolerating sexual side effects
Side Effects:
- • Abnormal ejaculation
- • Dizziness
- • Nasal congestion
Class: Non-selective alpha-1 blocker
Dosage: 4 mg once daily (titrate)
Onset: 4-7 days
Cost: NZ$15/month
Best For: Men with concurrent hypertension
Side Effects:
- • Low blood pressure
- • Fatigue
- • Edema
Class: Alpha-1A blocker
Dosage: 8 mg once daily
Onset: 2-3 days
Cost: NZ$22/month
Best For: Patients who don’t mind sexual changes
Side Effects:
- • Retrograde ejaculation
- • Dry mouth
Class: 5-alpha-reductase inhibitor
Dosage: 5 mg once daily
Onset: 6-12 months
Cost: NZ$20/month
Best For: Large prostates (>40 g) or rising PSA
Side Effects:
- • Decreased libido
- • Erectile dysfunction
- • Breast tenderness
Key Considerations
- For quick relief: Tamsulosin offers fastest onset (24 hrs)
- For minimal side effects: Uroxatral has fewer cardiovascular impacts
- For hypertension: Doxazosin helps control blood pressure
- For prostate shrinkage: Finasteride reduces gland size over months
- For affordability: Uroxatral is the cheapest option
Always consult your healthcare provider before starting or changing medications.
Detailed Comparison Chart
| Drug (Generic) | Class | Dosage/Frequency | Onset of Relief | Common Side Effects | Cost (NZ$) | Best For |
|---|---|---|---|---|---|---|
| Alfuzosin | Alpha-1 blocker | 10 mg once daily | 3-5 days | Dizziness, headache | $12 | Patients wanting once-daily dosing with minimal BP impact |
| Tamsulosin | Alpha-1A blocker | 0.4 mg once daily | 24 hours | Ejaculation issues, dizziness | $18 | Those needing fast relief and tolerating sexual side effects |
| Doxazosin | Non-selective alpha-1 blocker | 4 mg once daily (titrate) | 4-7 days | Hypotension, fatigue | $15 | Men with concurrent hypertension |
| Silodosin | Alpha-1A blocker | 8 mg once daily | 2-3 days | Retrograde ejaculation, dry mouth | $22 | Patients who don't mind sexual changes |
| Finasteride | 5-alpha-reductase inhibitor | 5 mg once daily | 6-12 months | Sexual dysfunction, breast changes | $20 | Large prostates (>40 g) or rising PSA |
When treating benign prostatic hyperplasia (BPH), Uroxatral is a prescription alpha‑1 blocker (generic name Alfuzosin) that relaxes prostate smooth muscle to improve urine flow. Many patients ask how it stacks up against the many other pills on the market. This guide breaks down the science, the side‑effect profile, and the cost factors so you can decide whether the Uroxatral comparison you’re reading is worth your time.
Key Takeaways
- Uroxatral works by selectively blocking alpha‑1A receptors in the prostate, offering once‑daily dosing with relatively few cardiovascular effects.
- Common alternatives-Tamsulosin, Doxazosin, Silodosin, and 5‑alpha‑reductase inhibitors like Finasteride-differ in mechanism, dosing frequency, and side‑effect spectrum.
- For men with an enlarged prostate but normal blood pressure, an alpha‑1 blocker (Uroxatral, Tamsulosin, Silodosin, Doxazosin) is typically first‑line.
- If prostate size is large (>40g) or PSA is rising, adding a 5‑alpha‑reductase inhibitor (Finasteride or Dutasteride) can shrink the gland over months.
- Cost in NewZealand varies: generic Alfuzosin is cheapest, while brand‑name alternatives may cost up to three times more.
How Alfuzosin Works
Alfuzosin belongs to the alpha‑1 blocker class. It binds preferentially to the alpha‑1A subtype located in prostate smooth muscle, reducing muscle tone without a strong effect on blood vessels. This selectivity means fewer episodes of dizziness or orthostatic hypotension compared with less selective agents like Doxazosin.
Typical dosing is 10mg taken after a meal, once a day. Food improves absorption and reduces the chances of an upset stomach. Peak plasma levels appear within 4‑6hours, and steady‑state concentrations are reached after about five days.
Top Alternatives at a Glance
Below are the most frequently prescribed BPH drugs, each introduced with a short microdata definition.
Tamsulosin is an alpha‑1A selective blocker sold as Flomax, known for its rapid onset (within 24hours) and a once‑daily bedtime dose.
Doxazosin is a non‑selective alpha‑1 blocker (brand Cardura) that also lowers blood pressure, often used when BPH co‑exists with hypertension.
Silodosin is a highly alpha‑1A selective agent (brand Rapaflo) that may cause retrograde ejaculation in up to 10% of users.
Finasteride is a 5‑alpha‑reductase inhibitor (brand Proscar) that shrinks prostate volume over 6‑12months but can lower libido and cause sexual dysfunction.
5‑alpha‑reductase inhibitor is a drug class that blocks the enzyme that converts testosterone to dihydrotestosterone, resulting in gradual prostate shrinkage.
Benign Prostatic Hyperplasia is a non‑cancerous enlargement of the prostate gland that obstructs urine flow and is common after age 50.
Side‑Effect Snapshot
- Uroxatral: mild dizziness, headache, rare cardiac arrhythmia.
- Tamsulosin: abnormal ejaculation, dizziness, nasal congestion.
- Doxazosin: low blood pressure, fatigue, edema.
- Silodosin: retrograde ejaculation, dry mouth.
- Finasteride: decreased libido, erectile dysfunction, breast tenderness.
Comparison Table
| Drug (Generic) | Class | Typical Dose/Frequency | Onset of Symptom Relief | Common Side Effects | NZ$ Cost (30days) | Best For |
|---|---|---|---|---|---|---|
| Alfuzosin | Alpha‑1 blocker | 10mg once daily | 3‑5days | Dizziness, headache | ~$12 | Patients wanting once‑daily dosing with minimal blood‑pressure impact |
| Tamsulosin | Alpha‑1A blocker | 0.4mg once daily | 24hours | Ejaculation issues, dizziness | ~$18 | Those needing fast relief and tolerating sexual side effects |
| Doxazosin | Non‑selective alpha‑1 blocker | 4mg once daily (titrate) | 4‑7days | Hypotension, fatigue | ~$15 | Men with concurrent hypertension |
| Silodosin | Alpha‑1A blocker | 8mg once daily | 2‑3days | Retrograde ejaculation, dry mouth | ~$22 | Patients who don’t mind sexual changes |
| Finasteride | 5‑alpha‑reductase inhibitor | 5mg once daily | 6‑12months | Sexual dysfunction, breast changes | ~$20 | Large prostates (>40g) or rising PSA |
Choosing the Right Medication
Ask yourself these three questions before committing to a pill:
- Is my blood pressure normal? If you have hypertension, a drug that also lowers pressure (like Doxazosin) might kill two birds with one stone.
- Do I mind changes in ejaculation? Tamsulosin and Silodosin are more likely to affect sexual function.
- How big is my prostate? If imaging shows a large gland, adding a 5‑alpha‑reductase inhibitor (Finasteride) can provide long‑term shrinkage.
Most clinicians start with an alpha‑1 blocker because it works quickly and is cheap. If symptoms persist after 4‑6weeks, they may switch to a different blocker or combine it with a 5‑alpha‑reductase inhibitor.
Managing Common Side Effects
- Dizziness: Take the dose after a meal, rise slowly from sitting, and stay hydrated.
- Ejaculatory changes: Discuss with your doctor; switching to Alfuzosin or a non‑selective blocker often reduces the issue.
- Sexual dysfunction from Finasteride: A “drug holiday” after 6months can sometimes restore libido, but only under medical supervision.
Frequently Asked Questions
Can I switch from Tamsulosin to Uroxatral without a washout period?
Yes. Both drugs are alpha‑1 blockers, so most doctors advise a direct switch on the same day. However, keep an eye on blood pressure and report any new dizziness.
Is Alfuzosin safe for men over 80?
Alfuzosin’s selectivity makes it one of the safer options for older adults, but dose adjustments may be needed if kidney function declines. Always have renal labs checked before starting.
Do I need to take Alfuzosin with food?
Taking it after a meal improves absorption and reduces stomach upset, so it’s the recommended practice.
How long will it take to notice symptom relief?
Most patients report improvement within 3‑5days. Full maximal effect can take up to two weeks.
Can I combine Alfuzosin with a 5‑alpha‑reductase inhibitor?
Yes, the combination is common for men with large prostates. The blocker gives quick relief, while the inhibitor works slowly to shrink the gland.
Armed with this side‑by‑side look, you can talk to your doctor with confidence, weigh the pros and cons, and pick the BPH pill that fits your lifestyle and health profile.
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