Tags

Type your tag names separated by a space and hit enter

Cardiovascular and ocular safety of α1-adrenoceptor antagonists in the treatment of male lower urinary tract symptoms.
Expert Opin Drug Saf. 2014 Sep; 13(9):1187-97.EO

Abstract

INTRODUCTION

α1-Adrenoceptor antagonists (α-blockers) represent first-line drug treatment for male lower urinary tract symptoms. Their adverse events (AEs) include asthenia, dizziness, nasal congestion, arterial (orthostatic) hypotension and intraoperative floppy iris syndrome (IFIS).

AREAS COVERED

This report focuses on cardiovascular and ocular AEs of α-blockers as related to their mechanism of action and subtype selectivity.

EXPERT OPINION

The incidence of hypotension differs between α-blockers. It is greatest with doxazosin or terazosin, but others including tamsulosin can also lead to hypotension especially upon treatment initiation. Concomitant antihypertensive medication increases the incidence of hypotension with some α-blockers. Use of α(1A)-selective blockers, evening dosing and drug intake after a meal can reduce the risk of hypotension. IFIS can occur with all drugs exerting α(1)-adrenoceptor antagonist properties and has especially been reported for tamsulosin. It makes cataract surgery more challenging but does not constitute a health risk to patients. IFIS seems to result from inhibition of iris dilator muscle contraction and occurs in men or women, even after α-blockers have been discontinued. To reduce the risk of IFIS, the authors suggest taking a careful drug history, postponing α-blocker treatment for patients with scheduled cataract surgery and careful counseling of patients taking α-blockers.

Authors+Show Affiliations

Hannover Medical School, Department of Urology , Hannover , Germany.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Review

Language

eng

PubMed ID

25073735

Citation

Oelke, Matthias, et al. "Cardiovascular and Ocular Safety of Α1-adrenoceptor Antagonists in the Treatment of Male Lower Urinary Tract Symptoms." Expert Opinion On Drug Safety, vol. 13, no. 9, 2014, pp. 1187-97.
Oelke M, Gericke A, Michel MC. Cardiovascular and ocular safety of α1-adrenoceptor antagonists in the treatment of male lower urinary tract symptoms. Expert Opin Drug Saf. 2014;13(9):1187-97.
Oelke, M., Gericke, A., & Michel, M. C. (2014). Cardiovascular and ocular safety of α1-adrenoceptor antagonists in the treatment of male lower urinary tract symptoms. Expert Opinion On Drug Safety, 13(9), 1187-97. https://doi.org/10.1517/14740338.2014.936376
Oelke M, Gericke A, Michel MC. Cardiovascular and Ocular Safety of Α1-adrenoceptor Antagonists in the Treatment of Male Lower Urinary Tract Symptoms. Expert Opin Drug Saf. 2014;13(9):1187-97. PubMed PMID: 25073735.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiovascular and ocular safety of α1-adrenoceptor antagonists in the treatment of male lower urinary tract symptoms. AU - Oelke,Matthias, AU - Gericke,Adrian, AU - Michel,Martin C, Y1 - 2014/07/29/ PY - 2014/7/31/entrez PY - 2014/7/31/pubmed PY - 2015/3/17/medline KW - adverse drug event KW - alfuzosin KW - blood pressure KW - doxazosin KW - hypotension KW - intraoperative floppy iris syndrome KW - silodosin KW - tamsulosin KW - terazosin KW - α1-adrenoceptor antagonist SP - 1187 EP - 97 JF - Expert opinion on drug safety JO - Expert Opin Drug Saf VL - 13 IS - 9 N2 - INTRODUCTION: α1-Adrenoceptor antagonists (α-blockers) represent first-line drug treatment for male lower urinary tract symptoms. Their adverse events (AEs) include asthenia, dizziness, nasal congestion, arterial (orthostatic) hypotension and intraoperative floppy iris syndrome (IFIS). AREAS COVERED: This report focuses on cardiovascular and ocular AEs of α-blockers as related to their mechanism of action and subtype selectivity. EXPERT OPINION: The incidence of hypotension differs between α-blockers. It is greatest with doxazosin or terazosin, but others including tamsulosin can also lead to hypotension especially upon treatment initiation. Concomitant antihypertensive medication increases the incidence of hypotension with some α-blockers. Use of α(1A)-selective blockers, evening dosing and drug intake after a meal can reduce the risk of hypotension. IFIS can occur with all drugs exerting α(1)-adrenoceptor antagonist properties and has especially been reported for tamsulosin. It makes cataract surgery more challenging but does not constitute a health risk to patients. IFIS seems to result from inhibition of iris dilator muscle contraction and occurs in men or women, even after α-blockers have been discontinued. To reduce the risk of IFIS, the authors suggest taking a careful drug history, postponing α-blocker treatment for patients with scheduled cataract surgery and careful counseling of patients taking α-blockers. SN - 1744-764X UR - https://www.unboundmedicine.com/medline/citation/25073735/Cardiovascular_and_ocular_safety_of_α1_adrenoceptor_antagonists_in_the_treatment_of_male_lower_urinary_tract_symptoms_ L2 - http://www.tandfonline.com/doi/full/10.1517/14740338.2014.936376 DB - PRIME DP - Unbound Medicine ER -