The Effect of Switching Patients with Symptomatic Benign Prostatic Hyperplasia from Tamsulosin 0.2 mg to 0.4 mg

Abstract

Objectives: In 2010, tamsulosin 0.2 mg (OD) was withdrawn from Thailand and replaced with tamsulosin 0.4 mg (OD). Therefore, we assessed the impact of this change on the patients, at a men’s health clinic, with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH). Material and Methods: Subjects were 100 men with BPH who had been taking tamsulosin 0.2 mg as needed for at least 3 months. The outcome measures were IPSS, AMS and IEFF5 scores and uroflowmetry. Tolerability was evaluated on by adverse events. Changes from baseline were assessed using the paired t -test. SPSS version 12.0 was used for statistical analysis, with p < 0.05 considered significant. Results: The mean follow up of tamsulosin 0.2 and 0.4 mg were 20.23 and 10.56 months respectively. On switching from tamsulosin 0.2 to 0.4 mg, mean IPSS score improved from 15.54 ± SD 1.25 to 14.13 ± SD 1.09 (p = 0.034), Q max 15.91 cm 3 /sec ± SD 1.36 to 16.69 cm 3 /sec ± SD 1.52 (p = 0.128), and nocturia 3.15 ± SD 0.32 to 2.68 ± SD 0.39 (p = 0.015), respectively. However IEFF-5 score and AMS score increased from14.78 ± SD 1.38 to 15.79 ± SD 1.03 (p = 0.0055) and 34.76 ± SD 2.76 to 33.21 ± SD 2.62 (p = 0.0853), respectively. Treatment-related adverse events of Tamsulosin 0.2 mg included dizziness (4%), postural hypotension (3%) and retrograde ejaculation (3%). Interest ingly, no withdrawals resulted from adverse events during Tamsulosin 0.4 mg assessment. Conclusions: Switching to tamsulosin 0.4 mg improves LUTS. The change was well tolerated by the majority of patients. Increased symptoms scores of erectile dysfunction and aging male during the study may be due to increased age.