Doxazosin

U.S. Brand Names: Cardura®

Use: Used to treat benign prostatic hyperplasia (BPH).

Pregnancy Risk Factor and Implications: Pregnancy Category C; unknown whether excreted in breast milk, use caution.

Contraindications: Do not use if you have a known sensitivity to quinazolines (prazosin, terazosin, etc).

Warnings/Precautions: Doxazosin can cause excessive hypotension and syncope especially with the first dose, when dosage is increased, and if use is abruptly stopped. Patients should avoid situations where injury could result if syncope occurred. In rare cases doxazosin may cause priapism (painful penile erection sustained for hours and unrelieved by sexual intercourse or masturbation). This condition can lead to permanent impotence if not properly treated. Prostate cancer shares many of the same symptoms as BPH and should be ruled out before being treatment with this drug.

Adverse Reactions:

Greater than 5% experienced: Fatigue, headache, dizziness

Less than 5% experienced: Back pain, chest pain, influenza-like symptoms, pain, hypotension, palpitation, abdominal pain, diarrhea, dyspepsia, nausea, edema, dry mouth, somnolence, dyspnea, respiratory disorder, abnormal vision, impotence, urinary tract infection, sweating increased, anxiety, insomnia, angina pectoris, postural hypotension, syncope, tachycardia, dysuria, decreased libido.

Overdose/Toxicology: Experience with doxazosin overdosage is limited although the most likely symptoms of an overdose would include hypotension.

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Prazosin

U.S. Brand Names: Minipress®

Use: Used to treat benign prostatic hyperplasia, relaxes blood vessels so that blood passes through them more easily. Will not shrink the size of the prostate but will help relieve symptoms.

Pregnancy Risk Factor and Implications: This drug has not been shown to cause birth defects or other problems, use with caution. This drug does enter breast milk, use with caution.

Warnings/Precautions: Before using this medicine tell your doctor if you have ever had an allergic response to prazosin, doxazosin, or terazosin. Tell your doctor if you have had chest pain, severe heart disease, or kidney disease before using this drug. Do not take any other medicines while taking this drug unless they have been approved for use by your doctor. This drug may cause dizziness, lightheadedness, or sudden fainting so be careful when getting up suddenly. Limit alcohol use while using this drug as it will increase these effects. This drug may also cause drowsiness so do not drive or operate heavy machinery until you know how you will react to this drug.

Adverse Reactions:

Common side effects: Dizziness, lightheadedness, sudden fainting, drowsiness, headache, lack of energy

Less common side effects: Loss of bladder control, pounding heartbeat, swelling of feet or lower legs, dry mouth, nervousness, unusual tiredness or weakness

Rare side effects: Chest pain, painful inappropriate erection of penis, shortness of breath, frequent urge to urinate, nausea

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Terazosin

U.S. Brand Names: Hytrin®

Use: Used to treat benign Prostatic Hyperplasia (BPH).

Pregnancy Risk Factor and Implications: Pregnancy Category C; not recommended during pregnancy unless the benefits outweigh the risks; unknown if excreted in breast milk, use with caution.

Contraindications: Do not use if you have a known allergy to terazosin hydrochloride.

Warnings/Precautions: This drug can cause a marked lowering of blood pressure, usually postural hypotension and syncope especially with first doses, sudden dosage changes, and stopping drug use suddenly. Patients should use caution when driving or in other dangerous situations where injury could result should syncope occur. Rule out prostate cancer before beginning therapy with this drug as symptoms are often similar.

Adverse Reactions:

Greater than 5% experienced: Asthenia, dizziness

Less than 5% experienced: Flu syndrome, headache, hypotension, palpitations, postural hypotension, syncope, nausea, peripheral edema, weight gain, somnolence, vertigo, dyspnea, nasal congestion/rhinitis, blurred vision/amblyopia, impotence, urinary tract infection, fever, headache, postural hypotension, syncope, nausea, dizziness, vertigo, dyspnea, blurred vision/amblyopia, urinary tract infection

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Tamsulosin

U.S. Brand Names: Flomax®

Use: Used to treat benign prostatic hypertrophy, helps relax the muscles in the prostate and the opening of the bladder, will not shrink the prostate.

Warnings/Precautions: Tell your doctor if you have had a past allergic reaction to tamsulosin, tell your doctor if you are taking doxazosin, phentolamine, prazosin, terazosin, or warfarin. Get up slowly as this medicine may cause dizziness, lightheadedness, or fainting. Do not drive, use heavy machine, or do other dangerous activities unless you know how this medicine will affect you.

Adverse Reactions:

Common side effects: Abnormal ejaculation, back pain, diarrhea, dizziness, headache, stuffy or runny nose, unusual weakness

Less common side effects: Chest pain, decreased sexual drive or performance, difficulty sleeping, fainting or lightheadedness, drowsiness, nausea.

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Finasteride

U.S. Brand Names: Proscar®; Propecia®

Use: Used to treat benign prostatic hyperplasia.

Pregnancy Risk Factor and Implications: Do not use or handle if you are pregnant as this drug can cause birth defects in male fetuses.

Contraindications: Women of child-bearing age should not use or handle crushed finasteride tablets. Finasteridse can cause birth defects in male fetuses.

Warnings/Precautions: Tell your doctor if you have had an allergic reaction to finasteride in the past.

Adverse Reactions: Side effects include breast enlargement and tenderness, skin rash, swelling of lips, abdominal pain, back pain, decreased libido, decreased volume of ejaculate, diarrhea, dizziness, headache, and impotence.

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Ciprofloxacin

U.S. Brand Names: Ciloxan®

Use: Used to treat infections caused by susceptible strains of the designation microorganisms in urinary tract infections and in chronic bacterial prostatitis.

Pregnancy Risk Factor and Implications: Category C, is excreted in human milk, potential for serious adverse reactions in nursing infants.

Contraindications: Do not use if you have a known allergy to ciprofloxacin or to any member of the quinolone class of antimicrobial agents.

Warnings/Precautions: The safety of this drug in pediatric patients, people less than 18 years old, pregnant and lactating women has not been established. This drug may cause cartilage erosion of weight-bearing joints. This drug may also cause convulsion, intracranial pressure, toxic psychosis, and it may cause central nervous system events. Use with caution in patients with CNS disorders or in patients with risk factors such as certain drug therapies and renal dysfunction that may predispose them to seizure or lower their seizure threshold. Serious and fatal reactions have been reported in patients receiving concurrent administration of ciprofloxacin and theophylline. Serious and occasionally fatal hypersensitivity reactions have been reported in patients receiving quinolone therapy. Severe hypersensitivity reactions characterized by rash, fever, eosinophilia, jaundice, and hepatic necrosis with fatal outcome have also been rarely reported in patients receiving ciprofloxacin along with other drugs. Psuedomembranous colitis has been reported with nearly all antibacterial agents including ciprofloxacin, and may range in severity from mild to life-threatening. Treatment with antibacterial agents alters the normal flora of the colon. Achilles and other tendon ruptures that required surgical repair or resulted in prolonged disability have been reported with ciprofloxacin and other quinolones. Avoid excessive sunlight as moderate to severe phototoxicity manifested as an exaggerated sunburn reaction has been observed in some patients while on the quinolone class of drugs.

Adverse Reactions:

At least 5% experienced: Nausea

Less than 5% experienced: Diarrhea, vomiting, abdominal pain/discomfort, headache, restlessness, rash, palpitation, atrial flutter, ventricular ectopy, syncope, hypertension, angina pectoris, myocardial infarction, cardiopulmonary arrest, cerebral thromobosis, dizziness, lightheadedness, insomnia, nightmares, hallucinations, manic reaction, irritability, tremor, ataxia, convulsive seizures, lethargy, drowsiness, weakness, malaise, anorexia, phobia, depersonalization, depression, paresthesia, painful oral mucous, oral candidiasis, dysphagia, intestinal perforation, gastrointestinal bleeding, cholestatic jaundice, arthralgia or back pain, joint stiffness, achiness, neck or chest pain, flare up of gout, interstitial nephritis, nephritis, renal failure, polyuria, urinary retention, urethral bleeding, vaginitis, acidosis, dyspnea, epistaxis, laryngeal or pulmonary edema, hiccough, memophysis, bronchospase, pumonary embolism, pruritus, urticaria, photosensitivity, flushing, fever, chills, angioedema, edema of the face, neck, lips, conjuctivae or hands, cutaneous candidiasis, hyperpigmentation, erythera nodosum, blurred vision, disturbed vision, decreased visual acuity, diplopia, eye pain, tinnitus, hearing loss, bad taste, vaginitis, headache, vaginal pruritus, abdominal discomfort, lymphadenopathy, foot pain, dizziness, breast pain, nausea, diarrhea, central nervous system disturbance, abnormalities of liver associated enzymes, eosinophila, restlessness, rash, cardiovascular collapse, cardiopulmonary arrest, myocardial infarction, arrhythmia, tachycardia, palpitation, cerebral thrombosis, syncope, cardiac murmur, hypertension, hypotension, angina pectoris, convulsive seizures, paranoia, toxic psychosis, depression, dysphasia, phobia, depersonalization, manic reaction, unresponsiveness, ataxia, confusion, hallucinations, dizziness, lightheadedness, paresthesia, anxiety, tremor, insomnia, nightmares, weakness, drowsiness, irritability, malaise, lethargy, ileus, jaundice, gastrointestinal bleeding, C. difficle associated diarrhea, pseudomembranous colitis, pancreatitis, hepatic necrosis, intestinal perforation, dyspepsia, epigastric or abdominal pain, vomiting, constipation, oral ulceration, oral candidiasis, mouth dryness, anorexia, dysphagia, flatulence, thrombophlebitis, burning, pain, pruritus, paresthesia, erythema, swelling, arthralgia, jaw, arm or back pain, joint stiffness, neck and chest pain, achiness, flare up of gout, renal failure, intarstitial nephritis, hemorrhagic cystitis, renal calcuti, frequent urination, acidosis, urethral bleeding, polyuria, urinary retention, gynecomastia, candiduria, vaginitis. Crystalluria, cylindruria, hematuria, and albuminutia have also been reported, respiratory arrest, pulmonary embolism, dyspnea, pulmonary edema, respiratory distress, pleural effusion, hemoptysis, epistaxis, hiccough, anaphylactic reactions, erythema multiforme/Stevens-Johnson syndrome, exfoliative dermatitis, toxic epidermal necrolysis, vasculitis, angioedema, edema of the lips, face, neck, conjunctivae, hands or lower extremities, purpura, fever, chills, flushing, pruritus, urtigaria, cutaneous candidiasis, vesicles, increased perspiration, hyperpigmentation, erythema nodosum, photosensitivity. Allergic reactions ranging from urticaria to anaphylactic reactions have been reported. Also experienced were decreased visual acuity, blurred vision, disturbed vision (flashing lights, change in color perception, overbrightness of lights, diplopia), eye pain, anosmia, hearing loss, tinnitus, nystagmus, a bad taste, agranulocytosis, prolongation of prothrombin time, and possible exacerbation of myasthenia gravis, change in serum phenytoin, postural hypotension, vasculitis, agitation, confusion, delirium, dysphasia, myoclonus, nystagmus, toxic psychosis, constipation, dyspepsia, flatulence, hepatic necrosis, jaundice, pancreatitis, pseudomembranous colitis. (The onset of pseudomembranous colitis symptoms may occur during or after antimicrobial treatment.), agranulocytosis, hemolytic anemia, methemaglobinemia, prolongation of prothrombin time, elevation of serum triglycerides, cholesterol, blood glucose, serum potassium, myalgia, possible exacerbation of myasthenia gravis, tendinitis/tendon rupture, albuminuria, candiduria, renal calculi, vaginal candidiasis, anaphylactic reactions, erythema multiforme/Stevens-Johnson syndrome, exfoliative dermatitis, toxic epidermal necrolysis, anosmia, taste loss.

Overdose/Toxicology: In case of an overdose empty the stomach and maintain adequate hydration. Observe the patient carefully and give supportive treatment. Symptoms of an overdose may include tonic/clonic convulsions, hypoactivity, cyanosis, severe vomiting.

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