Silodosin Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Uses

Silodosin is used by men to treat the symptoms of an enlarged prostate (benign prostatic hyperplasia-BPH). It does not shrink the prostate, but it works by relaxing the muscles in the prostate and the bladder. This helps to relieve symptoms of BPH such as difficulty in beginning the flow of urine, weak stream, and the need to urinate often or urgently (including during the middle of the night).Silodosin belongs to a class of drugs known as alpha blockers.Do not use this medication to treat high blood pressure.

How to use Silodosin

Take this medication by mouth as directed by your doctor, usually once daily with a meal.

If you have difficulty swallowing this medication whole, you may sprinkle the entire contents of a capsule on a small amount (such as a tablespoon) of cool soft applesauce just before taking. Swallow the mixture right away (within 5 minutes). Do not chew the mixture, and do not save it for future use. Do not use hot applesauce. Drink a glass of cool water after each dose.

Silodosin may cause a sudden drop in your blood pressure, which could lead to dizziness or fainting. This risk is higher when you first start taking this drug, after your doctor increases your dose, or if you restart treatment after you stop taking it. During these times, avoid situations where you may be injured if you faint.

To avoid injury from dizziness or fainting, your doctor may tell you to take your first dose of silodosin with food at bedtime so that your body can get used to its effects.

The dosage is based on your medical condition and response to treatment.

Take this medication regularly to get the most benefit from it. To help you remember, take it with the same meal each day.

Tell your doctor if your condition does not improve or if it worsens.

Side Effects

Dizziness, lightheadedness, or ejaculation problems may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

To reduce the risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: fainting.

Rarely, males may have a painful or prolonged erection lasting 4 or more hours. If this occurs, stop using this drug and get medical help right away, or permanent problems could occur.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking silodosin, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease, low blood pressure, certain eye problems (cataracts, glaucoma).

This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery (including cataract/glaucoma eye surgery), tell your doctor or dentist if you are taking or have ever taken this medication, and about all the other products you use (including prescription drugs, nonprescription drugs, and herbal products).

Older adults may be more sensitive to the side effects of this drug, especially dizziness and low blood pressure when getting up from a sitting or lying position. These side effects can increase the risk of falling.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Some products that may interact with this drug include: other alpha blocker drugs (such as prazosin, terazosin).

If you are also taking a drug to treat erectile dysfunction-ED or pulmonary hypertension (such as sildenafil, tadalafil), your blood pressure may get too low which can lead to dizziness or fainting. Your doctor may need to adjust your medications to minimize this risk.

Other medications can affect the removal of silodosin from your body, which may affect how silodosin works. Examples include azole antifungals (such as itraconazole, ketoconazole), clarithromycin, cobicistat, cyclosporine, HIV protease inhibitors (such as lopinavir), mifepristone, ribociclib, ritonavir, among others.

Does Silodosin interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe dizziness, fainting.

Do not share this medication with others.

Lab and/or medical tests (such as prostate exams, blood pressure) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images

silodosin 4 mg capsule

Color: whiteShape: oblongImprint: S 4 mg

This medicine is a white, oblong, capsule imprinted with “S” and “4 mg”.

silodosin 8 mg capsule

Color: whiteShape: oblongImprint: S 8 mg

This medicine is a white, oblong, capsule imprinted with “S” and “4 mg”.

silodosin 8 mg capsule

Color: whiteShape: oblongImprint: LU Q72

This medicine is a white, oblong, capsule imprinted with “S” and “4 mg”.

silodosin 4 mg capsule

Color: whiteShape: oblongImprint: AN 1421

This medicine is a white, oblong, capsule imprinted with “S” and “4 mg”.

silodosin 8 mg capsule

Color: whiteShape: oblongImprint: AN 1420

This medicine is a white, oblong, capsule imprinted with “S” and “4 mg”.

silodosin 8 mg capsule

Color: whiteShape: oblongImprint: H S2

This medicine is a white, oblong, capsule imprinted with “S” and “4 mg”.

silodosin 4 mg capsule

Color: whiteShape: oblongImprint: H S1

This medicine is a white, oblong, capsule imprinted with “S” and “4 mg”.

silodosin 8 mg capsule

Color: white,blueShape: oblongImprint: logo SLN 8

This medicine is a white, oblong, capsule imprinted with “S” and “4 mg”.

silodosin 4 mg capsule

Color: whiteShape: oblongImprint: logo SLN 4

This medicine is a white, oblong, capsule imprinted with “S” and “4 mg”.

silodosin 4 mg capsule

Color: whiteShape: oblongImprint: LU Q71

This medicine is a white, oblong, capsule imprinted with “S” and “4 mg”.

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Drug Survey

Are you currently using Silodosin?

This survey is being conducted by the WebMD marketing sciences department.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Side Effects, Dosage, Uses, and More

Highlights for silodosin

1. Silodosin oral capsule is available as a brand-name drug and a generic drug. Brand name: Rapaflo.
2. Silodosin comes only as a capsule you take by mouth.
3. Silodosin is used in adult men to treat benign prostatic hyperplasia (BPH).

• Fainting and dizziness warning: This drug may cause low blood pressure when you stand up after sitting or lying down, which may lead to dizziness and fainting. Don’t drive, use machinery, or perform dangerous tasks until you know how it affects you.
• Cataract surgery warning: This drug may affect your pupils during cataract surgery. A complication known as intraoperative floppy iris syndrome (IFIS) has occurred in some people who were taking or recently took this type of drug.

Silodosin is a prescription medication. It comes as an oral capsule.

Silodosin oral capsule is available as the brand-name drug Rapaflo. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in every strength or form as the brand-name drug.

Silodosin may be used as part of a combination therapy. That means you need to take it with other drugs.

Why it’s used

Silodosin is used to treat the symptoms of benign prostatic hyperplasia (BPH) in adult men. This condition is also called enlarged prostate. It helps lessen your BPH symptoms and improve your ability to urinate.

When the prostate is enlarged, it can pinch or squeeze your urethra and affect your ability to urinate. This may cause:

• nighttime urination (nocturia)
• sudden urge to urinate
• frequent urge to urinate
• difficulties in starting to urinate
• feeling like you can’t completely empty your bladder
• weak urine flow
• straining while urinating
• dribbling (leaking) after urination

How it works

This drug belongs to a class of drugs called alpha-1 blockers. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.

Alpha-1 receptors are located in your prostate and bladder. They’re responsible for the contraction of the smooth muscles of the bladder and prostate. Silodosin blocks these receptors, which causes the smooth muscles in the prostate and bladder to relax. This will reduce your BPH symptoms and improve your ability to urinate.

Silodosin oral capsule doesn’t cause drowsiness, but it can cause other side effects.

More common side effects

The more common side effects that can occur with silodosin include:

• dizziness
• diarrhea
• orthostatic hypotension (low blood pressure when you stand up after sitting or lying down)
• headache
• retrograde ejaculation (occurs when semen enters the bladder instead of out the tip of the penis)
• common cold
• stuffy nose

Mild side effects may disappear within a few days or a couple of weeks. Talk to your doctor or pharmacist if they’re more severe or don’t go away.

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

• Allergic reaction (drug hypersensitivity). Symptoms may include:
  • swelling of your face, lips, tongue, or throat
  • problems with breathing or swallowing
  • skin rash
  • itching
  • hives
  • blisters on your skin or in your mouth, nose, or eyes
  • peeling skin
  • fainting or feeling dizzy
  • very rapid heartbeat
• Liver problems. Symptoms may include:
  • yellowing of your skin or the whites of your eyes
  • nausea
  • vomiting
  • loss of appetite
  • stomach pain and swelling
  • bruising easily
  • pale stool color
  • dark urine
  • unusual or unexplained tiredness
• Prolonged erection (priapism). This is an erection that lasts longer than four hours.
• Sudden drop in blood pressure, especially when you stand up after sitting or lying down. Symptoms may include:
  • dizziness
  • feeling lightheaded
  • fainting

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Silodosin oral capsule can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with silodosin are listed below.

Antifungals

Taking these drugs with silodosin can increase the levels of silodosin in your body. Do not take these drugs with silodosin:

• itraconazole
• ketoconazole

Blood pressure drugs

Taking calcium channel blockers with silodosin may increase the levels of silodosin in your body. Examples of these drugs include:

• diltiazem
• verapamil

Antibiotics

Taking clarithromycin with silodosin increases the levels of silodosin in your body. Do not take this drug with silodosin.

Taking erythromycin with silodosin may increase the levels of silodosin in your body and increase your risk of side effects.

HIV medications

These medications belong to a drug class called protease inhibitors. Taking these medications with silodosin may increase the levels of silodosin in your body. Examples of these drugs include:

• atazanavir
• darunavir
• fosamprenavir
• indinavir
• nelfinavir
• saquinavir

Taking ritonavir with silodosin increases the levels of silodosin in your body. Do not take this drug with silodosin.

Immune-suppressing drug

Taking cyclosporine with silodosin may increase the levels of silodosin in your body. Taking these drugs together is not recommended.

Other drugs used to treat benign prostatic hyperplasia (BPH)

These medications may cause your blood pressure to become too low if taken with silodosin. They may also increase your risk of orthostatic hypotension, which is a sudden drop in blood pressure when getting up after sitting or lying down. This condition can cause dizziness or fainting.

Examples of these drugs include:

• alfuzosin
• doxazosin
• prazosin
• terazosin
• tamsulosin

Blood pressure drugs

These medications may cause your blood pressure to become too low if taken with silodosin. They may also increase your risk of orthostatic hypotension, which is a sudden drop in blood pressure when getting up after sitting or lying down. This condition can cause dizziness or fainting.

Examples of these drugs include:

• metoprolol
• carvedilol
• atenolol
• lisinopril
• losartan
• valsartan
• amlodipine
• clonidine

Erectile dysfunction drugs

These medications may cause your blood pressure to become too low if taken with silodosin. They may also increase your risk of orthostatic hypotension, which is a sudden drop in blood pressure when getting up after sitting or lying down. This condition can cause dizziness or fainting.

Examples of these drugs include:

• avanafil
• sildenafil
• tadalafil
• vardenafil

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

This drug comes with several warnings.

Allergy warning

This drug can cause a severe allergic reaction. Symptoms may include:

• trouble breathing
• swelling of your throat or tongue
• hives
• itching
• rash

Call 911 or go to the nearest emergency room if you develop these symptoms.

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal (cause death).

Grapefruit warning

If you drink grapefruit juice while taking silodosin, it may increase the levels of silodosin in your body and possibly cause increased side effects. Talk to your doctor about whether grapefruit products are safe for you.

Alcohol interaction warning

Silodosin can make you dizzy. Consuming alcohol may also make you dizzy and drowsy. You should limit the amount of alcohol you drink.

Warnings for people with certain health conditions

For people with kidney disease: Your body gets rid of this drug partly through your kidneys. If your kidneys aren’t working well, more of the drug may stay in your body. This increases your risk of side effects. This drug isn’t recommended if you have severe kidney disease. If you have moderate kidney disease, your doctor may give you a lower dosage.

For people with liver disease: This drug is processed by your liver. If your liver isn’t working well, more of the drug may stay in your body. This increases your risk of side effects. This drug isn’t recommended if you have severe liver disease, because it hasn’t been studied in people with this condition.

For people with low pressure (hypotension): This drug may cause low blood pressure when you stand up after sitting or lying down, dizziness, and even further lowering of your blood pressure. Don’t drive, use machinery, or perform dangerous tasks until you know how it affects you.

Warnings for other groups

For pregnant women: This drug is used to treat BPH in men. It isn’t intended for use in women.

This drug is a pregnancy category B drug. That means two things:

1. Studies of the drug in pregnant animals haven’t shown risk to the fetus.
2. There aren’t enough studies done in pregnant women to show the drug poses a risk to the fetus.

For women who are breastfeeding: This drug is used to treat BPH in men. It isn’t intended for use in women. It isn’t known if this drug passes through breast milk.

For seniors: If you’re 65 years or older, you may be at higher risk for low blood pressure when you stand up from sitting or lying down (orthostatic hypotension).

For children: It isn’t known if this drug is safe and effective in children younger than 18 years old.

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

• your age
• the condition being treated
• the severity of your condition
• other medical conditions you have
• how you react to the first dose

Drug forms and strengths

Generic: Silodosin

• Form: oral capsule
• Strengths: 4 mg and 8 mg

Brand: Rapaflo

• Form: oral capsule
• Strengths: 4 mg and 8 mg

Dosage for benign prostatic hyperplasia

Adult dosage (ages 18–64 years)

The typical dosage is 8 mg taken once per day with a meal.

Child dosage (ages 0–17 years)

The safety and effectiveness of silodosin in children younger than 18 years of age haven’t been established.

Senior dosage (ages 65 years and older)

As you age, your organs (such as liver or kidneys) may not work as well. Your body may process this drug more slowly. Too much drug in your body can lead to more side effects. Based on how well your liver and kidneys are working, your doctor may decide to adjust your dosage, or not prescribe this drug at all.

Special dosage considerations

For people with kidney disease: Dosing for silodosin depends on your kidney function.

• Severe kidney disease: Silodosin isn’t recommended.
• Moderate kidney disease: The recommended dosage is 4 mg taken once per day with a meal.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Silodosin is used for long-term treatment. It comes with serious risks if you don’t take it as prescribed.

If you don’t take it at all or stop taking it: If you don’t take or stop taking this drug, you may have increased symptoms of BPH. If you stop or forget to take this medication for several days, talk with your doctor before starting again.

If you take too much: You may experience low blood pressure, especially when you stand up after sitting or lying down. Symptoms may include:

• feeling dizzy or lightheaded
• fainting
• weakness
• blurry vision
• confusion

If you think you’ve taken too much of this drug, call your doctor or seek guidance from the American Association of Poison Control Centers at 1-800-222-1222 or through their online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.

What to do if you miss a dose: If you miss a dose, take it as soon as you can. However, if it’s just a few hours until your next dose, skip the missed dose. Never try to catch up by taking two capsules at once. This could result in dangerous side effects.

How to tell if the drug is working: Your BPH symptoms should improve. You may have an easier time urinating.

Keep these considerations in mind if your doctor prescribes silodosin for you.

General

• This drug should be taken with a meal.
• Taking this drug on an empty stomach may increase your risk of side effects, such as a drop in blood pressure when rising after sitting or lying down.
• Take this drug at the same time every day. This may help to reduce side effects.
• If you have trouble swallowing capsules, you can open the capsule carefully and sprinkle the powder it contains onto a tablespoonful of applesauce. Swallow the applesauce within five minutes without chewing. Drink an 8-ounce glass of cool water to make sure you completely swallowed the powder. The applesauce shouldn’t be hot and it should be soft enough to be swallowed without chewing. Don’t store any of this powder/applesauce mixture for future use.

Storage

• Store silodosin at a temperature between 59°F and 86°F (15°C and 30°C).
• Keep this drug away from light.
• Don’t store this medication in moist or damp areas, such as bathrooms.

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Travel

When traveling with your medication:

• Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
• Don’t worry about airport X-ray machines. They can’t hurt your medication.
• You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
• Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Clinical monitoring

During your treatment with silodosin, your doctor may do certain tests. These tests may include:

• Prostate-specific antigen blood test: The symptoms of BPH and prostate cancer may be similar. Your doctor may perform a prostate exam and a blood test called a prostate specific antigen (PSA) to make sure you don’t have prostate cancer before prescribing this drug.
• Blood pressure check: You doctor may check to see if your blood pressure is low. If you have low blood pressure (hypotension), taking this drug may lower your blood pressure even more and may not be safe for you to take.

Your diet

To help reduce the symptoms of BPH, your doctor may instruct you to limit the amount of fluid you drink at night. They may also recommend that you reduce the amount of alcohol and caffeine you drink.

Availability

Not every pharmacy stocks this drug. When filling your prescription, be sure to call ahead to make sure your pharmacies carries it.

Prior authorization

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Silodosin – description of the substance, pharmacology, use, contraindications, formula

Contents

• Structural formula

• Russian name

• English title

• Latin name

• Gross formula

• Pharmacological group of the substance Silodosin

• CAS code

• Trade names with the active substance Silodosin

Structural formula

Russian name

Silodosin

English name

Silodosin

Latin name

Silodosinum ( genus 90 036 Silodosini)

Gross formula

C ₂₅ H ₃₂ F ₃ N ₃ O ₄

Pharmacological group Silodosin

Alpha blockers

Drugs that affect the metabolism in the prostate gland and correctors of urodynamics

CAS code

160970-54-7

Trade names with active ingredient Silodosin

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Lek. form
All lek. capsule forms substance-powder

Dosage
All dosages 4 mg 8 mg No dosage

Manufacturer
All manufacturers Active ingredient Recordati Ilach Sanayi ve Tijaret A.S. Recordati Industry Chemist and Pharmaceutical

Information for healthcare professionals only.
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Clinical benefits of Urorek in the treatment of urinary disorders in patients with BPH. First Moscow Urological School. Recordati satellite symposium “BPH – Breaking it down”

Advances in modern pharmacology have provided a variety of drugs for the treatment of benign prostatic hyperplasia, but according to the latest recommendations of the European Urological Association (European Association of Urology), alpha-blockers remain first-line drugs. Within the framework of the First Moscow School of Urology, held on November 27, 2015, a satellite symposium of the Recordati company was held, at which the advantages of the highly selective alpha-adrenergic blocker silodosin (Urorec drug) were discussed. It was noted that Urorek allows to achieve a stable positive effect on the symptoms of the lower urinary tract in patients with benign prostatic hyperplasia and comorbid diseases with a minimal risk of complications.

PhD A.V. Govorov

Professor D.Yu. Pushkar

Do urologists need a new alpha blocker?

According to the recommendations of the European Association of Urology in 2015, alpha-blockers are the first-line drugs for the conservative treatment of benign prostatic hyperplasia (BPH) ¹ . The mechanism of action of alpha-blockers is well known. They block alpha-adrenergic receptors, reduce the effect of sympathetic influence on the smooth muscle elements of the bladder neck, prostate and prostatic part of the urethra, which leads to relaxation of the smooth muscles of the lower urinary tract, a decrease in the dynamic component of infravesical obstruction and the severity of BPH symptoms. The use of alpha-adrenergic blockers, which have good efficacy and tolerability, results in a decrease in the total score on the International Prostate Symptom Score (IPSS) by 30–40% and an improvement in maximum urination rate by 20–25% ¹ .

When choosing a specific drug, it is necessary to take into account the age of the patient, the severity of BPH, as well as the severity of the comorbidity. Associate Professor of the Department of Urology, Moscow State Medical University. A.I. Evdokimova, Ph.D. Alexander Viktorovich GOVOROV proposed to consider the algorithm of actions of a urologist when a patient with BPH contacts him using a specific example.

Clinical case

Complaints and anamnesis. A 71-year-old patient, an official, leads a “sedentary” lifestyle. Complains of a weak stream of urine and frequent urination, including at night (two or three times). Suffering from lower urinary tract symptoms (LUTS) for three to four years, symptoms have worsened in the last year. Concomitant diseases – arterial hypertension (takes enalapril) and diabetes mellitus (takes metformin). The patient smokes over 50 years, drinks alcohol moderately. According to him, sexual function is not so important for him.

Inspection. Body mass index – 31 kg/m ² , the bladder is not determined by percussion. Blood pressure – 155/90 mm Hg. Art., which, according to the patient, is almost the norm for him. External genitalia without pathology. On digital rectal examination, the prostate is of medium size, homogeneous.

Examination. IPSS score – 16 points, quality of life score – 3 points. Maximum urination rate – 9 ml / s, residual urine volume – 105 ml, prostate specific antigen level – 1.9ng/ml. Glucose level is 7.0 mmol/l, urinalysis is normal, prostate volume is 55 ml.

As noted by A.V. They say that often patients with BPH with concomitant pathologies for the first time seek help from a urologist, therefore, when examining and examining such patients, one should take into account not only urological symptoms, but also the general condition of the man. There is a direct relationship between an increase in the volume of the prostate gland and an increase in blood pressure. There is reason to believe that there is a correlation between BPH and metabolic syndrome. In this regard, the patient was asked to be examined by other specialists.

Treatment. In accordance with the 2015 European Association of Urology guidelines, in the treatment of moderate to moderate LUTS due to BPH, lifestyle changes are indicated, as well as therapy with alpha-blockers and 5-alpha reductase inhibitors ¹ . In this regard, the patient was recommended to change his lifestyle with the help of diet and physical activity, start taking finasteride, alpha-blocker therapy (tamsulosin).

The patient independently refused finasteride and started taking tamsulosin at a dose of 0.4 mg once a day. After three months of therapy, he noted a decrease in the severity of LUTS, but he had episodes of dizziness.

The patient paid a second visit together with his nephew, who was very determined and asked to find “modern treatment with a minimal risk of side effects” for his relative. Instead of tamsulosin, the patient was prescribed Urorek (silodosin) at a dose of 8 mg once a day (in the morning).

Urorek is a new original alpha-blocker, the main qualities of which are selectivity, persistence of the effect and freedom from the risk of side effects.

Urorek has the highest selectivity among alpha-1-adrenergic blockers for the subtype of alpha-1A adrenoreceptors. Thus, the affinity of silodosin for alpha-1A-adrenergic receptors is 162 times higher than for the alpha-1B subtype.

Urorek simultaneously alleviates the most painful symptoms of BPH: nocturnal pollakiuria, frequent urination and a feeling of incomplete bladder emptying (comparison was made with tamsulosin and placebo, the difference is statistically significant). At the same time, silodosin is superior to tamsulosin in terms of improving nocturia (quantitatively) ² .

Urorek has a high safety profile. The drug has a minimal effect on blood pressure parameters. No statistically or clinically significant correlation was found between the concentration of silodosin in blood plasma and heart rate, the duration of QT and PR intervals, and the width of the QRS complex. Urorek did not disturb myocardial repolarization, did not have a clinically significant effect on blood pressure in the supine position ³ .

While taking Urorek, an undesirable transient and reversible phenomenon, which is characteristic of selective alpha-1-adrenergic receptor antagonists, may be observed – ejaculation disorders. However, it has been shown that the occurrence of ejaculation disorders is an indirect sign of the effectiveness of ⁴ . Patients with ejaculatory disorders showed a more pronounced improvement in the overall symptom score on the IPSS scale compared with patients who did not have ejaculatory disorders during treatment or with patients who received placebo.

Thus, Urorek is a new original alpha-blocker, the overall effectiveness of which is comparable to that of tamsulosin. Urorek can be taken concomitantly with antihypertensive agents. The drug has fewer side effects on the part of the cardiovascular system compared to other alpha-blockers, the frequency of unwanted lowering of blood pressure when taking silodosin is comparable to placebo.

Conclusion. The patient started taking Urorek at a dose of 8 mg per day. On the background of Urorek therapy, he had a decrease in the severity of LUTS. The lifestyle changes recommended by the urologist proved to be beneficial for the patient’s general condition. There were no side effects from the cardiovascular system.

Silodosin in the treatment of patients with BPH – results of a Russian multicenter observational study

According to the head of the Department of Urology, Moscow State Medical University named after. A.I. Evdokimov, Chief Urologist of the Ministry of Health of Russia and Moscow, Professor Dmitry Yuryevich PUSHKAR, the advantages of Urorek, a highly selective representative of the alpha-blocker class, are a good safety profile and a quick urodynamic effect. “Cilodosin can be successfully used in patients with acute urinary retention, the effect develops after eight to nine hours from the start of taking the drug,” the speaker noted.

The results of a Russian multicentre observational prospective study confirm the efficacy and safety of silodosin in the treatment of LUTS associated with BPH. The study involved 40 specialists from 21 cities, including leading clinics in Moscow, the Urals, the Far East, the Volga Federal District, the Central Region, and the Southern Federal District.

The study included 1000 patients aged 50 to 91 with a diagnosis of BPH. All patients received Urorek 8 mg daily for eight weeks. The effectiveness criterion was the change in the total points on the IPSS scale, the total score on the assessment of the quality of life. The total score on the subscales of symptoms of urination and urinary retention was assessed separately. Patients were examined four and eight weeks after enrollment in the study. In total, the study included three visits to the urologist. At each visit, patients filled out an IPSS questionnaire, side effects were recorded.

At the end of the study, statistically significant positive dynamics was demonstrated for all assessed indicators: the overall IPSS score after four weeks of therapy decreased from the initial 19.29 to 13.3 points (-5.92 points), and after eight weeks – to 9.8 points (-9.39 points). Silodosin therapy also reduced IPSS scores on the urinary retention subscale by 3.8 points and on the voiding subscale by 5.6 points. In terms of the sum of scores for assessing the quality of life, an improvement was also observed: from 4.25 points at the first visit to 1.93 points on the third visit (-2.32 points). All changes were statistically significant (p

The study once again demonstrated that the use of Urorek allows for effective therapy aimed at reducing the symptoms characteristic of BPH and increasing the maximum volumetric flow rate of urine.