Tamsulosin, dutasteride and imidafenacin – a promising new treatment combination for BPH

This study examined the effects of combining 3 different types of therapies – tamsulosin (Flomax), dutasteride (Avodart), and imidafenacin (Uritos) – in the treatment of benign prostatic hyperplasia (BPH). Authors concluded that this treatment combination is safe and effective in reducing urinary symptoms caused by BPH.

BPH can cause bothersome urinary symptoms that affect quality of life. Men with BPH commonly experience problems passing as well as storing urine. Drugs that are often prescribed for BPH include alpha-blockers such as tamsulosin. Alpha-blockers work by relaxing the muscles in the prostate and bladder neck, making it easier to urinate. However, many men still have persistent storage symptoms despite alpha-blockers. Anticholinergic drugs, such as imidafenacin, have been reported to be effective in these cases.

Dutasteride is a type of 5-alpha reductase inhibitor, which affect the levels of male hormones in the prostate. This is believed to reduce the size of the prostate and increase the flow of urine. Whether 5-alpha reductase inhibitors and anticholinergic drugs are safe and effective when combined is still being investigated.

The aim of this study was to examine the safety and effectiveness of combining tamsulosin, dutasteride, and imidafenacin.

163 men with BPH were included in the study. All men had a prostate volume larger than 30 ml. All had persistent overactive bladder symptoms despite at least 8 weeks of tamsulosin treatment. Men were randomly assigned to receive either tamsulosin with dutasteride (TD group) or tamsulosin with dutasteride and imidafenacin (TDI group). Treatment outcomes were compared at 24 weeks.

Urinary symptoms were significantly more improved in the TDI group compared to the TD group. Improvements occurred as early as 4 weeks in both groups. Symptoms continued to improve between Week 4 and Week 12.

Daytime and nighttime urinary frequency, the number of urinations per 24 hours, and incontinence episodes were all significantly decreased with TDI treatment compared to the TD group. Urinary flow rate and complete bladder emptying was also significantly increased in the TDI group.

Quality of life improved in both groups as early as 4 weeks of treatment. Quality of life continued to improve significantly between Week 4 and Week 24 in the TDI group.

2.5% of men in the TD group and 13.4% of men in the TDI group reported side effects. These included blurred vision, dizziness standing up, and erectile dysfunction. Two men discontinued treatment due to side effects, one due to blurred vision and one due to dizziness standing up. No cases of urinary retention (an inability to pass urine) or other serious side effects were noted.

Authors concluded that tamsulosin, dutasteride and imidafenacin are a safe and effective treatment option for urinary symptoms caused by BPH.

Larger studies are needed to confirm the effectiveness of this treatment combination.