Combination Therapy With Doxazosin and Tenoxicam for the Management of Lower Urinary Tract Symptoms

Abstract

To compare the efficacy and safety of a combination therapy, doxazosin plus tenoxicam, and doxazosin alone for lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH), as various combination therapies increase the efficacy of medical therapy. Alpha blocker agents have been widely used for the treatment of LUTS secondary to BPH. Fifty-seven patients complaining of LUTS secondary to BPH were enrolled in this clinical trial. Patients were randomly assigned to receive doxazosin 4 mg or doxazosin 4 mg plus tenoxicam 20 mg treatment. Patients were evaluated for BPH according to the European Association of Urology and American Urological Association clinical guidelines. In addition, patients were assessed with Overactive Bladder Symptom Score (OABSS) and International Index of Erectile Function (IIEF). Patients were reevaluated after a 6-week treatment course. The International Prostatic Symptom Score (IPSS), IPSS-Quality of Life (IPSS-QoL), maximal urinary flow rates (Q(max)), and average urinary flow rates (AFR) were determined at baseline and again at 6 weeks as efficacy parameters. The total IPSS, IPSS-QoL, and OABSS decreased significantly in both tenoxicam plus doxazosin group and doxazosin alone group compared with baseline (P < .01). Also, Q(max) and AFR significantly improved in both groups (P < .01). The improvements in IPSS, IPSS-QoL, and OABSS were significantly better in patients treated with combination therapy (P < .05). COX-2 inhibitors in combination with an alpha blocker may increase the effectiveness of the therapy for LUTS secondary to BPH without significant effects on side effect profile.