Management of benign prostatic hyperplasia with silodosin.

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Yamanishi T, Mizuno T, Kamai T, Yoshida K, Sakakibara R, Uchiyama T

Management of benign prostatic hyperplasia with silodosin.

Open Access J Urol. 2009 Aug 20;1:1-7. doi: 10.2147/rru.s5004.

PubMed ID

24198606 [ View in PubMed

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Abstract

It has been reported that blockade of alpha1A-adrenoceptor (AR) relieves bladder outlet obstruction, while blockade of alpha1D-AR is believed to alleviate storage symptoms due to detrusor overactivity. Silodosin, (-)-1-(3-hydroxypropyl)-5-[(2R)-2-({2-[2-(2,2,2trifluoroethoxy) phenoxy]ethyl}amino)propyl]-2,3-dihydro-1H-indole-7- carboxamide, is a new alpha1A-AR selective antagonist. Silodosin is highly selective for the alpha1A-AR subtype, showing an affinity for the alpha1A-AR that is 583- and 55.5-fold higher than its affinity for the alpha1B-and alpha1D-ARs, respectively. In randomized, double-blind, placebo-controlled phase III studies performed in Japan and the United States, silodosin has been shown to be effective for both storage and voiding symptoms associated with benign prostatic hyperplasia. Early effects of silodosin (after 2-6 hours or day 1) on lower urinary tract symptoms have also been reported. In urodynamic studies, detrusor overactivity disappeared in 40% and improved in 35% of patients after administration. In pressure flow studies, the grade of obstruction on the International Continence Society nomogram showed improvement in 56% of patients. The rate of adverse events in the silodosin, tamsulosin and placebo groups was 88.6%, 82.3%, and 71.6%, respectively. The most common adverse event was (mostly mild) abnormal ejaculation (28.1%). However, few patients (2.8%) discontinued silodosin because of abnormal ejaculation. Orthostatic hypotension showed a similar incidence in the silodosin (2.6%) and placebo (1.5%) groups. In conclusion, silodosin improves detrusor overactivity and obstruction and thus may be effective for both storage and voiding symptoms in patients with benign prostatic hyperplasia.

DrugBank Data that Cites this Article

Drugs

Silodosin

Drug Targets

Drug	Target	Kind	Organism	Pharmacological Action	Actions
Silodosin	Alpha-1A adrenergic receptor	Protein	Humans	Yes	Antagonist	Details
Silodosin	Alpha-1B adrenergic receptor	Protein	Humans	Yes	Antagonist	Details
Silodosin	Alpha-1D adrenergic receptor	Protein	Humans	Yes	Antagonist	Details