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Flomax vs Cardura
Introduction
For patients dealing with benign prostatic hyperplasia (BPH) or symptoms of an enlarged prostate, there are certain medications that can help manage the condition and ease discomfort. Flomax and Cardura are two such drugs often prescribed for this purpose. They each work by relaxing muscles in the bladder and prostate, making it easier to urinate. However, they do have some differences in how they affect your body. Flomax (tamsulosin) is known as an alpha-blocker which specifically targets receptors in the urinary tract, providing relief from BPH symptoms without significantly lowering blood pressure. On the other hand, Cardura (doxazosin), while also being an alpha blocker, has a broader effect and can be used not only for managing BPH but also for treating hypertension due to its more substantial blood-pressure-lowering effects.
Flomax vs Cardura Side By Side
| Attribute | Flomax | Cardura |
|---|---|---|
| Brand Name | Flomax | Cardura |
| Contraindications | Should not be taken with other alpha-blockers or phosphodiesterase-5 inhibitors. Inform ophthalmologist prior to eye surgery due to risk of intraoperative floppy iris syndrome. Sudden discontinuation could worsen symptoms of BPH. | Should not be taken with other alpha-blockers or phosphodiesterase-5 inhibitors. Risk of intraoperative floppy iris syndrome; inform ophthalmologist before eye surgery. |
| Cost | For brand name, around $170 for 30 capsules (0.4 mg). For generic tamsulosin, costs range from $10-$40 depending on pack size and pharmacy. | For brand name, about $90 for 30 tablets of the 1mg dose. For generic doxazosin, costs typically between $9 and $45. |
| Generic Name | Tamsulosin | Doxazosin |
| Most Serious Side Effect | Allergic reactions, vision changes, heart-related problems, low blood pressure, nervous system reaction. | Allergic reactions, sudden and severe stomach pain, chest pain, painful erection lasting 4 hours or longer, shortness of breath, swelling due to fluid retention, feeling like you might pass out. |
| Severe Drug Interactions | Concurrent use with other alpha-blockers or phosphodiesterase-5 inhibitors can lead to significant drop in blood pressure. | Concurrent use with other alpha-blockers or phosphodiesterase-5 inhibitors can lead to significant drop in blood pressure. |
| Typical Dose | Starts at 0.4 mg/day, up to a maximum of 0.8 mg/day. | Starts at 1 mg/day, gradually increased up to 16 mg/day based on patient response. |
What is Flomax?
Tamsulosin (the generic name for Flomax) was the first drug of its kind, an alpha blocker, which marked a significant advancement from previous treatments for urinary symptoms related to benign prostatic hyperplasia (BPH). Tamsulosin was first approved by the FDA in 1997. Flomax works by relaxing muscles in the prostate and bladder neck, thereby making it easier to urinate. It is prescribed mainly for men with BPH. Unlike other alpha blockers such as doxazosin (generic name for Cardura), tamsulosin has a selective influence on alpha-1 receptors located in the prostate and bladder, thus reducing side effects like low blood pressure which are more commonly seen with non-selective alpha blockers that also affect alpha-1 receptors found elsewhere in the body.
What conditions is Flomax approved to treat?
Flomax is approved for the treatment of certain urinary conditions:
- Benign Prostatic Hyperplasia (BPH), also known as enlarged prostate
- Improvement in symptoms related to BPH such as difficulty urinating, weak stream, and incomplete bladder emptying.
On the other hand, Cardura is utilized not only for treating signs of an enlarged prostate but also hypertension. It works by relaxing blood vessels which allows for smoother blood flow.
How does Flomax help with these illnesses?
Flomax (tamsulosin) helps to manage symptoms of an enlarged prostate by targeting the alpha-1 receptors in the smooth muscle of the bladder and prostate. It does this by blocking these receptors, so they can't respond to certain signals that normally cause constriction. This action results in relaxation of these muscles and improved urine flow. Alpha-1 adrenergic receptors are involved in various physiological processes including blood pressure regulation, heart rate control, and urinary output amongst others things. In conditions like benign prostatic hyperplasia where prostate enlargement causes lower urinary tract symptoms such as difficulty starting urination or weak stream, Flomax can help alleviate these issues.
Cardura (doxazosin), on the other hand, is a similar medication also used for treating signs and symptoms of an enlarged prostate. It works similarly to Flomax by relaxing muscles in the prostate and bladder neck but it also relaxes blood vessels throughout the body which makes it useful for managing high blood pressure as well. So while both drugs have similar effects on easing urinary troubles due to enlarged prostate glands, Cardura has added benefits for patients with hypertension.
What is Cardura?
Cardura, the brand name for doxazosin, is an alpha-1 adrenergic receptor antagonist that has been used primarily to treat hypertension and benign prostatic hyperplasia (BPH). By blocking these receptors in certain parts of the body, Cardura helps to relax blood vessels and muscles in the prostate and bladder neck. This mechanism allows it to facilitate smoother urination while also aiding blood flow throughout the body. First approved by the FDA in 1990, Cardura does not act on other types of alpha or beta receptors, which means its side-effect profile differs from those medications that do. In particular, it doesn't cause significant changes in heart rate or lipid levels—common side effects associated with other hypertensive drugs like Flomax. While it's beneficial for managing symptoms related to BPH and hypertension alike, patients who don't respond well due to specific contraindications may find better results with different therapeutic options such as Flomax.
What conditions is Cardura approved to treat?
Cardura is approved for the treatment of:
- Benign prostatic hyperplasia (BPH, also known as an enlarged prostate)
- Hypertension (high blood pressure)
This medication belongs to a class of drugs called alpha blockers. It works by relaxing the muscles in the bladder and prostate, making it easier to urinate. Additionally, it dilates blood vessels to lower high blood pressure effectively.
How does Cardura help with these illnesses?
Cardura, also known as doxazosin, is an alpha blocker that works by relaxing the muscles in both the prostate and bladder neck. This process allows for easier urination and is particularly helpful in treating symptoms of benign prostatic hyperplasia (BPH). Just like norepinephrine impacts various body functions such as memory recall and responses to stress, Cardura affects multiple aspects of urinary function. While Flomax similarly serves to improve urine flow, it primarily targets receptor sites located in the prostate gland and only moderately impacts those within the bladder itself. Consequently, Cardura may be considered a more comprehensive treatment option for some patients dealing with urinary problems. Its wider range of action can lead to better patient outcomes when compared to treatments focusing solely on specific areas such as Flomax.
How effective are both Flomax and Cardura?
Both tamsulosin (Flomax) and doxazosin (Cardura) have established histories of success in treating patients with benign prostatic hyperplasia, and they were initially approved by the FDA within a few years of each other. Since they act on different types of adrenergic receptors, they may be prescribed under different circumstances. The effectiveness of Flomax and Cardura in alleviating symptoms associated with enlarged prostate was directly studied in multiple clinical trials; the two drugs exhibited similar efficacy in managing urinary symptoms as well as similar safety profiles.
A 2007 review indicated that Flomax is effective at relieving lower urinary tract symptoms starting from the first week of treatment, that its side effect profile is generally favorable compared to many other medications used for this condition, including Cardura. Furthermore, since it specifically targets alpha-1a adrenergic receptors found primarily in the prostate and bladder neck muscles, it tends to cause less blood pressure-related side effects than non-selective alpha blockers like Cardura.
A 2010 meta-analysis revealed that while both Flomax and Cardura seem more effective than placebo in improving urination issues related to an enlarged prostate, there are some differences between them. Cardura has a longer duration action which allows once-daily dosing but can significantly lower blood pressure especially upon initiation or dose increase hence careful monitoring is necessary during these periods. On the contrary, due to its unique pharmacology focusing mainly on uroselective alpha blockade rather than systemic vasodilation seen with doxazosin use , tamsulosin may be a better choice for patients who have concurrent conditions such as hypertension where additional blood-pressure lowering effects would not be desirable.
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At what dose is Flomax typically prescribed?
Oral dosages of Flomax typically start at 0.4 mg/day, which has been shown to be effective in treating benign prostatic hyperplasia (BPH) symptoms in most men. If little or no response is observed after two to four weeks, the dosage can be increased up to a maximum of 0.8 mg/day. For Cardura, the initial recommended dose for BPH treatment is 1 mg daily with an increase over a few weeks based on patient response up to a maximum dosage of 16 mg/day if necessary. Both medications are specifically intended for adult male patients and are not typically prescribed for children or adolescents.
At what dose is Cardura typically prescribed?
Cardura treatment is typically initiated at a dose of 1 mg/day, taken orally once daily. The dosage may be gradually increased to 2 mg/day, then up to 4-8 mg/day based on individual patient response and tolerability. Each dose can be taken with or without food but should be administered around the same time each day. The maximum recommended dose is 16 mg/day and it may be tested if there's no significant improvement in symptoms after several weeks of treatment at lower dosages.
What are the most common side effects for Flomax?
When comparing Flomax and Cardura, both of which are used to treat the symptoms of an enlarged prostate, there are some common side effects that you may experience:
- Dizziness
- Lightheadedness or fainting when standing up suddenly (postural hypotension)
- Sleepiness/drowsiness
- General weakness or fatigue
- Headache
- Nasal congestion
- Back pain
- Abnormal ejaculation (Flomax is more likely to cause this than Cardura)
-Decreased sex drive or impotence (less common but possible with both medications)
-Nausea
-Diarrhea or constipation
Remember your individual response will vary and it's always important to discuss any bothersome side effects with your healthcare provider.
Are there any potential serious side effects for Flomax?
While Flomax and Cardura are both medications used to treat symptoms of an enlarged prostate, they can have different side effects. Here are some potential adverse effects to be aware of:
- Allergic reactions: Signs may include skin rash, itching or hives, swelling of the face, lips or tongue.
- Vision changes: Some people experience blurred vision or other eye issues.
- Heart-related problems: Symptoms can include rapid heartbeat, palpitations, shortness of breath and dizziness. In extreme cases fainting may occur.
- Low blood pressure - This could cause lightheadedness when standing up quickly from a lying or sitting position (orthostatic hypotension).
- Nervous system reaction: In rare instances individuals might experience muscle weakness/loss of strength.
If you notice any of these symptoms while taking either Flomax or Cardura it is important that you seek medical attention immediately. It's also essential to remember that just like with any medication there is a chance for drug interactions so always let your healthcare provider know what else you're taking including over-the-counter medicines and supplements.
What are the most common side effects for Cardura?
Cardura, a medication used to treat symptoms of an enlarged prostate and high blood pressure, has potential side effects which include:
- Mild dizziness or lightheadedness
- Feeling of fatigue or weakness
- Headache
- Nausea
- Weight gain
- Shortness of breath
- Dry mouth -Palpitations or fast heartbeat.
It is important to note that these side effects are not experienced by everyone who takes the medication. If you experience any unusual discomfort after starting Cardura, it is advised to consult your healthcare provider immediately.
Are there any potential serious side effects for Cardura?
Cardura, while generally safe and effective for those with hypertension or benign prostatic hyperplasia, does have the potential to cause some serious side effects in rare cases. These can include:
- Signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- A sudden and severe stomach pain
- Chest pain
- A painful erection that lasts 4 hours or longer (this is a medical emergency)
- Shortness of breath during light physical activity
- Swelling in your hands, ankles, feet or rapid weight gain due to fluid retention
- Feeling like you might pass out when standing up from sitting/lying position (postural hypotension)
If any of these symptoms present themselves while taking Cardura it's important to seek immediate medical attention.
Contraindications for Flomax and Cardura?
Both Flomax and Cardura, along with most other medications treating benign prostatic hyperplasia (BPH), may cause side effects such as dizziness, fatigue, or low blood pressure. If you notice severe lightheadedness or fainting after taking these medications, please seek immediate medical attention.
Neither Flomax nor Cardura should be taken if you are currently using other alpha-blockers or phosphodiesterase-5 inhibitors like sildenafil for erectile dysfunction. Always inform your doctor about any medications you are taking; the simultaneous use of these drugs can lead to a significant drop in blood pressure which can be dangerous.
It's also worth noting that both Flomax and Cardura have been associated with intraoperative floppy iris syndrome (IFIS) which may complicate cataract surgery. Therefore, it is crucial to inform your ophthalmologist prior to eye surgery if you have been on either medication.
In addition to this, sudden discontinuation of Flomax could potentially worsen symptoms of BPH so always consult with your healthcare provider before making changes in medication regimen.
How much do Flomax and Cardura cost?
For the brand name versions of these drugs:
- The price for 30 capsules of Flomax (0.4 mg) averages around $170, which works out to approximately $5.67/day.
- The price for Cardura (doxazosin mesylate), is about $90 for 30 tablets of the 1mg dose, averaging at about $3/day.
Thus, if you are taking a higher dosage range for Flomax (i.e., up to 0.8 mg/day), then brand-name Cardura is less expensive on a per-day treatment basis. Please note that cost should not be the primary consideration in determining which of these drugs is right for you.
For generic versions of both Flomax (tamsulosin hydrochloride) and Cardura (doxazosin):
- Tamsulosin can be found in packs from 20 up to 100 capsules with approximate costs ranging from $10-$40 depending upon pack size and pharmacy chosen. This means daily costs could be as low as $0.40 or as high as over one dollar.
- Doxazosin comes in similar package sizes with costs typically between $9 and $45 making it slightly cheaper than tamsulosin overall, though again this depends greatly on where you buy your medication and how much you purchase at once.
Popularity of Flomax and Cardura
Tamsulosin, in generic form as well as brand names such as Flomax, was estimated to have been prescribed to about 8.3 million people in the US in 2020. Tamsulosin accounted for roughly 10% of prescriptions for benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). Notably, it is a selective alpha-1A and alpha-1B adrenergic receptor antagonist which has shown a consistent increase in prescription rates since its introduction.
Doxazosin, including brand versions like Cardura, was prescribed to about 1.7 million people in the USA during the same year. In regard to BPH treatment and LUTS management, doxazosin accounts for just under 5% of overall prescriptions. As an alpha-1-adrenergic blocker with non-selective activity on all three subtypes of these receptors (alpha-1A, -1B and -1D), it has seen steady usage over the last few years due to its additional indication for hypertension treatment.
Conclusion
Both Flomax (tamsulosin) and Cardura (doxazosin) have long-standing records of usage in patients with benign prostatic hyperplasia, a condition that causes an enlarged prostate. Numerous clinical studies have shown both drugs to be effective at relieving symptoms such as frequent urination or difficulty starting a urine stream. Because these two drugs belong to the same class known as alpha-blockers, they work similarly by relaxing the muscles in the bladder neck and prostate, thus improving urine flow.
Flomax is often chosen as first-line treatment because it's more selective for the type of receptors found in these tissues than Cardura. This selectivity allows it to target urinary issues without significantly lowering blood pressure like other non-selective alpha-blockers might do.
On the contrary, while Cardura can also treat symptoms of an enlarged prostate effectively, its less selective nature means it may also be used for treating high blood pressure.
Both medications are available in generic form which brings significant cost savings especially for patients who need to pay out-of-pocket expenses.
The side effect profile is similar between these two medicines; both generally well-tolerated but some patients might experience dizziness or lightheadedness due to decreased blood pressure caused by their mechanism of action on smooth muscle relaxation.
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Refrences
- Wilde, M. I., & McTavish, D. (1996, December). Tamsulosin. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-199652060-00012
- Kava, B. R., Verbeek, A. E., Wruck, J. M., & Gittelman, M. (2019, August). Tamsulosin dispensation patterns in the United States: a real-world, longitudinal, population claims database analysis. Translational Andrology and Urology. AME Publishing Company.http://doi.org/10.21037/tau.2019.07.02
- Kuritzky, L., Rosenberg, M. T., & Sadovsky, R. (2006, February 22). Efficacy and safety of alfuzosin 10 mg once daily in the treatment of symptomatic benign prostatic hyperplasia. International Journal of Clinical Practice. Hindawi Limited.http://doi.org/10.1111/j.1368-5031.2005.00830.x
- Fulton, B., Wagstaff, A. J., & Sorkin, E. M. (1995, February). Doxazosin. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-199549020-00011
- Nordling, J. (2005, April 15). Efficacy and safety of two doses (10 and 15 mg) of alfuzosin or tamsulosin (0.4 mg) once daily for treating symptomatic benign prostatic hyperplasia. BJU International. Wiley.http://doi.org/10.1111/j.1464-410x.2005.05456.x
- Narayan, P., & Lepor, H. (2001, March). Long-term, open-label, phase III multicenter study of tamsulosin in benign prostatic hyperplasia. Urology. Elsevier BV.http://doi.org/10.1016/s0090-4295(00)01042-6