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Proscar vs Cardura
Introduction
For patients with benign prostatic hyperplasia (BPH) or other types of prostate disorders, certain drugs that affect hormone levels and muscle relaxation can help in reducing uncomfortable symptoms. Proscar and Cardura are two such drugs that are prescribed for those conditions. They each impact different aspects of the body's function, but both have symptom-reducing effects in patients with prostate disorders. Proscar is a 5-alpha reductase inhibitor, affecting levels of dihydrotestosterone (DHT), a hormone which contributes to prostate growth. Cardura, on the other hand, is classified as an alpha-blocker; it primarily affects smooth muscle relaxation within the prostate gland and at the bladder neck to ease urination.
Proscar vs Cardura Side By Side
| Attribute | Proscar | Cardura |
|---|---|---|
| Brand Name | Proscar | Cardura |
| Contraindications | Cannot be handled by women who are pregnant or planning to become pregnant due to risk of birth defects. Men should avoid donating blood while on this medication. | Cannot be taken with certain types of antihypertensives. Not suitable for patients with a history of orthostatic hypotension. |
| Cost | Around $100 for 30 tablets of 5 mg; Generic: $.50 - $.75 per tablet | Around $90 for 30 tablets of 4 mg; Generic: Less than $1 per day |
| Generic Name | Finasteride | Doxazosin |
| Most Serious Side Effect | Signs of allergic reactions, breast lumps, pain or discharge, testicle pain, inability to urinate | Allergic reaction signs, fainting upon standing up quickly, fast or irregular heartbeats, priapism |
| Severe Drug Interactions | Certain types of antihypertensives | Not specified, but caution is advised with other blood pressure-lowering medications to avoid excessive hypotension. |
| Typical Dose | 5 mg/day | 1 mg/day initially, up to 8 mg/day |
What is Proscar?
Finasteride, the generic name for Proscar, is a drug primarily used to treat an enlarged prostate or hair loss in men. It's part of the 5-alpha reductase inhibitors class and was first approved by the FDA in 1992. Proscar works by decreasing levels of dihydrotestosterone (DHT), a hormone that causes enlargement of the prostate gland. This results in reduced urinary problems and decreased need for surgical procedures related to benign prostatic hyperplasia (BPH). On the other hand, Doxazosin, sold under the brand name Cardura among others, belongs to a family of drugs known as alpha blockers. It was first approved by the FDA in 1990 and is predominantly used for treating symptoms of BPH and hypertension due its efficacy in relaxing muscles within blood vessels and easing blood flow. While both medications can be used to manage symptoms associated with BPH, they have distinct mechanisms action which could cause different side effects.
What conditions is Proscar approved to treat?
Proscar is approved for the treatment of various conditions linked to an enlarged prostate:
- Benign Prostatic Hyperplasia (BPH), also known as an enlarged prostate
- To improve symptoms, reduce urinary retention and lower the risk of surgery.
Cardura on the other hand:
- Is used to treat hypertension (high blood pressure)
- Can be used in combination with other drugs to manage BPH
How does Proscar help with these illnesses?
Proscar helps in managing symptoms of an enlarged prostate (benign prostatic hyperplasia) by reducing the amount of dihydrotestosterone (DHT), a hormone linked to prostate growth, available within the body. It does this through inhibiting 5-alpha reductase, an enzyme that transforms testosterone into DHT. This results in a decreased volume of an enlarged prostate and relief from problems associated with urination such as difficulty in beginning the flow or needing to urinate frequently. On the other hand, Cardura works by relaxing bladder neck muscles and muscle fibers in the prostate itself and easing urinary discomforts. As alpha-1 adrenergic blocker, it blocks receptors responsible for causing smooth muscle contraction which can improve urine flow rates while mitigating other challenging urinary symptoms commonly seen in individuals with prostate enlargement.
What is Cardura?
Cardura, known generically as doxazosin, is an alpha-adrenergic blocker that works by relaxing the muscles in your prostate and bladder neck, making it easier to urinate. Cardura affects the balance of norepinephrine (also called noradrenaline) which helps muscle cells in the prostate and bladder neck relax to reduce urinary symptoms. First approved by the FDA in 1995, unlike Proscar or finasteride – a 5-alpha reductase inhibitor – it does not inhibit conversion of testosterone into dihydrotestosterone but focuses on muscle relaxation. This means its side-effect profile is different from that of 5-alpha reductase inhibitors such as Proscar; for instance, it doesn’t have significant impact on sexual function—a common concern with drugs like Proscar—but may cause dizziness due to its blood pressure-lowering effect. The effects on norepinephrine can be beneficial for treatment of benign prostatic hyperplasia (BPH), particularly in patients who don't respond well or are unable to take "typical" BPH drugs such as Proscar.
What conditions is Cardura approved to treat?
Cardura, also known as doxazosin, is approved for the treatment of several conditions including:
- Benign prostatic hyperplasia (BPH), a condition that causes enlargement of the prostate gland and can cause problems with urination.
- Hypertension, or high blood pressure. Cardura works by relaxing blood vessels so that blood can flow more easily.
How does Cardura help with these illnesses?
Cardura, much like Proscar, is often used in the treatment of benign prostatic hyperplasia (BPH), a common condition in older men characterized by an enlarged prostate. Cardura works by blocking alpha-1 adrenergic receptors on smooth muscle within the prostate and bladder neck. This action relaxes these muscles, improving urinary flow and reducing BPH symptoms. Unlike Proscar which acts as a 5-alpha reductase inhibitor to reduce size of the prostate over time, Cardura takes effect more immediately to ease urination issues associated with BPH. Furthermore, it also holds an advantage in being able to lower blood pressure due its alpha-blocking effects on vascular smooth muscle elsewhere in the body. Therefore, it can be particularly useful for patients who have co-existing hypertension along with their BPH.
How effective are both Proscar and Cardura?
Both finasteride (Proscar) and doxazosin (Cardura) are commonly prescribed for the treatment of benign prostatic hyperplasia. These two drugs were approved by the FDA within a few years of each other, with Proscar being approved in 1992 and Cardura following soon after in 1995. They function through different mechanisms: finasteride inhibits the conversion of testosterone into dihydrotestosterone which is involved in prostate growth, while doxazosin relaxes the muscles in the prostate and bladder neck to aid urination.
Clinical trials comparing these two treatments have shown that both Proscar and Cardura effectively improve urinary symptoms associated with an enlarged prostate. However, research has found some differences between them. For instance, a study published in The New England Journal of Medicine concluded that patients taking Cardura had a significantly higher risk of cardiovascular events compared to those on Proscar.
A review from 2010 suggested that finasteride may be more effective over time than alpha-blockers like doxazosin at improving symptoms, reducing prostate volume, and decreasing surgical intervention rates. Furthermore, side effects such as sexual dysfunction can occur less frequently with Proscar than with similar medications.
On the other hand, doxazosin use can result in significant improvements quickly – often within one to two weeks – making it advantageous when rapid symptom relief is desired. However, it's typically considered after lifestyle modifications or if minimally invasive procedures aren't suitable or effective.
It should also be noted that while both drugs treat BPH effectively alone they’re often used together for better results according to studies like “The Medical Therapy Of Prostatic Symptoms (MTOPS)” trial conducted by National Institute of Health. Nonetheless due to their unique pharmacological profiles either drug could potentially offer superior benefits depending on individual patient characteristics including age severity & pattern of symptoms co-existing diseases etc
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At what dose is Proscar typically prescribed?
Oral dosages of Proscar (Finasteride) typically consist of 5 mg/day for the treatment of benign prostatic hyperplasia. However, some studies have shown that doses as low as 0.2 mg/day can be effective. For Cardura (Doxazosin), initial dosage for hypertension is often started at 1mg once a day, with most patients responding to doses between 4 and 8 mg per day depending on individual response and tolerance levels. Dosage may be slowly increased over several weeks if there is no immediate response to therapy. The maximum daily dose recommended for both drugs should not exceed 8 mg and 10 mg respectively, in any case.
At what dose is Cardura typically prescribed?
Cardura treatment is typically initiated at a dosage of 1 mg/day. The dose can then be increased to 2-4 mg/day, divided into two doses, spaced 12 hours apart. Maximum dose is 8 mg/day divided into two doses of 4 mg and spaced evenly throughout the day. This may be tested if there is no response to treatment at lower dosages after several weeks. As with any medication, it's important to monitor your body's response and communicate regularly with your healthcare provider about any side effects or concerns that arise during treatment.
What are the most common side effects for Proscar?
Common side effects of Proscar and Cardura can vary.
For Proscar, these may include:
- Decreased libido (sex drive)
- Ejaculation disorders
- Impotence
- Swelling in your hands or feet, swelling or tenderness in your breasts
- Dizziness, weakness
- Feeling like you might pass out
- Headache
- Runny nose
For Cardura, the most common side effects are:
- Low blood pressure upon standing
- Dizziness
- Fatigue
- Malaise (general feeling of discomfort)
- Edema (swelling caused by fluid retention)
- Shortness of breath
- Palpitations
As always if any of these side effects persist or worsen it's important to seek medical help immediately.
Are there any potential serious side effects for Proscar?
Both Proscar and Cardura are medications used primarily for treating symptoms of an enlarged prostate. As with any medication, they may cause side effects in some users. Here are the potential serious side effects that you need to watch out for:
For Proscar (Finasteride):
- Signs of allergic reactions such as hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Breast lumps, pain or discharge
- Testicle pain
- Inability to urinate
Meanwhile for Cardura (Doxazosin):
- Allergic reaction signs like rash; itching/swelling (especially of the face/tongue/throat); severe dizziness; trouble breathing
- Fainting upon standing up quickly due to a sudden drop in blood pressure
- Fast or irregular heartbeats -Prolonged erection lasting 4 hours or more
If you experience any of these symptoms while taking either medication, it is essential to seek immediate medical attention.
What are the most common side effects for Cardura?
Cardura, a medication primarily used to treat high blood pressure and symptoms of an enlarged prostate, can have various side effects including:
- Dry mouth or throat
- Mild dizziness or lightheadedness, particularly when first starting the medication
- Feeling of fatigue or weakness
- Mild nausea or upset stomach
- Headache
- Runny or stuffy nose
- Weight changes
- Decreased sexual desire or ability
Remember that each individual's reaction to drugs varies. It is important to consult your healthcare provider if any side effects persist or become bothersome.
Are there any potential serious side effects for Cardura?
When taking Cardura, a user may experience side effects that could warrant immediate medical attention. These include:
- Signs of an allergic reaction such as hives, difficulty breathing, swelling in your face or throat
- Severe skin reactions with symptoms like fever, sore throat, burning eyes, skin pain and red or purple rashes that blister and peel
- A sudden drop in blood pressure which might cause fainting during the first few doses
- Unusual changes in mood or behaviour
- Heart palpitations or irregular heartbeats
- Priapism - a painful erection lasting for more than four hours (this is a serious condition that needs immediate treatment)
If you notice any of these side effects while using Cardura, seek medical help immediately.
Contraindications for Proscar and Cardura?
Both Proscar and Cardura, along with most other medications for benign prostatic hyperplasia (BPH), may worsen symptoms in some people. If you notice your BPH symptoms worsening or an increase in urinary issues, please seek immediate medical attention.
Neither Proscar nor Cardura can be taken if you are taking, or have been taking certain types of antihypertensives. Always inform your physician about which medications you are currently on; these drugs might require a period of several weeks to clear from the system to prevent dangerous interactions with Proscar and Cardura.
Furthermore, it is crucial to mention that both these drugs cannot be handled by women who are pregnant or planning to become pregnant as they may cause birth defects. Men should also avoid donating blood while on these medications until their system has completely cleared off them.
How much do Proscar and Cardura cost?
For the brand name versions of these drugs:
- The average price for 30 tablets of Proscar (5 mg) is around $100, which works out to about $3.33/day.
- For Cardura, a package of 30 tablets (4 mg) averages around $90, so the cost per day would be approximately $3.
Therefore, if you are on higher dosage range for either drug (for instance up to 20mg daily for Cardura), then Proscar and Cardura have similar costs on a per-day treatment basis. Remember that cost should not be your primary consideration in determining which medication might be right for you.
As far as generic versions are concerned:
- Finasteride, the active ingredient in Proscar, can significantly reduce costs. A pack of 30 tablets (5mg each) can run between $.50 - $.75 per tablet or roughly $.15 - $.25/day.
- Doxazosin mesylate is the generic form of Cardura. Costs vary but typically fall within less than a dollar a day when taking typical dosages ranging from 2mg to16mg daily depending on medical need and doctor's prescription.
Popularity of Proscar and Cardura
Finasteride, commonly known by the brand name Proscar, was estimated to have been prescribed to about 2.1 million people in the US in 2020. Finasteride accounted for approximately 11% of all prescriptions for benign prostatic hyperplasia (BPH) or enlarged prostate treatment in the US. It is an inhibitor that prevents testosterone from converting into DHT, a hormone which can cause prostate growth.
Doxazosin, including branded versions such as Cardura, was prescribed to around 3 million people in the USA during the same year. In terms of BPH medications usage, doxazosin accounts for just over 15% of alpha blocker prescriptions and around 8% overall when considering drugs used to treat BPH symptoms. This drug has been consistently popular since it not only alleviates urinary symptoms associated with an enlarged prostate but also manages high blood pressure - making it a useful choice for patients needing treatment for both conditions.
Conclusion
Both Proscar (finasteride) and Cardura (doxazosin) are widely used in treating benign prostatic hyperplasia (BPH), a condition characterized by an enlarged prostate gland. They have been the subjects of multiple clinical studies, with data suggesting that they are more effective than placebo treatments. Their different mechanisms of action mean they may be prescribed under varying circumstances: Proscar works by inhibiting the conversion of testosterone to dihydrotestosterone, thereby reducing prostate size over time, while Cardura is an alpha-blocker that relaxes prostate muscles to alleviate symptoms quickly.
These medications can sometimes be combined for optimal results but should always be done so under careful supervision from a healthcare provider due to potential contraindications.
Proscar and Cardura both come in generic forms which represent significant cost savings for patients who must pay out-of-pocket expenses. Both drugs require some time before noticeable effects kick in – this is particularly true for finasteride which may take several months to show benefits.
The side effect profiles of these two drugs are relatively similar and usually well-tolerated; however, finasteride has been linked with sexual dysfunction while doxazosin may cause dizziness or fatigue. It's crucial that patients closely monitor their conditions when starting treatment on either medication and seek immediate medical attention if any serious adverse effects arise.
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Refrences
- McConnell, J. D., Roehrborn, C. G., Bautista, O. M., Andriole, G. L., Jr., Dixon, C. M., Kusek, J. W., … Smith, J. A. (2003, December 18). The Long-Term Effect of Doxazosin, Finasteride, and Combination Therapy on the Clinical Progression of Benign Prostatic Hyperplasia. New England Journal of Medicine. Massachusetts Medical Society.http://doi.org/10.1056/nejmoa030656
- Doggrell, S. A. (2004, May). Combination of finasteride and doxazosin for the treatment of benign prostatic hyperplasia. Expert Opinion on Pharmacotherapy. Informa Healthcare.http://doi.org/10.1517/14656566.5.5.1209