The efficacy of ED drugs alone or in combination with alpha-blockers for the treatment of ED

[Nelson Vergel]

The efficacy of PDE5 inhibitors alone or in combination with alpha-blockers for the treatment of erectile dysfunction and lower urinary tract symptoms due to benign prostatic hyperplasia: A systematic review and meta-analysis - Abstract

INTRODUCTION: Erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) are both highly prevalent in aging men.
Alpha-blockers and PDE-5 inhibitors are widely used for the treatment of LUTS/benign prostatic hyperplasia (BPH) and ED.

AIM: The purpose of this meta-analysis was to evaluate the efficacy of phosphodiesterase type 5 (PDE5) inhibitors alone or in combination with alpha-blockers for the treatment of ED and LUTS.

METHODS: The databases MEDLINE, EMBASE, PubMed, the Cochrane Controlled Trial Register of Controlled Trials, and the Chinese Biological Medical Database were searched to identify randomized controlled trials that referred to the use of a combination of PDE5 inhibitors and alpha-blockers for the treatment of ED and LUTS associated with BPH. A systematic review and meta-analysis was conducted.

MAIN OUTCOME MEASURES: International Prostate Symptom Score (IPSS), the maximum flow rate (Qmax), and International Index of Erectile Function-Erectile Function (IIEF-EF) domain score were used in this meta-analysis.

RESULTS: Seven publications involving 515 patients were included in the meta-analysis. In the analysis, we found significantly improved IIEF, IPSS, and Qmax values in the combination use group compared with the use of PDE5 inhibitors alone (P = 0.04, 0.004, 0.007, respectively).

CONCLUSIONS: The combined use of PDE5 inhibitors and alpha-blockers results in additive favorable effects in men with ED and LUTS suggestive of BPH compared with PDE5 inhibitor monotherapy. The alpha-blockers may enhance the efficacy of the PDE5 inhibitors, which is beneficial for the treatment of ED and LUTS.

Written by:
Yan H, Zong H, Cui Y, Li N, Zhang Y.
Department of Urology, Beijing Tian-Tan Hospital, Capital Medical University, Beijing, China.
Reference: J Sex Med. 2014 Mar 13. Epub ahead of print.

Doxazosin restored my morning erections

I have been on a stable TRT protocol administered by one of the more reputable physicians often mentioned on this forum, but have been chasing ED issues since the beginning. Most recently, I was having issues getting physically aroused, and would lose my erection during intercourse, which is...

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Questions about ED and Doxazosin

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Interaction Between a Daily Dosed Tadalafil, Dosazoxin and Tamsulosin

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Flomax giving me good erections

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Gene's Nitric Oxide Stack

Many have used this stack for massive hard pumps in the gym, significant vascularity and excellent erectile function not discounting the health benefits. If you're looking for any of these benefits and more...give it a try! Nitric Oxide Stack Bed Time 5 mg of Tadalafil (Cialis) 3000 mg of...

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[Gene Devine]

Yep, knew this for some time now. See my NO stack thread.

 

[Nelson Vergel]

It's always good to have one more reference. In fact, this is the first review of all studies on the subject!

 

[SuperDutyDave]

I do the protocol doxazosin and daily and have seen marked improvement in my ED. Also have noticed better overall circulation in all extremities hands/feet with it

Firmly believe it has helped with vasco-constriction hampered by high neoroperneherine levels which definitely impact erection quality

 

[DeMegaMan619]

Does anyone know if a beta blocker works against ED drugs?

 

[Nelson Vergel]

Beta blockers are well known to decrease sex drive and erectile function.

Medications that could cause decreased sex drive or erectile dysfunction:


One reason that testosterone may not lead to better erections and sex drive is the use of medications that may interfere with those two benefits.

A great review of all studies of drugs that affect sexual function in men was provided by Dr. Walter K.H. Krause in his book “Drugs Compromising Male Sexual Health”.He was able to identify evidence from different studies (many uncontrolled and small) about the common classes of prescription medications that can cause erectile dysfunction. It is not known if testosterone replacement can counteract the effects of these medication classes. Among the medications are:

• Antidepressants: Selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, monoamineoxidase inhibitors


• Blood pressure medications (antihypertensives): Beta-blockers, diuretics, guanethidine, methyldopa

• Narcotics and opiates

• Barbiturates and benzodiazepines

• Hormone related products: Anabolic steroids, antiandrogens used in prostate cancer, estrogens,medroxyprogesterone, 5-alpha- reductase inhibitors (Proscar, Propecia)

• Anti-acids: Histamine2 receptor antagonists (Tagamet), proton pump inhibitors (Prilosec)

• Cholesterol–lowering agents: Bile acid sequestrants, fenofibrates
(Tricor, etc), statins(Lipitor, etc)

 

[Dr.V.P.C.]

There is a betablocker that actually promotes higher levels of nitric oxide , and can be useful in treating ED: nebivolol .

Nebivolol dilates human penile arteries and reverses erectile dysfunction in diabetic rats through enhancement of nitric oxide signaling - PubMed

 

[Nelson Vergel]

I tried Nebivolol and really did not feel any effects of increased nitric oxide.

 

[DeMegaMan619]

I have/had issues with PVC's. After a week of being on a beta blocker (Carvedilol) the PVC's went away for the most part. I'd love a more libido friendly drug but don't want the PVC's to return.

 

[Dr.V.P.C.]

I like the combination of dox and tadalafil , but be sure to take dox at a low dose or the relax of penis smooth tissue can be too much and complicate erection process.
For me anthing more than 1mg of dox a day can be counterproductive.
I like 5mg of tadalafil + 0,5 mg of dox , each day .

 

[Nelson Vergel]

I wish that combo did not give me so many side effects (stuffy nose, headaches, heartburn). It surely is a great combo for ED and cardiovascular health.

 

[Gene Devine]

I like the combination of dox and tadalafil , but be sure to take dox at a low dose or the relax of penis smooth tissue can be too much and complicate erection process.
For me anthing more than 1mg of dox a day can be counterproductive.
I like 5mg of tadalafil + 0,5 mg of dox , each day .

Been doing this dosage but twice daily; just before bed and 12 hours later.

Given the half life of each drug this goes to make sure serum levels are always at peak levels and trust me, for me at least, it works great!!!

 

[marsh300m]

Blood pressure meds

Been doing this dosage but twice daily; just before bed and 12 hours later.

Given the half life of each drug this goes to make sure serum levels are always at peak levels and trust me, for me at least, it works great!!!

Wow i couldn't figure out what was causing my ed I'm on coreg 25 mg twice a day noravasc 10 mg Cozaar 100mg and methdopa 750 mg 3x aday and a torsimide water pill 10 mg I feel like crap only thing helps is cialis I just started trt treatment 2wks ago hope it'help

 

[Nelson Vergel]

Wow!! What a combo. How tall are you and how much do you weigh? Diabetes or other condition? I would feel like crap on that combo. Has your blood pressure been that hard to manage? Please expand.

 

[Nelson Vergel]

Guideline for the Management of High Blood Pressure in Adults

Read more at: Guideline for the Management of High Blood Pressure in Adults

 

[marsh300m]

Yes my blood pressure is very hard to control I'm 6_1 /2 my weight is 258 and yes I I'm type 2 diabetic I'm currently taking 40 units of insulin Humalog mix 75 /25 I'm 49 years old this blood pressure thing and diabetes runs in my family my died at 50 years old of a massive heart attack and my mother was on dialysis she died in 1999 at 59 years old my doctor want me at 205 but I struggle to get there cause I'm just so fatigue all the time did a ton of blood work and my testosterone levels came back at 381 and my free was 11.1 so he put me on testosterone 1 ml injection every 2 wks but I changed it to half doses once of week cause I crashed in about 6 days my thyroid hormone pth I think I got it came back at 86.3

 

[Nelson Vergel]

marsh300m

Have you been tested for sleep apnea? How about your TSH, free T4 and free T3? How is your diet?

 

[bluerage]

Is doxazosin a prescribed medication? I'd like to give this a try with my daily cialis but don't know the best way to source this in Canada.
Are there any OTC alpha blockers that would also work well with cialis?

 

[DixieWrecked]

I know this thread is old but just got on the doazosin and so far so good! I'm liking it!

 

[Golfboy307]

Dixie,

Are you noticing a nice bump in erection quality? I am considering asking my doctor to add a low dose of it.