All alpha-blockers are equally effective and the choice of agent depends on tolerability. They should not be used in catheterised patients.

There is a high placebo effect with alpha blockers and it is suggested that the drug is stopped after 3 – 4 months to see if therapy needs to continue.

Please refer to NICE CG97 The management of lower urinary tract symptoms in men (May 2010).

Drugs also used for urinary retention not listed here:

• Doxazosin (see section 2.5.4 Alpha-adrenoceptor blocking drugs)
• Finasteride (see section 6.4.2 Male sex hormones and antagonists)

Tamsulosin hydrochloride

• Modified-release capsules 400micrograms (£1.49 = 400micrograms daily)

Indications

• Benign prostatic hyperplasia

Dose

• 400micrograms daily

Alfuzosin hydrochloride

• Modified-release tablets 10mg (£11.68 = 10mg daily)

Indications

• Benign prostatic hyperplasia

Dose

• 10mg tablet daily

Notes

1. First dose may cause collapse due to hypotensive effect (therefore should be taken on retiring to bed). Patient should be warned to lie down if symptoms such as dizziness, fatigue or sweating develop, and to remain lying down until they abate completely.