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The effects of tamsulosin and sildenafil in separate and combined regimens on detailed hemodynamics in patients with benign prostatic enlargement.

Nieminen T, Tammela TL, Kööbi T, Kähönen M

Department of Pharmacological Sciences, Medical School, University of Tampere, Medisiinarinkatu, Tampere 33014, Finland. tuomo.nieminen@iki.fi

PURPOSE: We measured the detailed hemodynamic effects of tamsulosin and sildenafil separately and together in patients with benign prostatic enlargement. MATERIALS AND METHODS: The supine effects of and responses to passive orthostasis (60 degrees for 8 minutes) were measured in 16 patients with benign prostatic enlargement with the finger blood pressure method and whole-body impedance cardiography. The medications, 100 mg sildenafil (single doses) and 0.4 mg tamsulosin (once daily for up to 14 days), were administered in a randomized, double-blind, crossover fashion. RESULTS: Supine systolic arterial pressure decreased with sildenafil (mean +/- SEM -11 +/- 2 mm Hg) and sildenafil plus tamsulosin (-14 +/- 2 mm Hg) more than with placebo (-2 +/- 4 mm Hg, p <0.05). In comparison to placebo sildenafil plus tamsulosin decreased the systemic vascular resistance index (328 +/- 129 vs -241 +/- 134 dyn.sec/cm.m, p = 0.01). Tamsulosin alone did not cause any significant changes in comparison to placebo. Heart rate, diastolic arterial pressure, stroke index, cardiac index and arterial pulse wave velocity were not affected to a statistically significant degree by any of the treatments compared to placebo. Upon head-up tilt the drugs caused only 1 significant change in that diastolic arterial pressure was significantly higher (-2.7 vs -8.0 mm Hg, p = 0.04) in the placebo group than in the tamsulosin plus sildenafil group. CONCLUSIONS: Tamsulosin does not disturb hemodynamics in patients with benign prostatic enlargement. Sildenafil decreases blood pressure with the patient supine but not during head-up tilt. The combination treatment also decreases the systemic vascular resistance index in the supine position.

Published 6 November 2006 in J Urol, 176(6): 2551-6.
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