Reasons for Prescription Change of α1-Blockers in Patients With Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia

Objective To investigate the reasons for prescription change of α1-blockers in patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Methods The ratio and interval of prescription change were assessed in 3200 patients who were eligible for the study and took 1 of 4 different α1-blockers (doxazosin, alfuzosin, tamsulosin, or silodosin). The reasons for prescription change and evaluation of efficacy were analyzed in 444 patients whose medical records were complete. Results Prescription change to another α1-blocker occurred in 694 of 3200 patients (21.7%), and the mean duration of taking their first α1-blocker was 10.8 ± 8.2 weeks. Lack of efficacy (52.7%) was the main reason for changing α1-blockers, followed by adverse events (33.1%), relatively high cost compared with other α1-blockers (7.0%), inconvenience of taking drugs (4.1%), and cardiovascular comorbidity (3.2%). The mean duration of treatment according to each reason is as follows: increased adverse events: 6.3 ± 5.2 weeks, relatively high cost compared with other α1-blockers: 8.7 ± 4.5 weeks, cardiovascular comorbidity: 10.5 ± 6.8 weeks, inconvenience of taking drugs: 10.8 ± 3.9 weeks, and lack of efficacy: 14.8 ± 6.8 weeks. The proportion of prescription change (16.3%) and prescription change because of hemodynamic adverse events (2.4%) in the silodosin group were low compared with those in the other groups ( P