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doxazosin.

At present, there is a 'trend' toward using combination therapies to target BPH and comorbid conditions such as erectile dysfunction, which has important consequences for safety considerations. In a recent placebo-controlled study of healthy volunteers, the combination of tadalafil (a phosphodiesterase type 5 (PDE5)-inhibitor used in the treatment of erectile dysfunction) with doxazosin significantly reduced the blood pressure compared with tadalafil and placebo (the mean difference in systolic blood pressure was 9.8 mmHg); however, this effect was not observed with tadalafil and tamsulosin, supporting the conservative use of this latter combination in the treatment of BPH patients with erectile dysfunction.50 Whether, the PDE5-inhibitor can prevent the high incidence of abnormal ejaculation observed with tamsulosin remains a key topic for future studies assessing combination therapies. However, combination strategies have now become recommended as treatment approaches in guidelines (as discussed below).

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