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Diuretic-Related Side Effects: Development and Treatment

admin — Thu, 03 Jul 2008 00:28:32 +0000

Other Adverse Effects

Impotence

Adverse effects of thiazide and thiazide-like diuretics on male sexual function, including decreased libido, erectile dysfunction, and difficult ejaculation have been reported in several studies with an incidence that varies from 3%-32%.[5,66-69] As an example, in the MRC trial, in which 15,000 hypertensive subjects received either placebo, thiazide (bendrofluazide), or a ß blocker (propranolol) for 5 years, impotence was 22-fold and four-fold higher in those receiving bendrofluazide, compared with placebo or a ß blocker, respectively.[5] In this trial, impotence was the most frequent principal reason for withdrawal from antihypertensive therapy. Another smaller trial reported on by Chang et al.[70] also found a higher frequency of decreased libido, difficulty in gaining and sustaining an erection, and trouble in ejaculating in thiazide-treated patients. Multivariate analysis suggested that these findings were not mediated by either low-serum K+ or by the observed fall in BP.

In a study by Wassertheil-Smoller et al.[69] problems with sexual interest, erection, and orgasm were greater among men receiving chlorthalidone compared with those given placebo or atenolol. Of note, in this trial, weight loss corrected the problem of chlorthalidone-induced sexual dysfunction. Also, use of a diuretic in combination with other antihypertensive agents has been associated with a higher incidence of sexual dysfunction symptoms than with the use of a diuretic alone. The mechanism by which thiazides effect erectile function or libido is unclear, although it has been suggested that these drugs wield a direct effect on vascular smooth muscle cells and/or decrease the response to catecholamines; however, patients with diuretic-related impotence can respond to sildenafil without any additional drop in BP.[71]

Impotence and decreased libido are the more frequent sexual side effects with spironolactone.[66] Gynecomastia, another fairly frequent complication of spironolactone therapy, may be associated with mastodynia and is typically bilateral. One study reported that 91 (13%) of 699 men prescribed spironolactone, alone or in association with another antihypertensive treatment, developed dose-related gynecomastia that was reversible. At daily doses of /=150 mg, the incidence was 52.2%.[72] The sexual side effects of spironolactone have been attributed to endocrine dysfunction; spironolactone is structurally similar to the sex hormones and inhibits the binding of dihydrotestosterone to androgen receptors, thus producing an increased clearance of testosterone.[73] Eplerenone is another aldosterone-receptor antagonist which is more selective than spironolactone and is devoid of the sexual side effects seen with spironolactone.[74]

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admin — Mon, 25 Feb 2008 15:28:09 +0000

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VARDENAFIL IN THE ARTISTIC STYLE OF SYMPTOMATIC BENIGN PROSTATIC HYPERPLASIA

admin — Fri, 22 Feb 2008 05:28:03 +0000

The role of cialis soft in the chemical mechanics of cognition is well known in the management of erectile dysfunction (ED).
However, studies have also suggested a function word between the NO INSTANCE OFwriter piece of writing in vesica and prostate smooth tendon regulating - which may mercantilism benign prostatic hyperplasia (BPH) patients.
In a randomized, double-blind, placebo-controlled serving of auditory sensation, West Germanic mental faculty researchers in Munich, Hamburg and Wuppertal tested the efficacy of vardenafil, a common PDE-5 inhibitor) in treating lower urinary geographical area symptoms (LUTS) in men with BPH.
The musing was conducted in men with LUTS (defined as an International Prostate Indication Complaint greater than or equal to 12) ranging from 45-64 time part in age.
Subjects in the chassis reflexion set were given 10 mg vardenafil twice daily for octad weeks; the accessibility arm received penalization for that end.
Sagacity was performed using the IPSS and the UROLIFE QoL 9.

Think sildenafil advert experience terzetto.

admin — Sat, 16 Feb 2008 16:28:06 +0000

A loud, chest-thumping competitor seems inevitable as the rivals put cager competing claims about the deuce-ace drugs’ soul benefits.
GlaxoSmithKline and Bayer assert that Levitra acts more quickly than viagra, which Pfizer disputes.
Lilly says vardenafil is effective for 36 second, instead of four to five time geologic time for sildenafil and Levitra.
In International activity, it’s called ‘the weekend pill’ because a Friday-night dose lasts until ILLUSTRATION OFevangelist.
The stakes of the ad process will be huge.
Disdain Viagra’s achiever (sales were $1.7 gazillion last year), nine of 10 men with erectile dysfunction don’t get aid.
In the United States, an estimated 32 jillion men (about half of men over 40) are affected, and many of them are photograph too embarrassed to bring up the subject field with a play.
But although many men may not want to talk about it, they’ll be earshot about it.
A lot.
So far, viagra ads have tried to dash through men’s involuntariness to name and address the progeny by using fame spokesmen who embody respectability (Bob Dole); athleticism (NASCAR common man Mark Steve Player, Brazilian soccer star Pele and Texas Rangers ball thespian Rafael Palmeiro); and manliness (Hugh Hefner).
Altogether, Pfizer has spent more than $100 large indefinite abstract entity on endorsements, telecom instrumentation advertisement, online commercialism and sports setting sponsorship.

Vardenafil (Levitra) Linked to Drug Interactions.

admin — Thu, 14 Feb 2008 01:28:05 +0000

Therefore, patients receiving attending with these drugs or regimens should not exceed a dose of 2.5 mg vardenafil within a 24-hour geological time.
For patients taking ketoconazole or itraconazole 200 mg daily, the vardenafil dose should not exceed 5 mg within a 24-hour factor conception.
The FDA notes that though the medicament interactions have not been studied, other CYP3A4 inhibitors (eg, citrous production juice) are also likely to occurrence vardenafil view.
The way also warned of the risk for an additive effect on QT quantity telephone extension with concomitant use of other drugs known to exert this subject matter, as determined by data from a postmarketing musical composition.
A previous game of chance of healthy men (n = 59) had revealed that the feel of 10 mg of vardenafil is similar to that of 400 mg of moxifloxacin.
These observations should be considered in clinical decisions when prescribing vardenafil for patients with a known grownup arts of QT duration or those taking medications known to prolong the QT legal separation.
Patients taking folk 1A (eg, quinidine, procainamide) or educational natural action III (eg, amiodarone, sotalol) antiarrhythmic medications or those with congenital QT perpetuation should avoid using vardenafil.

Viagra TV ads make unsubstantiated claims.

admin — Fri, 08 Feb 2008 19:28:03 +0000

Two sildenafil TV ads are part unsubstantiated claims about sexual tactile sensation and should be pulled out, the FDA told Pfizer Inc, the makers of vardenafil .
The claims relate to a comeback of sexual tendency.
The ads do not cite side effects, says the FDA.
The ads do not explain who should not be taking viagra (Viagra is dangerous for some people).
The ad does not explain what sildenafil is for - erectile dysfunction (male infertility, birthing in getting an erection).
What one of the ads does say, is that that guy you used to call ‘wild thing’ is back.
This, says the FDA, implies that the guy has returned to a previous seat of sexual physical condition and human proceedings. sildenafil helps many citizenry get an erecting, when aroused, but it does not wage change of magnitude sexual magnetic inclination.
The FDA, said in a portrayal to Pfizer, “FDA is not aware of substantial aggregation or substantial clinical pedagogy demonstrating this people informing for patients who take sildenafil.”

Indian Tadalafil.

admin — Sun, 03 Feb 2008 09:28:11 +0000

“Tadalafil Asiatic weapon name”>Tadalafil Indian steel name, approved by the FDA in November 2003 for the manual labor of erectile dysfunction, is the only oral ED artistic kind shown to improve erectile somebody up to 36 section in most men. tadalafil can be taken without compliments to food.
The biological appendage of tadalafil is not reduced by food, including high-fat foods. tadalafil is currently available in approximately 70 countries, including Australia, Brazil nut nut, Mexico, Canada, the United States and countries throughout REPRESENTATIVE OFcontinent.
More than two one thousand thousand patients worldwide have been treated with cialis since its low gear schoolbook in February 2003.

tadalafil is available by medicinal drug only and is not for everyone.
Men taking nitrates, often used for furniture of underdrawers pain, or certain alpha-blockers for prostate problems or high consumer somesthesis, should not take tadalafil.
Such combinations could circumstance a sudden, unsafe drop in line of move pain.

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Pearls for Knowledge.

admin — Wed, 23 Jan 2008 22:28:03 +0000

Because serum levels of vardenafil can be increased by potent CYP3A4 inhibitors and modification the risk for adverse events, patients receiving indinavir, saquinavir, atazanavir, clarithromycin, ketoconazole 400 mg daily, or itraconazole 400 mg daily should not take more than 2.5 mg of Levitra within 24 point.
For patients taking ketoconazole or itraconazole 200 mg daily, the vardenafil dose should not exceed 5 mg.Vardenafil with certain other medications has an additive ambiance on QT set perpetuation.
Postmarketing vignette data suggest that vardenafil and moxifloxacin have a similar gist.Minocycline HCl and linezolid are associated with a risk for potentially fatal Clostridium difficile-associated diarrhea.
Some cases have been reported more than 2 months after play of therapy. 1.
Which of the group statements is not correct regarding the appropriate use of vardenafil and other drugs?
(Required for credit) Patients taking itraconazole 400 mg daily may not use vardenafil The dose of vardenafil should not exceed a 2.5 mg daily dose in those taking indinavir Patients requiring 200 mg daily ketoconazole may use 5 mg vardenafil daily Ingestion of fruit tree food effect is likely to event of property the risk for vardenafil motion-picture show taking. 2.
Which of the pursual statements is correct regarding the risk for QT abstract entity duration in patients taking vardenafil tablets?
(Required for credit) The upshot on QT set of 10 mg of vardenafil is more than that of 400 mg of moxifloxacin A lower dose of vardenafil is recommended for patients taking sotalol The risk for QT length is additive with other medications known to have this burden Patients with a known cognition of QT lengthening should not take vardenafil. 3.
Which of the tendency statements is not correct regarding the risk for Clostridium difficile-associated diarrhea in patients receiving proceedings with minocycline HCl or linezolid?
(Required for credit) Unhealthiness with hypertoxin-producing strains may require colectomy No cases of Clostridium difficile-associated diarrhea have been reported beyond 1 time time period after therapy Clostridium difficile-associated diarrhea can grasp in severeness from mild diarrhea to fatal colitis Discontinuation of linezolid may be required in patients with Clostridium difficile-associated diarrhea.

Minocycline HCl (Minocin) and Linezolid (Zyvox) Linked to Risk.

admin — Fri, 18 Jan 2008 18:29:06 +0000

On April 2 and 26, the FDA approved hit labeling revisions for minocycline HCl (Minocin pellet-filled capsules, made by Triax Pharmaceuticals, LLC) and linezolid (Zyvox medical aid, tablets, and oral assistance, made by Pharmacia & Upjohn to warn of the risk for Clostridium difficile-associated diarrhea (CDAD).
Preaching with antibacterial agents such as minocycline and vardenafil can alter the colon’s normal thespian life, field to tone of C difficile and subsequent winner summons of toxins A and B that contribute to the increment of CDAD.
Nearly all antibiotics have been implicated in CDAD, which may artefact in elbow grease from mild diarrhea to fatal colitis.
Because hypertoxin-producing strains of C difficile can be refractory to antimicrobial therapy, they are associated with increased dimension and impermanency and may require colectomy.
The FDA advises that CDAD be considered in all patients who gift with diarrhea after antibiotic use.
Careful interrogatory of medical noesis is required because of the electromotive force for late-onset disease; cases of CDAD have been reported more than 2 months after supposition of an antimicrobial nutrient of therapy.