The latest drug for enlarged prostate - Flomax

Healthfacts, Jan, 1998

Flomax is the newest drug for treating the urinary symptoms associated with an enlarged prostate, also known as benign prostatic hyperplasia (BPH). It is heavily promoted to doctors in glossy four-age medical journal ads heralding, Improvements in urine flow and symptoms of BPH seen at week one. Now four drugs are available to men in whom the prostate becomes enlarged to the point of constricting the urethra and therefore urine flow. But no study has compared the four drugs to each other, according to The Medical Letter (10 October 1997), a physicians publication with no drug company advertising. As noted frequently in HealthFacts, the FDA requires manufacturers to test new drugs against a placebo, but there is no requirement to prove the new drug is an improvement over older ones.

About six years ago, Proscar became the first drug to be approved solely for the treatment of BPH. Many doctors had long been prescribing Hytrin, which was originally approved in 1987 as drug for hypertension. Thanks to a 1996 study which compared Proscar with Hytrin, the former was shown to be ineffective but the latter is helpful in alleviating urinary symptoms (HealthFacts, September 1996). A fourth drug, Cardura, is also an anti-hypertensive similar to Hytrin.

The Medical Letter concluded that the new drug, Flomax, appears to be as effective as Hytrin and Cardura for the treatment of BPH, possibly with less effect on blood pressure, but direct comparisons are lacking. Until Flomax became available, Proscar was the most expensive drug for BPH at $63 for a months supply. Depending upon whether a man takes the 0.4 mg or 0.8 mg dose, Flomaxs cost is $39 or $78 for a months supply.