Archive for the ‘medications’ Category.

MUSE for erection problems

17th June 2009, 12:00 pm

MUSE stands for “medicated urethral system for erections.” The medicine is a small pellet that is inserted inside the opening at the end of the penis (urethra). The applicator has a thin tube that contains the pellet of medicine. The tube is inserted into the urethra. By pressing a button on the applicator, you release the pellet. The medicine is absorbed through the membrane that lines the inside of the urethra. An erection develops in about 10 minutes and lasts at least 30 minutes, but usually less than 60 minutes.

Your doctor may have you try this medicine while you are in the office. This allows the doctor to see how well the medicine works, see whether you can properly use the medicine, and check for adverse reactions, such as a painfully long-lasting erection (priapism) or an allergic reaction.

How It Works

The medicine relaxes the muscles in the surrounding blood vessels of the penis, increasing the blood flow into the penis. This allows an erection to occur. The medicine is inserted into the penis before sex. How well it works depends on how much medicine is inserted.

Long-term use of MUSE may improve a man’s ability to have erections, particularly in men whose erection problems have psychological causes.

Why It Is Used

This medicine may be prescribed for erection problems (erectile dysfunction) that are caused by psychological or physical problems, or both. Short-term use may help increase confidence in men whose erection problems are psychological.

How Well It Works

This medicine is effective, but how well it works depends on the dose you use. More than 6 out of 10 men had successful intercourse at least once using a higher dose of MUSE. But smaller doses had smaller percentages of positive results.1

Side Effects

Side effects of MUSE are usually minor and may include:

  • Pain. About one-third of men complain of mild to moderate urethral ache, which causes some men to discontinue use.1
  • Mild injury to the urethra, such as a small scrape that produces a drop of blood at the tip of the urethra.
  • Low blood pressure (uncommon).

The MUSE system does not cause bruising or scar tissue, like injections may.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

When considering MUSE, it is important to include your partner in your decision.

This medicine is less likely to be effective in men whose blood flow into or out of the penis is severely impaired.

Partners of men who have vision problems or who may have difficulty inserting the pellet can be taught how to use these products.

This medicine can be used by men who are taking medicine to prevent blood clots (anticoagulants), such as warfarin [Coumadin, for example]).

The medicine may cause irritation to the vagina of the man’s partner when he ejaculates.

When you use this medicine, your partner should avoid performing oral sex.

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Muscle relaxants for prostatitis

12th June 2009, 12:00 pm

Examples

Flexeril, Valium, Skelaxin

How It Works

These medications relax muscles throughout the body. They are believed to work because they calm both the central nervous system and the muscles. These medications may make you sleepy.

Why It Is Used

Muscle relaxants may be used to treat pain caused by chronic prostatitis/pelvic pain syndrome, inflammatory or noninflammatory.

How Well It Works

The use of these medications to treat prostatitis has not been carefully studied. However, doctors find that these medications are often helpful, especially for men with chronic prostatitis/pelvic pain syndrome, noninflammatory.1

Side Effects

The side effects of these medications include:

  • Drowsiness.
  • Dry mouth.
  • Urinary retention.
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LH-RH agonists/GnRH agonists for prostate cancer

6th June 2009, 12:00 pm

Examples

Zoladex, Lupron, Trelstar Depot

How It Works

Luteinizing hormone-releasing hormone (LH-RH) agonists and gonadotropin-releasing hormone (GnRH) agonists are hormone therapy drugs that lower the production of testosterone in a man’s body. This drop in testosterone usually slows or stops the growth of prostate cancer for a period of time.

These drugs work by causing the pituitary gland to release the hormones that cause the testicles and adrenal glands to make testosterone. The pituitary gland then runs out of its hormones, and testosterone production drops.

These drugs are usually given by injection. They may be given once a month, once every 3 to 4 months, or once a year.

Why It Is Used

LH-RH and GnRH agonists are used to treat advanced prostate cancer. They are often used with other treatments, such as surgery or radiation therapy.

LH-RH and GnRH agonist therapy can also be used to relieve pain caused by metastatic prostate cancer.

How Well It Works

LH-RH agonist therapy improves a man’s chances of living longer. One study of men with locally advanced prostate cancer found that treatment with LH-RH agonists and radiation therapy resulted in an improvement of overall survival rates.

When combined with radiation therapy or surgery to remove the prostate, LH-RH therapy may improve survival in men who have locally advanced cancer. One study of treatment for locally advanced cancer found that 74% of men who received both external radiation and LH-RH therapy were disease-free after 5 years, compared with 40% for men who received radiation therapy alone.

Treatment with LH-RH agonists may control severe pain caused by metastatic prostate cancer and may improve a man’s quality of life. LH-RH agonists may be able to reduce bone fractures and spinal cord compression caused by metastatic disease if treatment is started as soon as cancer progression is evident.

Side Effects

Side effects from LH-RH agonists and GnRH agonists may include:

  • Erection problems.
  • Decreased sex drive.
  • Hot flashes.
  • Thin or brittle bones (osteoporosis.)
  • Spontaneous bone fractures.
  • Breast enlargement (gynecomastia).
  • Anemia.
  • Fatigue.
  • Weight gain.
  • Loss of muscle mass.

Because these drugs work on the pituitary gland to release its hormones, the testicles may temporarily produce extra testosterone, causing a temporary growth in the tumor. This is called a tumor flare. Tumor flare may be accompanied by bone pain, urinary blockage, or other symptoms of rapid cancer growth. This may indicate that the drug is working, and although the tumor may grow initially, it will shrink over time. Tumor flare can be prevented by taking a different hormone drug called an antiandrogen before or during treatment with the LH-RH agonist.

One study found that treating prostate cancer with drugs to block androgen may increase the risk for gum disease.

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Hormonal therapy for erection problems

15th May 2009, 11:55 am

Examples

Depo-Testosterone/Virilon IM (testosterone cypionate), Andryl/Arderone (testosterone enanthate), Androderm/AndroGel/Testoderm transdermal (testosterone), Parlodel (bromocriptine mesylate), Dostinex (cabergoline).

These medications can be used to treat men who have high prolactin levels, which can reduce the amount of testosterone produced by the body and may lead to problems such as infertility or erection problems. Bromocriptine and cabergoline are taken by mouth.

How It Works

Replacing testosterone, if it is low, may increase a man’s sexual desire, or libido.

Bromocriptine and cabergoline help to lower the amount of prolactin in the body. In some men, a noncancerous tumor on the pituitary gland causes the gland to produce too much prolactin.

Why It Is Used

Testosterone may be prescribed for men who have low testosterone levels. It is not recommended for men with testosterone levels in the low part of the normal range.

Bromocriptine and cabergoline may be prescribed for men with high prolactin levels.

Blood tests are needed to determine the levels of these hormones.

How Well It Works

Testosterone may improve libido and, as a result, may improve erection problems (erectile dysfunction) in men who have low testosterone levels.

Bromocriptine and cabergoline may help restore sexual interest and potency when erection problems are caused by high prolactin levels. At least 4 weeks of continuous therapy is needed to lower the prolactin level to the normal range.

Side Effects

Side effects of testosterone may include:

  • An elevated number of red blood cells (polycythemia), which can increase the risk of stroke or heart attack.
  • Painful enlargement of the breasts.
  • Water retention.
  • High blood pressure.
  • An elevated blood cholesterol level.
  • Abnormal liver function tests.
  • Increased risk of heart failure.
  • Increased prostate-specific antigen (PSA) levels.
  • Increased growth of preexisting prostate cancer.

Side effects of bromocriptine may include:

  • Confusion, hallucinations, and uncontrolled body movements, particularly in older men.
  • Worsening of liver disorders.
  • Worsening of certain mental disorders.
  • High blood pressure.
  • Infertility.

Side effects of cabergoline may include:

  • Low blood pressure.
  • Headache, dizziness, and vertigo.
  • Depression, nervousness, and anxiety.
  • Abdominal pain, nausea, constipation, diarrhea, and flatulence.
  • Dry mouth.
  • Anorexia and weight fluctuation.

Side effects may cause some men to stop taking the medication. Nervous system and mental side effects may linger for 2 to 6 weeks after a man stops taking the medication.

What To Think About

When considering hormonal therapy for erection problems, it is important to include your partner in your decision.

During the first year of testosterone therapy, you should receive a prostate examination, a PSA blood test, a complete blood count, and a liver function test every 3 to 6 months.

Although replacement of testosterone through injections or patches can improve a man’s libido, it does not always improve a man’s ability to have an erection.

Cabergoline given weekly is as effective as daily doses of bromocriptine and may be associated with fewer side effects. Prolactin levels should be monitored monthly.

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Finasteride (Proscar) for prostatitis

7th May 2009, 01:25 pm

How It Works

Finasteride interferes with the effect of male hormones (androgens) on the prostate gland, which cause the prostate to become larger. This stops the growth of the prostate and can even cause it to become smaller. Stopping the growth of the prostate or reducing its size may help relieve pain or urination problems caused by prostatitis.

Why It Is Used

Finasteride may be prescribed for men with prostatitis (especially chronic prostatitis/pelvic pain syndrome, inflammatory), who also have moderate symptoms of prostate enlargement.

How Well It Works

Some studies have shown that finasteride can help with symptoms of prostatitis. But in other studies, finasteride didn’t improve symptoms any more than placebo.

Side Effects

Finasteride (Proscar) is very safe and well-tolerated. Side effects develop in fewer than 1 in 5 men (20%). Potential side effects include:

  • Decreased sex drive (approximately 5% of men).
  • Reduced ejaculatory volume (most men).
  • Difficulty getting an erection (about 5%). However, sexual activity before the study was not evaluated.

Finasteride has fewer major side effects on sexual function than medications that were used in the past. The side effects go away when you stop taking the drug.

What To Think About

This medication should not be used by men who may father a child, because it may cause birth defects in male babies. Women who are pregnant or might become pregnant should not handle crushed finasteride tablets. There is a small chance that the medication could get into the woman’s system and cause a birth defect.

Finasteride reduces prostate-specific antigen (PSA) levels. Because PSA levels are used to detect early-stage prostate cancer, men interested in taking finasteride might consider the following:

  • Some experts suggest that men be checked for the presence of prostate cancer (using the PSA test and a digital rectal exam) before starting to take finasteride.
  • Follow-up PSA tests that have not decreased by approximately 50% after 6 months of taking finasteride may indicate a need for further testing for prostate cancer.
  • PSA levels above 2 ng/mL during finasteride treatment may indicate a need for further testing for prostate cancer.
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Bleomycin

29th April 2009, 03:10 pm

Bleomycin is an intravenous (IV) chemotherapy medication used to treat several types of cancers including testicular cancer and lymphoma, as well as cancers of the head and neck.

How It Works

Bleomycin interferes with a cell’s ability to divide and reproduce, resulting in the death of the cell. Each dose is usually given over a period of 10 minutes or continuously for 24 hours.

Why It Is Used

Bleomycin is used to slow or stop the spread of cancer cells in the body.

How Well It Works

Bleomycin is an effective antitumor medication. However, the type and extent of a cancer determines how effectively this medication slows or stops the growth of cancer cells in the body.

Side Effects

As with many chemotherapy medications, bleomycin is associated with some side effects, including:

  • Nausea, vomiting, and loss of appetite.
  • Fever and chills.
  • Hair loss. This is reversible, and hair will grow back when treatment ends.
  • Sores in the mouth or on the lips.

Other, less common side effects include:

  • Scarring of lung tissue.
  • Pain at tumor sites.
  • Pain where medication is injected into the bloodstream.
  • Lung irritation.
  • Allergic (anaphylactic) reaction, which may cause decreased blood pressure, confusion, rapid heart rate, wheezing, and facial swelling.

What To Think About

Bleomycin should be administered only under the supervision of a medical oncologist.

For both men and women, bleomycin can affect your ability to have children. You may not be able to get pregnant or father a child after taking this medication. Discuss fertility with your doctor before starting treatment.

Bleomycin can cause birth defects. Do not use this medication if you are pregnant or wish to become pregnant or father a child while you are taking it.

Because bleomycin can damage the lungs, you may have tests to measure the function of your lungs before your doctor prescribes bleomycin. These tests may be repeated over the course of your treatment. Tell your doctor if you have any shortness of breath or other problems breathing after you begin taking bleomycin.

Talk to your doctor before taking bleomycin if you:

  • Have any of the following medical problems:
    • Chickenpox or have recently been exposed to chickenpox
    • Gout
    • Heart disease
    • Congestive heart failure
    • Shingles
    • Kidney stones
    • Liver disease
    • Other forms of cancer
  • Are a woman using birth control hormones (pill, patch, ring, or implant).
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Anxiolytic agents for prostatitis

20th April 2009, 12:50 pm

Examples

Klonopin (clonazepam), Valium (diazepam), Ativan (lorazepam)

How It Works

Anxiolytic medications may reduce pain in the same way they reduce anxiety.

Why It Is Used

These medications are prescribed for men with prostatitis to:

  • Relieve the pain associated with chronic prostatitis/pelvic pain syndrome, noninflammatory.
  • Relax tense pelvic floor muscles associated with chronic prostatitis/pelvic pain syndrome, noninflammatory.
  • Relieve anxiety associated with chronic pelvic pain syndrome, noninflammatory.

How Well It Works

These medicines can help relieve pain caused by chronic prostatitis/pelvic pain syndrome.1

These medications can reduce or manage anxiety caused by long-term symptoms of chronic pelvic pain syndrome.

These medications can help relax tense pelvic muscles.

What To Think About

These medications may be used in combination with alpha-blockers, which relax the muscles in the prostate.

These medications do not cure problems with anxiety that may have contributed to prostatitis. Curing an underlying problem with anxiety may require counseling with a psychiatrist or psychologist.

This class of medications can be habit-forming. Long-term use of these medications to treat a chronic health problem is not usually recommended.

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Anticholinergics and antispasmodics for urinary incontinence in men

8th April 2009, 04:37 pm

Examples

Enablex (darifenacin hydrobromide), Ditropan/Ditropan XL/Oxytrol (oxybutynin chloride), Vesicare (solifenacin succinate), Detrol/Unidet (tolterodine tartrate), Sanctura (trospium chloride)

How It Works

These medicines calm the nerves that control bladder muscles. They may prevent uncontrollable bladder contractions that force urine out of the bladder.

Why It Is Used

Antispasmodics and anticholinergics are used to control the symptoms of urge incontinence. These medicines may also be used to treat stress incontinence, especially if you have both stress and urge incontinence.

How Well It Works

Many people taking these medicines have fewer problems with urinary incontinence.

Side Effects

Side effects vary with some of these medicines and include:

  • Dry mouth.
  • Headache.
  • Decreased sweating, skin rash.
  • Nausea, constipation.
  • Eye problems.
  • Rapid heartbeat.
  • Skin rash.
  • Drowsiness, confusion.
  • Nervousness.
  • Urinary retention.

What To Think About

Some of these medicines may cause you to sweat less. In hot weather, this could lead to heat exhaustion. Ask your health professional whether you should be careful about being physically active in hot conditions.

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Alpha-blocker medications for prostatitis

3rd March 2009, 04:42 pm

Examples

Brand Name Chemical Name
Uroxatral alfuzosin hydrochloride
Cardura doxazosin mesylate
Flomax tamsulosin hydrochloride
Hytrin terazosin hydrochloride

These medications are available in pill form. A low dose is used initially, then the dosage is gradually increased until the medication has the greatest effect on reducing symptoms with minimal side effects.

How It Works

These medications relax the muscles in the prostate and at the base of the bladder. This reduces muscle tightness and spasms that may prevent normal urine flow.

Why It Is Used

These medications may be used to treat symptoms of chronic prostatitis/pelvic pain syndrome, noninflammatory, a type of prostatitis, when muscle tightness and spasms are suspected to be the cause of symptoms and pain. Muscle tightness and spasms may force urine into the prostate, causing irritation that leads to prostatitis.

These medicines are approved by the U.S. Food and Drug Administration (FDA) for treating symptoms of benign prostatic hyperplasia (BPH), which may be caused by muscle spasms in the bladder neck or in the prostate. Although these medicines have not been approved by the FDA for the treatment of prostatitis, your doctor may prescribe one of these medicines to treat your prostatitis.

How Well It Works

Most men who take alpha-blockers for prostatitis have fewer symptoms, but it takes awhile for the medicine to give results. Alpha-blockers work best in men who haven’t already tried many different kinds of medicines for prostatitis and who have moderate to severe symptoms.

Side Effects

Alpha-blockers can reduce blood pressure to less than normal. This can result in lightheadedness, especially when you stand up abruptly after sitting or lying down (postural hypotension).

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Because the medication can cause lightheadedness, it may be given at night and started at a low dose that will be gradually increased.

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