Beste apotheek van Nederland

Prazosin (IU) versus placebo. One trial compared the efficacy and harms of prazosin versus
placebo. 303
Harms. Penile pain was reported by 5.5, 0.7, 1.4 and 1.1 percent of men allocated to 2000,
1000, 500, and 250µg IU prazosin, respectively, versus 1.7 percent of those allocated to placebo.
Urethral pain was reported by 0, 2.0, 2.0, and 2.1 percent of men allocated to 2000, 1000, 500,
and 250µg IU prazosin, respectively, versus 1.7 percent of those allocated to placebo.
Efficacy. In this trial, 3 percent of men assigned to 2000µg IU prazosin reported erections
sufficient for intercourse versus 0.4 percent of those assigned to treatment with placebo. Results
were not provided for the 250, 500, and 1000µg prazosin doses, though it was stated that 2000µg
was the most efficacious prazosin dose.
Alprostadil (IU) plus IU prazosin versus IU alprostadil versus IU prazosin versus
placebo. One trial compared the efficacy and harms of IU alprostadil plus IU prazosin versus IU
alprostadil versus IU prazosin versus placebo. 303 All combinations of IU alprostadil plus IU
prazosin appeared to improve erections more than IU prazosin or placebo.
Harms. The proportions of patients with penile pain among those allocated to various
alprostadil/prazosin combinations were: 23.9(125µg/250µg), 23.4 (125µg/500µg), 23.4
(250µg/250µg), 17.0 (250µg /500µg), 27.3 (250µg /1000µg), 23.2 (500µg /500µg), 23.1
(500µg/1000µg), 31.6 (500µg /2000µg), and 26.9 percent (1000µg /1000µg). The proportions of
patients with penile pain who were allocated to various doses of IU alprostadil were: 23.6
(1000µg), 20.5 (500µg), 20.9 (250µg), and 17.0 percent (125µg). The corresponding proportions
for various doses of IU prazosin were: 5.5 (2000µg), 0.7 (1000µg), 1.4 (500µg) and 1.1 percent
(250µg). Of the placebo-treated patients, 1.7 percent experienced penile pain.
The corresponding proportions of patients with urethral pain with respect to various
alprostadil/prazosin combinations were: 6.5, 10.6, 8.5, 8.5, 11.4, 7.1, 1.9, 5.3, and 13.5 percent
respectively. The corresponding proportions of men with urethral pain for various doses of IU
alprostadil were: 9.1, 8.0, 5.1, and 1.0 percent, respectively. The proportions for various doses of
IU prazosin were: 0, 2.0, 2.0, and 2.1 percent respectively. Urethral pain was experienced by 1.7
percent of the placebo-treated patients.
Efficacy. Erections sufficient for intercourse were reported by 30.4 percent of men assigned
to 125/500µg alprostadil/prazosin versus 31.9 percent with 250/500µg alprostadil/prazosin, 35.7
percent with 500/2000µg alprostadil/prazosin, 31.1 percent with 500µg alprostadil, 14.1 percent
with 125µg alprostadil, 3 percent with 2000µg prazosin, and 0.4 percent with placebo. Results
were not provided for the other six alprostadil/prazosin combinations tested, for the 250 and
1000µg alprostadil doses, or for the 250, 500, and 1000µg prazosin doses. However, it was stated
that 500/2000µg was the most efficacious alprostadil/prazosin dose, 500µg was most efficacious
alprostadil dose, and 2000µg was the most efficacious prazosin dose.
Quantitative Synthesis
There was a large degree of clinical heterogeneity among the eligible IU trials with regard to
patient characteristics (e.g. inclusion/exclusion criteria), interventions (e.g. fixed or flexible
dosing, dose titration, treatment duration per individual ranging from single administration to 3
months), and assessed outcomes (see Outcomes section above). Therefore, meta-analyses on
these studies were not performed.
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