J Prev Med Public Health.  2009 May;42(3):165-170. 10.3961/jpmph.2009.42.3.165.

The Risk of Fracture with Taking Alpha Blockers for Treating Benign Prostatic Hyperplasia

• Lee J
• Choi NK
• Jung SY
• Kim YJ
• Seong JM
• Oh SJ
• Park BJ

• KMID: 797672
• DOI: http://doi.org/10.3961/jpmph.2009.42.3.165

Abstract

OBJECTIVES
We evaluated the risk of fracture associated with hypotension-related adverse drug reaction caused by taking alpha blockers to treat benign prostatic hyperplasia (BPH).
METHODS
We used the Health Insurance Review and Assessment Service database from January 1st 2005 to June 30th 2006 for this study. The male patients with BPH and who had a prescription for alpha blockers following any fractures were defined as the cases. We set the 20 day long hazard period prior to the index date and the four control periods whose lengths were same with hazard period. After 1:4 matching of the hazard and control periods, conditional logistic regression was used to calculate the odds ratios for the risk of fractures as related to the alpha blocker exposure.
RESULTS
Doxazosin and tamsulosin showed the increased risk of fractures, whereas terazosin did not. After stratification using the defined daily doses, a protective effect was shown for the patients who took terazosin at the doses lower than 0.4 DDD and the hazardous effect at the doses higher than or equal to 0.4 DDD. There was no significant difference for the risk of patients taking tamsulosin at the doses higher than 1.0 DDD but there was a statistically significant increase in the risk at the doses higher than or equal to 1.0 DDD.
CONCLUSIONS
Alpha blockers for BPH may increase the risk of fracture in elderly patients who have comorbidities and take the concomitant medications. Alpha blockers need to be prescribed with caution, although some have high prostate specificity.

Keyword

Benign prostatic hyperplasia; Adrenergic alpha antagonist; Adverse drug reactions; Fracture; Case-crossover study

MeSH Terms

Adrenergic alpha-Antagonists/*therapeutic use
Aged
Aged, 80 and over
Cross-Over Studies
Drug Toxicity/complications
Fractures, Bone/*chemically induced/epidemiology
Humans
Korea/epidemiology
Male
Prostatic Hyperplasia/*drug therapy
Risk Assessment