Loxoprofen sodium treatment for elderly men with refractory nocturia: Effect on night‐time urine production

Okada, Shinsuke; Watanabe, Hideki; Kojima, Yoshiyuki; Yanai, Yoshimasa; Sasaki, Shoichi; Kohri, Kenjiro

doi:10.1111/j.1442-2042.2008.02021.x

Cited by 4 publications

(7 citation statements)

References 9 publications

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“…Several other treatment approaches have been explored in various populations with nocturia, but none of them has been systematically tested. Nocturia related to nocturnal polyuria has been reported to be sensitive to treatment with the cyclooxygenase inhibitors such as diclofenac 112 or loxoprofen 113 . Within the group of OAB patients, the serotonin‐norepinephrine uptake inhibitor duloxetine has also been reported to improve nocturia 114 .…”

Section: Treatment Optionsmentioning

confidence: 99%

“…Nocturia related to nocturnal polyuria has been reported to be sensitive to treatment with the cyclooxygenase inhibitors such as diclofenac 112 or loxoprofen. 113 Within the group of OAB patients, the serotonin-norepinephrine uptake inhibitor duloxetine has also been reported to improve nocturia. 114 At least among men with LUTS/BPH surgical treatment has also been reported to improve nocturia.…”

Section: Treatment Optionsmentioning

confidence: 99%

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Nocturia: A non‐specific but important symptom of urological disease

Schneider¹,

Rosette²,

Michel

2009

Int J of Urology

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Nocturia is a prevalent symptom that can adversely affect quality of sleep and overall quality of life leading to morbidity and even mortality. Nocturia can be due to a range of urological conditions and non-urological diseases. Nocturia can be due to an insufficient bladder capacity and/or (nocturnal) polyuria. Some of the possibly underlying non-urological diseases can be life-threatening, implying treatment priorities. Urological treatment options include a-adrenoceptor antagonists, muscarinic receptor antagonists and vasopressin receptor agonists. The former two have shown beneficial but small and inconsistent effects in patients assumed to have benign prostatic hyperplasia or overactive bladder, respectively. In contrast, the vasopressin analog desmopressin has consistently shown nocturia improvement in patients with proven polyuria. While supported by lower levels of evidence, lifestyle modifications are generally considered important for nocturia treatment. We conclude that nocturia is a urinary storage symptom with a major impact on patients' lives and a complex pathophysiology.

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Section: Treatment Optionsmentioning

confidence: 99%

Section: Treatment Optionsmentioning

confidence: 99%

Nocturia: A non‐specific but important symptom of urological disease

Schneider¹,

Rosette²,

Michel

2009

Int J of Urology

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“…The effectiveness of hypnotic or non-steroidal anti-inflammatory drugs has been reported; however, such drugs have positional side effects including affinity for benzodiazepine which is associated with adverse effects on cognitive function with the potential for abuse, dyspepsia, and nephropathy. For ramelteon on the other hand, both safety with chronic insomnia have been reported in Japanese patients [12,13,27]. Therefore, we selected ramelteon for the BPH patients with nocturia.…”

Section: Discussionmentioning

confidence: 99%

Ramelteon combined with an α1-blocker decreases nocturia in men with benign prostatic hyperplasia

et al. 2013

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BackgroundNocturia is defined as waking one or more times during the night due to the urge to void. Recently, the effectiveness of several sedatives and analgesics for nocturia has been reported. We herein investigated the effects of ramelteon, an antioxidant and sleep inducer, on nocturia unresponsive to α1-blocker monotherapy in males with lower urinary tract symptoms (LUTS) as a pilot study.MethodsSubjects were 19 patients who had LUTS suggestive of benign prostate hyperplasia, received α1-blockers (tamsulosin, silodosin, or naftopidil), and continued to have two or more episodes of nocturia per night before starting ramelteon. Ramelteon at 8 mg once daily for one month was added to the α1-blocker. A self-administered questionnaire including the International Prostate Symptom Score (IPSS), quality of life (QoL) index, Overactive Bladder Symptom Score (OABSS), and Nocturia Quality-of-Life Questionnaire (N-QOL) were assessed before and one month after starting ramelteon.ResultsThe mean score on IPSS question 7 (nocturia) decreased significantly from 2.88 before starting ramelteon to 2.41 one month after starting the medication (P = 0.03). The mean total OABSS decreased significantly from 6.31 to 5.38 (P = 0.03), and the mean for OABSS question 2 (nighttime frequency of nocturia) also significantly decreased from 2.63 to 2.13 (P = 0.01). The mean total N-QOL score did not change significantly. Two patients had dizziness; the remaining patients had no adverse drug-related events.ConclusionsRamelteon in combination with an α1-blocker could be a treatment option for reducing nocturia in men with BPH.

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“…In a study of loxoprofen and nocturia, Okada et al reported that nocturia was reduced by approximately 1.6 times when loxoprofen was taken before sleep for 2 weeks [8]. Saito et al had patients take loxoprofen before sleep for 1 week and reported the improvement of nocturia by approximately two times [9].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Effect of Loxoprofen Sodium on Nocturia in Patients with Benign Prostatic Hyperplasia

et al. 2011

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PurposeWe evaluated the long-term effects of loxoprofen on nocturia in patients with benign prostatic hyperplasia (BPH).Materials and MethodsBetween January 2006 and December 2008, 40 BPH patients with 2 or more episodes of nocturia received an alpha-blocker, 5-alpha reductase inhibitor, and a single dose of 60 mg of loxoprofen at night before sleep for 12 months (Group I). During the same period, 38 BPH patients selected as the control group received an alpha-blocker and 5-alpha reductase inhibitor (Group II). Patients were reevaluated after 3, 6, and 12 months of treatment by the number of nocturia episodes and side effects.ResultsAfter 3 months of treatment, the number of nocturia episodes decreased significantly compared with baseline in both group I and group II (1.9±0.7, 2.1±0.7, respectively, p<0.05). The degree of decrease in nocturia was significantly different between the groups (-1.5±0.9, -1.1±0.9, respectively, p=0.034). After 6 and 12 months, the number of nocturia episodes decreased significantly compared with baseline in both group I and group II (p<0.05), but the degree of decrease was not significantly different between the groups (p>0.05). After 6 and 12 months of treatment in group I, treatment-emergent adverse events, including 5 cases of gastric discomfort (12.5%), 3 cases of leg edema (7.5%), and 1 case of decreased urine volume (2.5%), occurred in 9 of the 40 (22.5%) patients.ConclusionsLoxoprofen can be an effective treatment for patients with nocturia secondary to BPH in the short term. Long-term use of loxoprofen is not recommended because of the side effects.

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Loxoprofen sodium treatment for elderly men with refractory nocturia: Effect on night‐time urine production

Cited by 4 publications

References 9 publications

Nocturia: A non‐specific but important symptom of urological disease

Nocturia: A non‐specific but important symptom of urological disease

Ramelteon combined with an α1-blocker decreases nocturia in men with benign prostatic hyperplasia

Long-Term Effect of Loxoprofen Sodium on Nocturia in Patients with Benign Prostatic Hyperplasia

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