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Study of Solifenacin Succinate and Tamsulosin Hydrochloride OCAS in Males With Lower Urinary Tract Symptoms (Neptune)

This study has been completed.
Sponsor:
ClinicalTrials.gov Identifier:
NCT01018511
First Posted: November 23, 2009
Last Update Posted: March 21, 2017
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
Information provided by (Responsible Party):
Astellas Pharma Inc ( Astellas Pharma Europe B.V. )
  Purpose
Clinical study to examine the efficacy, safety and tolerability of combination therapy of tamsulosin hydrochloride and solifenacin succinate compared to monotherapy of tamsulosin hydrochloride in the treatment of males with LUTS associated with BPH with a substantial storage component.

Condition Intervention Phase
Benign Prostatic Hyperplasia Lower Urinary Tract Symptoms Drug: Placebo tamsulosin hydrochloride OCAS 0.4 mg Drug: Placebo FDC tamsulosin hydrochloride/solifenacin succinate 0.4 mg/6 mg Drug: Placebo FDC tamsulosin hydrochloride/solifenacin succinate 0.4 mg/9 mg Drug: tamsulosin hydrochloride OCAS 0.4 mg Drug: tamsulosin hydrochloride/solifenacin succinate fixed dose combination (0.4 mg/6 mg) Drug: tamsulosin hydrochloride/solifenacin succinate fixed dose combination (0.4 mg/9 mg) Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Randomized, Double-blind, Parallel Group, Placebo Controlled, Multi-center Study of Fixed Dose Combinations of Solifenacin Succinate (6 mg and 9 mg) With Tamsulosin Hydrochloride OCAS 0.4 mg and Tamsulosin Hydrochloride OCAS 0.4 mg Monotherapy, in Male Subjects With Lower Urinary Tract Symptoms (LUTS) Associated With Benign Prostatic Hyperplasia (BPH) With a Substantial Storage Component

Resource links provided by NLM:


Further study details as provided by Astellas Pharma Inc ( Astellas Pharma Europe B.V. ):

Primary Outcome Measures:
  • Change From Baseline to End of Treatment in Total International Prostate Symptom Score [ Time Frame: Baseline and Week 12 ]

    The International Prostate Symptom Score (IPSS) is a validated global questionnaire to assess the degree of urinary symptoms, based on answers to 7 questions concerning urinary symptoms:

    • Incomplete emptying of the bladder
    • Intermittency
    • Weak stream
    • Hesitancy
    • Frequency
    • Urgency
    • Nocturia

    Each question is assigned points from 0 to 5 indicating increasing severity of the symptom. Total score can range from 0 to 35 (mildly symptomatic to severely symptomatic).


  • Change From Baseline to End of Treatment in Total Urgency Frequency Score (TUFS, Previously Known as Total Urgency Score [TUS]) [ Time Frame: Baseline and Week 12 ]

    The Patient Perception of the Intensity of Urgency Scale (PPIUS) is a validated scale completed as part of the micturition diary. For each micturition and/or incontinence episode, the participant rated the degree of associated urgency according to the following 5-point categorical scale:

    • 0. No urgency;
    • 1. Mild urgency;
    • 2. Moderate urgency;
    • 3. Severe urgency;
    • 4. Urgency incontinence

    TUFS was calculated as the sum of the PPIUS gradings from the 3-day diary divided by the number of days on which urgency grading was recorded. Higher scores indicate more severe urgency.



Secondary Outcome Measures:
  • Change From Baseline to End of Treatment in Mean Number of Micturitions Per 24 Hours [ Time Frame: Baseline and Week 12 ]
    A micturition is any voluntary urination, excluding episodes of incontinence only.The mean number of micturitions per 24 hours was calculated from data recorded by the participant in the micturition diary for the 3 days preceding each clinic visit.

  • Change From Baseline to End of Treatment in Mean Voided Volume Per Micturition [ Time Frame: Baseline and Week 12 ]
    A micturition is any voluntary urination, excluding episodes of incontinence only. The mean volume voided per micturition was calculated from data recorded by the participant in the micturition diary for the 3 days preceding each clinic visit.

  • Change From Baseline to End of Treatment in Maximum Volume Voided Per Micturition [ Time Frame: Baseline and Week 12 ]
    A micturition is any voluntary urination, excluding episodes of incontinence only. The maximum volume voided per micturition was calculated from data recorded by the participant in the micturition diary for the 3 days preceding each clinic visit.

  • Change From Baseline to End of Treatment in Mean Number of Urgency Episodes (PPIUS Grade 3 or 4) Per 24 Hours [ Time Frame: Baseline and Week 12 ]
    An urgency episode is defined as an episode of strong desire to void accompanied by fear of leakage or pain. The mean number of urgency episodes with PPIUS grade 3 (Severe urgency) or 4 (Urgency incontinence) per 24 hours was calculated from data recorded by the participant in the micturition diary for the 3 days preceding each clinic visit.

  • Change From Baseline to End of Treatment in Mean Number of Urgency Incontinence Episodes Per 24 Hours [ Time Frame: Baseline and Week 12 ]
    An urgency incontinence episode is defined as an episode with any involuntary leakage of urine accompanied by or immediately preceded by urgency. The mean number of urgency incontinence episodes with PPIUS grade 3 (Severe incontinence) or 4 (Urgency incontinence) per 24 hours was calculated from data recorded by the participant in the micturition diary for the 3 days preceding each clinic visit.

  • Change From Baseline to End of Treatment in Mean Number of Incontinence Episodes Per 24 Hours [ Time Frame: Baseline and Week 12 ]
    An incontinence episode is defined as an episode with any involuntary loss of urine. The mean number of incontinence episodes per 24 hours was calculated from data recorded by the participant in the micturition diary for the 3 days preceding each clinic visit.

  • Change From Baseline to End of Treatment in Mean Number of Nocturia Episodes Per 24 Hours [ Time Frame: Baseline and Week 12 ]
    A nocturia episode is defined as waking up at night to void (i.e., any voiding associated with sleep disturbance between the time the participant goes to bed with the intention to sleep until the time the patient gets up in the morning with the intention to stay awake). The mean number of nocturia episodes per 24 hours was calculated from data recorded by the participant in the micturition diary for the 3 days preceding each clinic visit.

  • Change From Baseline to End of Treatment in Mean Number of Pads Used Per 24 Hours [ Time Frame: Baseline and Week 12 ]
    The mean number of pads per 24 hours was calculated from data recorded by the participant in the micturition diary for the 3 days preceding each clinic visit.

  • Change From Baseline to End of Treatment in IPSS Voiding Score [ Time Frame: Baseline and Week 12 ]
    The IPSS is a validated global questionnaire to assess the degree of urinary symptoms based on answers to 7 questions. Each question is assigned points from 0 to 5 indicating increasing severity of the particular symptom. The voiding score is the sum of the responses to 4 voiding questions (incomplete emptying of the bladder, intermittency, weak stream, hesitancy) and ranges from 0 to 20 (mildly symptomatic to severely symptomatic).

  • Change From Baseline to End of Treatment in IPSS Storage Score [ Time Frame: Baseline and Week 12 ]
    The IPSS is a validated global questionnaire to assess the degree of urinary symptoms based on answers to 7 questions concerning urinary symptoms. Each question is assigned points from 0 to 5 indicating increasing severity of the particular symptom. The storage symptom score is the sum of the responses to 3 storage questions (frequency, urgency and nocturia) and ranges from 0 to 15 (mildly symptomatic to severely symptomatic).

  • Change From Baseline to End of Treatment in IPSS QoL Score [ Time Frame: Baseline and Week 12 ]
    The QoL assessment was a single question asking the participant how he would feel about tolerating his current level of symptoms for the rest of his life. The answers ranged from 0 to 6 (delighted to terrible).

  • Change From Baseline to End of Treatment in Individual IPSS Scores [ Time Frame: Baseline and Week 12 ]

    The IPSS is a validated global questionnaire to assess the degree of urinary symptoms, based on answers to 7 questions concerning urinary symptoms:

    • Incomplete emptying of the bladder
    • Intermittency
    • Weak stream
    • Hesitancy
    • Frequency
    • Urgency
    • Nocturia

    Each question is assigned points from 0 to 5 indicating increasing severity of the symptom.


  • Change From Baseline to End of Treatment in Symptom Bother Score [ Time Frame: Baseline and Week 12 ]
    The Overactive Bladder Questionnaire (OAB-q) is a self-reported questionnaire with items relating to Symptom Bother and health-related quality of life (HRQoL). The Symptom Bother portion consists of an 8-item scale scored from 1 to 6. The total symptom bother score was calculated from the 8 answers and then transformed to range from 0 to 100, with 100 indicating worst severity. A negative change from baseline indicates an improvement.

  • Change From Baseline to End of Treatment in Health Related QoL (HRQoL) Subscale: Coping Score [ Time Frame: Baseline and Week 12 ]

    The Overactive Bladder Questionnaire (OAB-q) is a self-reported questionnaire with items relating to Symptom Bother and health-related quality of life (HRQoL). The HRQoL portion consists of an 25-item HRQoL subscale containing the following domains scored from 1 to 6:

    • coping
    • concern
    • sleep
    • social interaction

    Coping score can range from 8 to 48 (none of the time to all of the time) and transformed to a scale from 0 to 100, with higher scores indicating better quality of life. A positive change from baseline indicates an improvement.


  • Change From Baseline to End of Treatment in HRQoL Subscale: Concern Score [ Time Frame: Baseline and Week 12 ]

    The Overactive Bladder Questionnaire (OAB-q) is a self-reported questionnaire with items relating to Symptom Bother and health-related quality of life (HRQoL). The HRQoL portion consists of an 25-item HRQoL subscale containing the following domains scored from 1 to 6:

    • coping
    • concern
    • sleep
    • social interaction

    Concern score can range from 8 to 48 (none of the time to all of the time) and transformed to a scale from 0 to 100, with higher scores indicating better quality of life. A positive change from baseline indicates an improvement.


  • Change From Baseline to End of Treatment in HRQoL Subscale: Sleep Score [ Time Frame: Baseline and Week 12 ]

    The Overactive Bladder Questionnaire (OAB-q) is a self-reported questionnaire with items relating to Symptom Bother and health-related quality of life (HRQoL). The HRQoL portion consists of an 25-item HRQoL subscale containing the following domains scored from 1 to 6:

    • coping
    • concern
    • sleep
    • social interaction

    Sleep score can range from 8 to 48 (none of the time to all of the time) and transformed to a scale from 0 to 100, with higher scores indicating better quality of life. A positive change from baseline indicates an improvement.


  • Change From Baseline to End of Treatment in HRQoL Subscale: Social Score [ Time Frame: Baseline and Week 12 ]

    The Overactive Bladder Questionnaire (OAB-q) is a self-reported questionnaire with items relating to Symptom Bother and health-related quality of life (HRQoL). The HRQoL portion consists of an 25-item HRQoL subscale containing the following domains scored from 1 to 6:

    • coping
    • concern
    • sleep
    • social interaction

    Social score can range from 8 to 48 (none of the time to all of the time) and transformed to a scale from 0 to 100, with higher scores indicating better quality of life. A positive change from baseline indicates an improvement.


  • Change From Baseline to End of Treatment in HRQoL Subscale: Total Score [ Time Frame: Baseline and Week 12 ]

    The Overactive Bladder Questionnaire (OAB-q) is a self-reported questionnaire with items relating to Symptom Bother and health-related quality of life (HRQoL). The HRQoL portion consists of an 25-item HRQoL subscale containing the following domains scored from 1 to 6:

    • coping
    • concern
    • sleep
    • social interaction

    Total score is calculated by adding the 4 HRQoL subscale scores and transforming to a scale from 0 to 100, with higher scores indicating better quality of life. A positive change from baseline indicates an improvement.


  • Percentage of Participants Who Were OAB-q Responders at End of Treatment [ Time Frame: Week 12 (end of treatment) ]
    A OAB-q responder was defined as a participant with an improvement from baseline in HRQoL subscale total score ≥ 10.

  • Change From Baseline to End of Treatment in EQ-5D Mobility Score [ Time Frame: Baseline and Week 12 ]

    The European quality of life-5 dimensions (EQ-5D) is an international standardized non-disease specific instrument for describing and valuing health status. The EQ5D has 5 domains:

    • mobility
    • self-care
    • usual activity
    • pain/discomfort
    • anxiety/depression

    Each domain has 3 response levels (1= no problem, 2= some problems, 3 = confined to bed).


  • Change From Baseline to End of Treatment in EQ-5D Self-care Score [ Time Frame: Baseline and Week 12 ]

    The European quality of life-5 dimensions (EQ-5D) is an international standardized non-disease specific instrument for describing and valuing health status. The EQ5D has 5 domains:

    • mobility
    • self-care
    • usual activity
    • pain/discomfort
    • anxiety/depression

    Each domain has 3 response levels (1= no problem, 2= some problems, 3 = unable to wash/dress).


  • Change From Baseline to End of Treatment in EQ-5D Usual Activities Score [ Time Frame: Baseline and Week 12 ]

    The European quality of life-5 dimensions (EQ-5D) is an international standardized non-disease specific instrument for describing and valuing health status. The EQ5D has 5 domains:

    • mobility
    • self-care
    • usual activity
    • pain/discomfort
    • anxiety/depression

    Each domain has 3 response levels (1= no problem, 2= some problems, 3 = unable to perform usual activities).


  • Change From Baseline to End of Treatment in EQ-5D Pain/Discomfort Score [ Time Frame: Baseline and Week 12 ]

    The European quality of life-5 dimensions (EQ-5D) is an international standardized non-disease specific instrument for describing and valuing health status. The EQ5D has 5 domains:

    • mobility
    • self-care
    • usual activity
    • pain/discomfort
    • anxiety/depression

    Each domain has 3 response levels (1= no pain, 2= moderate pain, 3 = extreme pain).


  • Change From Baseline to End of Treatment in EQ-5D Anxiety/Depression Score [ Time Frame: Baseline and Week 12 ]

    The European quality of life-5 dimensions (EQ-5D) is an international standardized non-disease specific instrument for describing and valuing health status. The EQ5D has 5 domains:

    • mobility
    • self-care
    • usual activity
    • pain/discomfort
    • anxiety/depression

    Each domain has 3 response levels (1= not anxious, 2= moderately anxious, 3 = extremely anxious).


  • Change From Baseline to End of Treatment in EQ-5D Visual Analogue Scale (VAS) Score [ Time Frame: Baseline and Week 12 ]
    Visual Analogue Scale (VAS) is part of the EQ-5D questionnaire. The VAS is self-rated by the participant ranging from 0 to 100 (worst imaginable health state to best imaginable health state).

  • Patient Global Impression Scale at End of Treatment: Overall Bladder Symptoms [ Time Frame: Baseline and Week 12 ]
    The Patient Global Impression (PGI) is a global questionnaire completed by the participant to assess both the change in the participants overall condition and the change in bladder symptoms since the start of the study. The questionnaire consists of 2 questions with 7 response levels ranging from 1 to 7 (very much improved to very much worse).

  • Patient Global Impression Scale at End of Treatment: General Health [ Time Frame: Baseline and Week 12 ]
    The Patient Global Impression (PGI) is a global questionnaire completed by the participant to assess both the change in the participants overall condition and the change in bladder symptoms since the start of the study. The questionnaire consists of 2 questions with 7 response levels ranging from 1 to 7 (very much improved to very much worse).

  • Clinician Global Impression Scale at End of Treatment: Overall Bladder Symptoms [ Time Frame: Baseline and Week 12 ]
    The Clinician Global Impression (CGI) is a questionnaire completed by the physician to assess change in the participants bladder symptoms since the start of the study. The questionnaire consists of 1 question with 7 response levels ranging from 1 to 7 (very much improved to very much worse).

  • Number of Participants With Adverse Events (AEs) [ Time Frame: From first dose of double-blind study drug up to 14 days of last dose of double-blind study drug (up to 14 weeks) ]
    Safety is monitored by collecting AEs, which include abnormal laboratory parameters, vital signs or ECG data if the abnormality induced clinical signs or symptoms, needed active intervention, interruption or discontinuation of study medication or was clinically significant. A serious AE (SAE) was an event resulting in death, persistent or significant disability/incapacity or congenital anomaly or birth defect, was life-threatening, required or prolonged hospitalization or was considered medically important. AEs were assessed by the Investigator for intensity as mild (no disruption of normal daily activities), moderate (affected normal daily activities) or severe (inability to perform daily activities) and for causal relationship to study drug. A treatment-emergent adverse event (TEAE) was defined as an AE that occurred after administration of the first dose of double-blind study drug until 14 days after the last dose of double-blind study drug.

  • Change From Baseline to End of Treatment in Post Void Residual (PVR) Volume [ Time Frame: Baseline and Week 12 ]
    PVR volume is the volume of urine retained after voiding. PVR volume was assessed by ultrasonography or bladder scan.

  • Change From Baseline to End of Treatment in Maximum Flow Rate (Qmax) [ Time Frame: Baseline and Week 12 ]
    Qmax during a micturition (urination) was recorded using uroflowmetry.

  • Change From Baseline to End of Treatment in Average Flow Rate (Qmean) [ Time Frame: Baseline and Week 12 ]
    Qmean during a micturition (urination) was recorded using uroflowmetry.

  • Apparent Clearance (CL/F) of Tamsulosin [ Time Frame: Week 4, Week 8 and Week 12 ]
  • Maximum Concentration at Steady State (Cmaxss) of Tamsulosin [ Time Frame: Week 4, Week 8 and Week 12 ]
  • Minimum Concentration at Steady State (Cminss) of Tamsulosin [ Time Frame: Week 4, Week 8 and Week 12 ]
  • Time of Maximum Concentration at Steady State (Tmaxss) of Tamsulosin [ Time Frame: Week 4, Week 8 and Week 12 ]
  • Area Under the Curve at Steady State (AUCss) of Tamsulosin [ Time Frame: Week 4, Week 8 and Week 12 (collection time points: trough, 1-3 hours post dose, 4-5 hours post-dose and 7-10 hours post-dose) ]
  • CL/F of Solifenacin [ Time Frame: Week 4, Week 8 and Week 12 ]
  • Cmaxss of Solifenacin [ Time Frame: Week 4, Week 8 and Week 12 ]
  • Cminss of Solifenacin [ Time Frame: Week 4, Week 8 and Week 12 ]
  • Tmaxss of Solifenacin [ Time Frame: Week 4, Week 8 and Week 12 ]
  • AUCss of Solifenacin [ Time Frame: Week 4, Week 8 and Week 12 (collection time points: trough, 1-3 hours post dose, 4-5 hours post-dose and 7-10 hours post-dose) ]

Enrollment: 1334
Study Start Date: January 2010
Study Completion Date: March 2011
Primary Completion Date: March 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Placebo Comparator: Placebo
Participants received 3 tablets once a day for 12 weeks. Placebo tamsulosin hydrochloride oral controlled absorption system (OCAS) 0.4 mg tablet; Placebo fixed dose combination (FDC) tamsulosin hydrochloride/solifenacin succinate 0.4 mg/6 mg tablet; Placebo FDC tamsulosin hydrochloride/solifenacin succinate 0.4 mg/9 mg tablet
Drug: Placebo tamsulosin hydrochloride OCAS 0.4 mg
tablet
Drug: Placebo FDC tamsulosin hydrochloride/solifenacin succinate 0.4 mg/6 mg
tablet
Drug: Placebo FDC tamsulosin hydrochloride/solifenacin succinate 0.4 mg/9 mg
tablet
Active Comparator: TOCAS 0.4 mg
Participants received 3 tablets once a day for 12 weeks. Tamsulosin hydrochloride OCAS (TOCAS) 0.4 mg tablet; Placebo FDC tamsulosin hydrochloride/solifenacin succinate 0.4 mg/6 mg tablet; Placebo FDC tamsulosin hydrochloride/solifenacin succinate 0.4 mg/9 mg tablet
Drug: Placebo FDC tamsulosin hydrochloride/solifenacin succinate 0.4 mg/6 mg
tablet
Drug: Placebo FDC tamsulosin hydrochloride/solifenacin succinate 0.4 mg/9 mg
tablet
Drug: tamsulosin hydrochloride OCAS 0.4 mg
tablet
Other Names:
  • Harnal ®
  • Omnic®
  • Flomax®
  • YM617
Experimental: FDC 0.4 mg/6 mg
Participants received 3 tablets once a day for 12 weeks. Placebo TOCAS 0.4 mg tablet; FDC tamsulosin hydrochloride/solifenacin succinate 0.4 mg/6 mg tablet; Placebo FDC tamsulosin hydrochloride/solifenacin succinate 0.4 mg/9 mg tablet
Drug: Placebo tamsulosin hydrochloride OCAS 0.4 mg
tablet
Drug: Placebo FDC tamsulosin hydrochloride/solifenacin succinate 0.4 mg/9 mg
tablet
Drug: tamsulosin hydrochloride/solifenacin succinate fixed dose combination (0.4 mg/6 mg)
tablet
Other Names:
  • Vesomni
  • EC905
Experimental: FDC 0.4 mg/9 mg
Participants received 3 tablets once a day for 12 weeks. Placebo TOCAS 0.4 mg tablet; Placebo FDC tamsulosin hydrochloride/solifenacin succinate 0.4 mg/6 mg tablet; FDC tamsulosin hydrochloride/solifenacin succinate 0.4 mg/9 mg tablet
Drug: Placebo tamsulosin hydrochloride OCAS 0.4 mg
tablet
Drug: Placebo FDC tamsulosin hydrochloride/solifenacin succinate 0.4 mg/6 mg
tablet
Drug: tamsulosin hydrochloride/solifenacin succinate fixed dose combination (0.4 mg/9 mg)
tablet
Other Name: EC905

  Eligibility

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


Ages Eligible for Study:   45 Years and older   (Adult, Senior)
Sexes Eligible for Study:   Male
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Voiding and storage symptoms diagnosed as LUTS associated with BPH for ≥ 3 months
  • A total International Prostate Symptom Score (IPSS) of ≥13
  • A maximum urinary flow rate of ≥4.0 mL/s and ≤12.0 mL/s, with voided volume of ≥120 mL during free flow
  • A micturition frequency of ≥8 and at least 2 episodes of urgency with Patient Perception of the Intensity of Urgency Scale grade 3 or 4 per day on average on the 3 day micturition diary (at randomization)

Exclusion Criteria:

  • Any significant Post Void Residual volume (>150 mL)
  • A prostate with estimated weight ≥75 ml as assessed by transvesical or transrectal ultrasound
  • Evidence of a symptomatic urinary tract infection
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01018511


  Show 118 Study Locations
Sponsors and Collaborators
Astellas Pharma Europe B.V.
Investigators
Study Chair: Use Central Contact Astellas Pharma Global Development
  More Information

Additional Information:
Publications:
Responsible Party: Astellas Pharma Europe B.V.
ClinicalTrials.gov Identifier: NCT01018511     History of Changes
Other Study ID Numbers: 905-CL-055
2008-001211-37 ( Other Identifier: EudraCT )
First Submitted: November 19, 2009
First Posted: November 23, 2009
Results First Submitted: October 14, 2015
Results First Posted: December 17, 2015
Last Update Posted: March 21, 2017
Last Verified: February 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: Details of the IPD sharing plan for this study can be found at www.clinicalstudydatarequest.com.

Keywords provided by Astellas Pharma Inc ( Astellas Pharma Europe B.V. ):
EC905
Solifenacin succinate
Tamsulosin hydrochloride OCAS
Treatment
Benign Prostatic Hyperplasia
Vesomni
Lower Urinary Tract Symptoms

Additional relevant MeSH terms:
Hyperplasia
Prostatic Hyperplasia
Lower Urinary Tract Symptoms
Pathologic Processes
Prostatic Diseases
Genital Diseases, Male
Urological Manifestations
Signs and Symptoms
Tamsulosin
Solifenacin Succinate
Adrenergic alpha-1 Receptor Antagonists
Adrenergic alpha-Antagonists
Adrenergic Antagonists
Adrenergic Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Physiological Effects of Drugs
Urological Agents
Muscarinic Antagonists
Cholinergic Antagonists
Cholinergic Agents