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Clinical Management<br />

STEP 3a: Addition of an<br />

antimuscarinic or beta-3 agonist<br />

If the patient has symptoms of both<br />

obstruction and irritation as well as bother<br />

! In multiple studies the combination of antimuscarinics were<br />

more efficacious in reducing voiding frequency, nocturia, or<br />

IPSS compared to α-blockers or placebo alone.<br />

! The β3 agonist class is newly available and has not been<br />

studied in combination with an AB.<br />

! Neither antimuscarinics or β3 agonists have been studied<br />

in combinations with PDE5i medications.<br />

Oelke M, et al. Eur Urol. 2013;64(1):118-140. PMID: 23541338.<br />

Rosenberg MT, et al. Publication pending.

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