Category

Name

Mechanism

Major adverse effects

Analgesics

Gabapentin (Neurontin™)
Pregabalin (Lyrica™)
Mexiletine (Mexitie™)
Pentazocine (Talwin™)
Prochlorperazine (Compazine™)
Propiram (Dirame™)
Tramadol (Ultram™)

Antiseizure
Antiseizure, analgesic
Oral ‘local’ anaesthetic
Opioid
Anti-emetic
Opioid
Non-opioid central acting

-----
Drowsiness, weight gain, edema
Retention
Retention
Drowsiness
Retention
Seizure risk ↑, antidepressants, nausea

Antidepressants

Mirtazapine (Remeron™) [best in class]
Amitriptyline (Elavil™)
Desipramine (Norpramin™)
Doxepin (Sinequan™)
Imipramine (Tofranil™)

Tricyclic NE/5HT uptake inhibitor
Tricyclic NE/5HT uptake inhibitor
Tricyclic NE/5HT uptake inhibitor
Tricyclic NE/5HT uptake inhibitor
Tricyclic NE/5HT uptake inhibitor

Sedation, weight gain
Sedation, Retention
Sedation
Sedation
Sedation

Antihormones - females

Leuprolide acetate (Lupron™)
Tamoxifen (Nolvadex™)

GnRH agonist
Oestrogen-receptor antagonist

‘Menopause state’
‘Menopause state’

Anti-inflammatory agents

Celecoxib (Celebrex™)
Choline magnesium trisalicylate (Trilisate™)
Dipyrone (Novalgin™)
Rofecoxib (Vioxx™)

COX-2 inhibitor
COX-inhibitor
COX-inhibitor, spasmolytic
COX-2 inhibitor

Diarrhoea
GI upset
Agranulocytic anaemia (1/106)
Diarrhoea

Leukotriene (LT) blockers

Montelukast (Singulair™)
Zafirlukast (Accolate™)
Zileuton (Zyflo™)

Leukotriene receptor antagonist
Leukotriene receptor antagonist
Leukotriene synthesis inhibitor

Headache, vasculitis
Headache
Ups serum levels of propranolol, warfarin

Immunosuppressive agents

Cyclosporin (Neoral™)
Etanercept (Embrel™)
Infliximab (Remicade™)
Methotrexate

IL-2 receptor antagonist
TNF soluble receptor (human)
TNF-a soluble antibody
Folic acid synthesis inhibitor

Nephro, hepatotoxicity
Ups susceptibility to
infection, headache
Chilitis, lowers blood counts

Mast cell mediator release/action inhibitors

Cimetidine (Tagamet™)
Cromolyn (Intal™, Gastrocrom™)
Hydroxyzine (Atarax™, Vistaril™)
Indolinone derivatives (SUGEN™)
IPD-1151T
Quercetin (ProstaQ™ & Q-Urol ™)
Pollen extract / Cernilton (Graminex ™)

Histamine-2 receptor antagonist
Mast cell ‘stabiliser’
Histamine-1 receptor antagonist
Tyrosine kinase inhibitors
Immunoregulator
Flavonoid
Flavonoid

Reversible impotence
GI upset
Sedation
Not in humans
None reported
None known
None known

Mucosal surface protectors

Chondroitin + quercetin (Algonot-Plus™)
Heparin
Hyaluronic acid (Cystistat™)
Prostaglandin E (Misoprostol™)

Proteoglycan and flavonoid
Proteoglycan (intravesical)
Proteoglycan (intravesical)
Prostaglandin E1 analogue

None known
Ups chance of bleeding
None know
Diarrhoea

Neuropeptide receptor antagonists

Resiniferatoxin (?)
CP-96,345 (Pfizer)
SR-48,968 (Sanofi)
SR-48,692 (Sanofi)

Capsaicin analogue (intravesically)
NK-1 receptor antagonist
NK-2 receptor antagonist
Neurotensin-receptor antagonist

Mild irritation
Phase I trials
Phase I trials
Phase II trials

Neurolytic (antineuronal)

Antalarmin (NIH)
Astressin (Neurocrine)
BP 2-94 (Bioprojet)
Tizanidine (Zanoflex)

Corticotropin-releasing hormone
Receptor antagonists
Histamine-3 receptor agonist
alpha-2 Receptor agonist

Not in humans
Not in humans
Not in humans
Impotence, mast cell activation

Smooth Muscle Relaxants

Terazosin HCl (Hytrin™)
Tamsulosin HCl (Flomax™)
Doxazosin (Cardura™)
Alfuzosin hydrochloride (Xatral™)

Alpha-blocker
Alpha-blocker
Alpha-blocker
Alpha-blocker

-
Retrograde Ejaculation
-
-

Other

BCG
Doxorubicin (Adriamycin™)
L-Arginine
Octreotide (Sandostatin™)

Immunostimulant
Antineoplastic agent
Amino acid nitric oxide precursor
Somatostatin analogue

Autoimmunity
Cardiotoxicity
None known
Ups mast cell activation

Analgesics that may be useful in IC and Male CP/CPPS:

Category

Name

Main Characteristics

Opioids

Pentazocine (Talwin™)
Propiram fumarate (Dirame™)
Tramadol (Ultram™)

High potency, fewer adverse effects
Post-operative pain
Non-addictive synthetic opioid

Non-opioids

Gabapentin (Neurontin™)
Pregabalin (Lyrica™)
Mexiletine
Prochlorperazine (Compazine™)

Anti-epileptic
Antiseizure, analgesic
Local anaesthetic
Antipsychotic


Source: Theoharides & Sant, with 2003 updates from Chronicprostatitis.com staff and readers.



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