Page 154 - Urological Health

1) Antibiotics
2) Anti-inflammatories
3) Alpha-blockers (for urination symptoms)
4) Muscle relaxants
5) Neuromodulators (for nerve pain)
6) Phytotherapies (herbals)

1.Antibiotics

If your bacterial prostatitis is confirmed, antibiotics help a lot. The best antibiotics are the
fluorquinolones (ciprofloxacin [Cipro], ofloxacin [Floxin], levofloxacin [Levaquin]), but others can be
tried as well (trimethoprim with or without a sulpha combination, a tetracycline such a doxycycline
or a macrolide such as clarithromycin). If you are not successful with a certain antibiotic, then it’s
likely that you don’t have an infection. Repeated antibiotics without a confirmation of bacteria in the
urine or prostate secretions will not help and can be harmful. Other therapies and medications should
be considered in this case.

2.Anti-inflammatories

Medications, such as celecoxib (Celebrex), naproxen (Aleve), ibuprofen (Advil) and acetaminophen
(Tylenol) can give you some relief during a flare. Some of these medications can be dangerous if taken
for a long time, so it’s important to only use them when your symptoms flare up.

3.Alpha-blockers UNDER REVIEW

These medications work in the part of the urethra that goes through the prostate. They help relax the
prostate to make urination easier. Examples of such medications are terazosin (Hytrin), doxazosin
(Cardura), tamsulosin (Flomax), alfuzosin (Xatral) and silodosin (Rapaflo). If one of the issues you
have with prostatitis is difficult or painful urination (or ejaculation), one of these drugs may help.
Alpha-blockers need time to be effective and they are most useful if taken for least 6 weeks.

4. Muscle relaxants

Men with pelvic floor muscle spasms and pain in the muscles around the prostate may have some
improvement from muscle relaxants, such as diazepam (Valium). No scientists have formally tested
this idea, but some patients have success with muscle relaxants.

5. Neuromodulators
If your pain is related to your nervous system (burning/shooting pain), these medications, such as
amitriptyline (Elavil) and gabapentin or pregabalin (Lyrica) can help. If you have constant burning
pain, severe shooting pain that burns or if the pain feels like a “shock,” then these types of
medications may be helpful.

6. Phytotherapies

Some herbal medicines show promise for pain relief; these include a plant extract called quercetin,
a pollen extract, and saw palmetto.

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