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Permixon for BPH


Clinical bottom line

From randomised studies in men with BPH, permixon appears to give a small improvement in maximum flow rate of about 2 mL/second over placebo in studies of three months or less. Nocturia may be reduced by about one episode per night.

Permixon is a standardised lipid extract of the American dwarf palm tree, Serenoa repens. Its mechanism of action is uncertain, but it may have antiandrogenic properties.


P Boyle et al. Meta-analysis of clinical trials of permixon in the treatment of symptomatic benign prostatic hyperplasia. Urology 2000 55: 533-539.


The review found 13 studies, eleven of which were randomised, and seven placebo controlled. No search strategy is given. Duration was from 21 to 180 days, though most were of less than three months duration. The dosage of permixon was 320 mg/day.

The number of patients, and baseline and end of study figures are given for maximum urinary flow rate and episodes of nocturia. Baseline mean urinary flow rates were generally 9-13 mL/second, with 2-4 episodes of nocturia. In three studies maximum flow rate was estimated from average flow rate.


In randomised studies the mean increase in maximum flow rate with placebo was 0.6 ml/second, and there was an additional 2 mL/second with permixon. The mean number of decreased episodes of nocturia was 0.6 with placebo and an additional 0.5 episodes with permixon.


The results were statistically significant, but the effect was small. Trials used the same preparation, but were of short duration. It was not clear which trials were being combined, and whether they were of sufficient quality to avoid bias.