Benign Prostatic Hyperplasia Treatments

BENIGN PROSTATIC HYPERPLASIA TREATMENTS
Generic Brand Form Strength Dose Note
5 ALPHA-REDUCTASE INHIBITORS1
dutasteride Avodart caps 0.5mg 0.5mg once daily • Inhibits type I (liver, skin) and II (genitourinary) 5 alpha-reductase
• >90% suppression of baseline serum DHT
finasteride Proscar tabs 5mg 5mg once daily • Inhibits type II (genitourinary) 5 alpha-reductase
• 70% suppression of baseline serum DHT
ALPHA1-BLOCKERS2,3
alfuzosin Uroxatral ext-rel 
tabs
10mg 10mg daily • Swallow whole
• Take after meal
• Dose titration not needed
doxazosin Cardura scored
tabs
1mg, 
2mg, 4mg, 8mg
Initially 1mg daily; may double dose every 1–2wks; max 8mg daily  
Cardura 
XL
ext-rel 
tabs
4mg, 8mg Initially 4mg daily; may titrate after 3–4wks; max 8mg daily • Swallow whole
• Take with breakfast
silodosin Rapaflo caps 4mg, 8mg 8mg once daily • Take with a meal
• Renal impairment (CrCl 30–50mL/min): 4mg
tamsulosin Flomax caps 0.4mg Initially 0.4mg daily; may increase to 0.8mg daily after 2–4wks • Swallow whole
• Take ½ hr after same meal each day
terazosin Hytrin caps 1mg, 2mg, 5mg, 10mg Initially 1mg daily; max 20mg daily • Give at bedtime
PHOSPHODIESTERASE TYPE 5 INHIBITOR
tadalafil Cialis tabs 2.5mg, 5mg, 10mg*, 20mg* 5mg taken at approximately the same time every day • Also indicated for erectile dysfunction + BPH: take without regard to timing of sexual activity.
• Moderate renal dysfunction (CrCl 30–50mL/min): Initially 2.5mg, may increase to 5mg.
• Severe renal dysfunction (CrCl <30mL/min): not recommended.
• Mild or moderate hepatic impairment: use caution; severe: not recommended.
• Concomitant alpha blockers: not recommended.
• Concomitant potent CYP3A4 inhibitors: max 2.5mg.
TYPE I and II 5 ALPHA-REDUCTASE INHIBITORS1 & ALPHA1-BLOCKER2,3
dutasteride

tamsulosin
Jalyn caps 0.5mg +
0.4mg
1 cap once daily • Swallow whole
• Take ½ hr after same meal each day
NOTES

* These strengths are not indicated for use in BPH.

¹5AR inhibitors lower prostate specific antigen (PSA) levels in a predictable fashion, adjust interpretation of PSA levels accordingly.

²α1-blockers may cause orthostatic hypotension; titrate dose slowly. When therapy has been interrupted for several days or longer, patients should be retitrated from the initial dose.

³Although rare, priapism and subsequent permanent impotence has been associated with the use of α1-blockers and patients should be fully informed of this risk.

Not an inclusive list of medications. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling.

(Rev. 11/2014)

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