Benign Prostatic Hyperplasia Treatments

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BENIGN PROSTATIC HYPERPLASIA TREATMENTS
Generic Brand Strength Form Dose Note
5 ALPHA-REDUCTASE INHIBITORS1
dutasteride Avodart 0.5mg caps 0.5mg once daily

• Inhibits type I (liver, skin) and II (genitourinary) 5 alpha-reductase

• >90% suppression of baseline serum DHT

finasteride Proscar 5mg tabs 5mg once daily

• Inhibits type II (genitourinary) 5 alpha-reductase

• 70% suppression of baseline serum DHT

ALPHA1-BLOCKERS2,3
alfuzosin Uroxatral 10mg ext‑rel 
tabs
10mg daily

• Swallow whole

• Take after same meal each day

• Dose titration not needed

doxazosin Cardura 1mg, 
2mg, 4mg, 8mg
scored
tabs
Initially 1mg daily; may double dose every 1−2wks; max 8mg daily  
Cardura 
XL
4mg, 8mg ext‑rel 
tabs
Initially 4mg daily; may titrate after 3−4wks; max 8mg daily

• Swallow whole

• Take with breakfast

silodosin Rapaflo 4mg, 8mg caps 8mg once daily

• Take with a meal

• Renal impairment (CrCl 30−50mL/min): 4mg

tamsulosin Flomax 0.4mg caps Initially 0.4mg daily; may increase to 0.8mg daily after 2−4wks

• Swallow whole

• Take ½ hr after same meal each day

terazosin 1mg, 2mg, 5mg, 10mg caps Initially 1mg daily; max 20mg daily

• Give at bedtime

PHOSPHODIESTERASE TYPE 5 INHIBITOR
tadalafil Cialis 2.5mg, 5mg, 10mg*, 20mg* tabs 5mg taken at approxi-
mately 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 0.5mg +
 0.4mg
caps 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. 11/2017)

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