From the Guidelines
Medications can significantly affect benign prostatic hyperplasia (BPH), with alpha-blockers and 5-alpha reductase inhibitors being primary treatment options. The main medications used to treat BPH include alpha-blockers like tamsulosin (Flomax), alfuzosin (Uroxatral), and doxazosin (Cardura), which relax the prostate and bladder muscles to improve urine flow, as noted in studies such as 1. These typically work within days to weeks and are taken daily. 5-alpha reductase inhibitors such as finasteride (Proscar) and dutasteride (Avodart) shrink the prostate by blocking the hormone that causes prostate growth, though they take 3-6 months to show full effect, as discussed in 1 and 1.
Some key points to consider in the treatment of BPH include:
- Combination therapy using both an alpha-blocker and a 5-alpha reductase inhibitor is often more effective than either medication alone for men with larger prostates, as seen in studies like 1.
- Certain medications can worsen BPH symptoms, including antihistamines, decongestants, and anticholinergics found in over-the-counter cold and allergy medications, which work by tightening muscles in the prostate and bladder neck, potentially increasing urinary symptoms.
- Men with BPH should check with their doctor before taking these medications to avoid worsening their condition, highlighting the importance of personalized medical advice.
The most recent and highest quality study, 1, provides strong recommendations for the management of lower urinary tract symptoms attributed to BPH, including the use of combination therapy for patients with demonstrable prostatic enlargement. This study supports the use of alpha-blockers and 5-alpha reductase inhibitors as primary treatment options for BPH, and emphasizes the importance of considering the size of the prostate and the presence of symptoms when selecting a treatment approach.
From the FDA Drug Label
Tadalafil tablets are indicated for the treatment of the signs and symptoms of benign prostatic hyperplasia (BPH). The efficacy and safety of tadalafil for once daily use for the treatment of the signs and symptoms of BPH was evaluated in 3 randomized, multinational, double-blinded, placebo-controlled, parallel-design, efficacy and safety studies of 12 weeks duration In each of these 2 trials, tadalafil 5 mg for once daily use resulted in statistically significant improvement in the total IPSS compared to placebo
Tadalafil can affect BPH by improving the signs and symptoms of the condition, as evidenced by statistically significant improvements in the total International Prostate Symptom Score (IPSS) in clinical trials 2.
- The medication has been shown to be effective in treating BPH, with improvements in IPSS scores starting at 4 weeks and remaining decreased through 12 weeks.
- Tadalafil has also been shown to be effective in treating ED and BPH simultaneously, with improvements in both conditions observed in clinical trials 2.
From the Research
Medications Affecting BPH
- Medications such as alpha blockers and 5-alpha reductase inhibitors can affect Benign Prostatic Hyperplasia (BPH) 3, 4, 5, 6
- Alpha blockers, including tamsulosin, alfusosin, and silodosin, can help relax the muscles in the prostate and bladder neck, making it easier to urinate 3, 4, 5
- 5-alpha reductase inhibitors, such as finasteride and dutasteride, can help shrink the prostate, reducing the risk of urinary retention and the need for surgery 3, 6
Treatment Options
- Combination therapy of 5-alpha reductase inhibitors and alpha blockers may be effective for treating lower urinary tract symptoms secondary to BPH 6
- Double dose alpha-blocker treatment may be superior to single dose treatment for managing patients with acute urinary retention caused by BPH 7
- Phosphodiesterase-5 (PDE-5) inhibitors, such as tadalafil, may also be considered for treating BPH-related symptoms 3