Medications Used to Treat Benign Prostatic Hyperplasia 2011

BPH, enlarged prostate treatment may include alpha-1 adrenergic blockers (alpha-blockers), 5-alpha-reductase inhibitors, or combination drugs. Here is information about recommended daily dosages, side effects and precautions for medications approved to treat BPH. Dosage recommendations represent an average range for the treatment of benign prostatic hyperplasia. The precise effective dosage varies from person to person and depends on many factors. Do not make any changes in your medication without consulting your doctor.

Alpha-blockers to Treat BPH

Alpha-blockers approved by the U.S. Food and Drug Administration (FDA) to treat benign prostatic hyperplasia include the following:

  • Cardura/Cardura XL (doxazosin)—1-8 mg daily (doctor will increase dosage slowly); Cardura: 1x/day, morning or evening. Cardura XL: every day with breakfast. Do not chew, cut, or crush tablets.
  • Flomax (tamsulosin)—0.4-0.8 mg; 30 minutes after the same meal every day.
  • Hytrin (terazosin)—1-10 mg (doctor will increase dosage slowly); Take first dose at bedtime; subsequent doses usually taken 1x/day, in the morning.
  • Rapaflo (silodosin)—8 mg (4 mg for men with moderate kidney disease); Take once daily with a meal.
  • Uroxatral (alfuzosin)—10 mg extended release; After the same meal every day. Do not cut or crush tablets.

Alpha-blockers work by blocking alpha-1-adrenergic receptors. These drugs relax muscle tissue in the prostate, bladder neck, and prostate capsule. The result is increased urinary flow and a reduction in urinary symptoms. Side effects include

  • Dizziness (especially when standing up)
  • Headache
  • Fatigue or sleepiness
  • Low blood pressure
  • Shortness of breath
  • Nasal congestion

Rapaflo also can cause retrograde ejaculation.

Alpha-blockers carry a risk of drowsiness or lightheadedness (avoid driving or operating machinery for 24 hours after the first dose or a dose increase). For Cardura and Hytrin, the initial dosage is usually 1 mg to avoid this problem. Dosage increases should be incremental. Don't take Rapaflo if you have severe kidney or liver disease. Don't take Uroxatral if you have liver problems or are taking antifungal drugs, protease inhibitors, or another alpha-blocker for high blood pressure. If you are planning to have cataract surgery, tell your surgeon you are taking an alpha-blocker.

Call your doctor if you develop

  • lightheadedness or dizziness
  • angina (chest or arm pain)
  • shortness of breath
  • a persistent erection
  • a fast or irregular heartbeat
  • swelling in the feet or lower legs

5-alpha-reductase Inhibitors to Treat BPH

These medications include:

  • Avodart (dutasteride)—0.5 mg; Once daily, with or without food.
  • Proscar (finasteride)—5 mg; Once daily, with or without food.
  • 5-alpha-reductase inhibitors work by blocking the enzyme 5-alpha-reductase, which converts testosterone into dihydrotestosterone (a hormone responsible for prostate growth), these drugs cause the prostate to shrink. The drugs are most effective when the prostate is significantly enlarged.

    Side effects are relatively infrequent and include erectile dysfunction (less than 5%), decreased libido, decreased ejaculate volume and swelling of the breasts (1%).

    These drugs usually require about a year to take full effect. Most men must use them indefinitely to control symptoms. Women who are pregnant or could become pregnant should not handle crushed tablets because of risk of birth defects. Do not donate blood while taking drug or for six months after stopping it to avoid passing it on to a woman or fetus.

    Call your doctor if you notice breast tenderness, enlargement or other changes; skin rash; or swelling of the lips.

    Combination Drug to Treat BPH

    Jalyn (dutasteride/tamsulosin) is a combination medication used in the treatment of enlarged prostate. The recommended daily dosage is 0.5 mg dutasteride/0.4 mg tamsulosin, taken 30 minutes after the same meal every day. Precautions and side effects are the same as for each drug (see above).

    Publication Review By: H. Ballentine Carter, M.D.

    Published: 16 Jun 2011

    Last Modified: 23 Oct 2014