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BPH Treatment Options

BPH Medications

If you are diagnosed with BPH, your primary care physician or urologist may prescribe medication to help relieve your symptoms. BPH medication typically falls into two categories:

  • Alpha-blockers, and

  • 5-Alpha Reductase Inhibitors (5-ARIs)

You may start with one type and then, if your symptoms do not improve sufficiently, you may be prescribed the other type or given a combination of both types of medication. These two medications are the most common.1 However, there are others that your doctor may prescribe to treat your BPH.

What’s the Difference between the Two Medications?

Alpha-blockers work to relax the muscles in the bladder and prostate to increase urinary flow.1 They do not shrink the prostate, but they can improve urine flow by relaxing the muscles.

There are several types of Alpha-blockers, including the following:

  • Tamsulosin (Flomax®)

  • Silodosin (Rapaflo®)

  • Alfuzosin (Uroxatral®)

  • Doxazosin (Cardura®)

  • Trazosin (Hytrin™)

Although there are slight differences in the side effect profiles of these medications, they are all considered to have similar effectiveness.2

5-Alpha Reductase Inhibitors (5-ARIs) can sometimes cause prostate shrinkage by blocking a male hormone called Dihydrotestosterone (DHT).1  You will have to be patient though, as it can take up to 6 months to see results.2

The most common 5-ARIs prescribed are:

  • Finasteride (Proscar®) and

  • Dutasteride (Avodart®)

Both have been found to have similar effectiveness. These medications are typically best for men with large prostate glands.

Benefits and Risks of Medications

Disappointed Man with Open Pill Bottle in Bathroom-1

For some men, BPH medications can be effective, well tolerated and may be all they need.1

Some common downsides of BPH medications include adverse side effects, lack of symptom improvement, cost, and inconvenience. Potential side effects of these BPH medications may include:

  • Dizziness

  • Headaches

  • Fatigue and

  • Adverse sexual side effects
    (including, but not limited to, decreased sex drive and enlargement or swelling of breast tissue)2

If you are planning to have cataract surgery soon, it is recommended that you avoid alpha-blockers as they may increase the risk of complications.1

New research has shown that other potential side effects from BPH medications may include an increased risk of stroke, dementia, and depression.4,5

It is important to understand that although 5-ARIs can shrink the prostate, continued use is required to sustain the effect. Patients on long term medical therapy often do not adhere to treatment, and if BPH is left untreated, this can lead to poor bladder health.6

If you are dissatisfied with your BPH medication, remember to speak with your doctor about other treatment options to address your BPH and potentially reduce your reliance on medication. Many men eventually find the side effects of these medications to be disruptive to their health and quality of life.3

There are alternative options to medication to help you in your BPH treatment journey.

See BPH treatment options here.

 

 

References

1.  BPH Patient Guide – Urology Care Foundation
2. EAU BPH Guidelines 2019
3. McConnell, N Engl J Med 2003;349:2387-98
4. Lai et al, CMAJ. 2016
5. Welk et al, J Neurol Sci. 2017
6. Tubaro et al. 2003 Drugs Aging

Flomax is a registered trademark of Astellas Pharma Inc. Rapaflo is a registered trademark of Allergan Sales, LLC.
Uroxatral is a registered trademark of Concordia Pharmaceuticals Inc. Cardura is a registered trademark if Pfizer, Inc.
Hytrin is a trademark of AbbVie Inc. Proscar is a registered trademark of Merck Sharp & Dohme Corp. Avodart is a
registered trademark of GlaxoSmithKline LLC.

 

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