Benign Prostatic Hyperplasia Treatments
BENIGN PROSTATIC HYPERPLASIA TREATMENTS
Generic Brand Strength Form Dose Note
5 ALPHA-REDUCTASE INHIBITORS1
dutasteride Avodart 0.5mg caps Monotherapy: 0.5mg once daily. Combination: 0.5mg once daily with tamsulosin 0.4mg once daily.

• Swallow whole

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

• >90% suppression of baseline serum DHT

finasteride Proscar 5mg tabs Monotherapy: 5mg once daily. Combination: 5mg once daily with doxazosin.

• Inhibits type II (genitourinary) 5 alpha-reductase

• 70% suppression of baseline serum DHT

ALPHA1-BLOCKERS2,3
alfuzosin Uroxatral 10mg ext‑rel 
tabs
10mg once 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 once daily. Titrate to 10mg once daily; usual max 20mg/day. Reevaluate if no response after 6wks.

• Give at bedtime

PHOSPHODIESTERASE TYPE 5 INHIBITOR2
tadalafil Cialis3 2.5mg, 5mg, 10mg*, 20mg* tabs Monotherapy: 5mg once daily at the same time each day. Combination: 5mg once daily with finasteride for up to 26wks.

• 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.

• 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

TYPE II 5 ALPHA-REDUCTASE INHIBITOR1 + PHOSPHODIESTERASE TYPE 5 INHIBITOR
finasteride/
tadalafil
Entadfi3 5mg/5mg caps 1 cap once daily at the same time each day for up to 26wks

• Take on empty stomach

NOTES

* These strengths are not indicated for use in BPH.

¹ 5AR inhibitors lower prostate specific antigen (PSA) levels in a predictable fashion, adjust interpretation of PSA levels accordingly.

² α1-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. Symptomatic hypotension can occur with concomitant α1-blockers and PDE5 inhibitors.

³ Although rare, priapism and subsequent permanent impotence has been associated with use 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. 10/2022)