Published on: 6/11/2024
The most common medications to treat benign prostatic hypertrophy (BPH) work in two major ways: relax the smooth muscles so urine flows out more freely and shrink the size of the prostate that is blocking urine flow. Alpha-adrenergic receptor blockers (alpha-blockers) and PDE5 inhibitors are the most common and help relax smooth muscle. 5 alpha-reductase inhibitors work by shrinking the size of the prostate.
BPH is treated with a variety of medications to either reduce pressure of urine flow by relaxing smooth muscles or shrinking the size of the prostate that is obstructing urine flow. Each drug is associated with different side effects so you should discuss your medication with your doctor.
This medicine directly relaxes the smooth muscles near the bladder outlet and in the prostate, alleviating lower urinary tract symptoms caused by BPH. The effects may be visible within one week from the day of oral administration. More common side effects include an ejaculation disorder called retrograde ejaculation and dizziness from lowered blood pressure. Additionally, since there is a rare possibility of a complication called intraoperative iris hypotonia syndrome (IFIS) occurring during eye surgery. Please be sure to inform your doctor in advance about the medications you are using before undergoing any surgeries.
Alpha1 blockers include drugs such as alfuzosin, doxazosin, terazosin, tamsulosin, and prazosin.
This medicine causes nitric oxide (NO) to be produced from the walls of blood vessels which indirectly relaxes the smooth muscles of the prostate and urethra. By relaxing the smooth muscles, urine can flow more freely and alleviate symptoms of BPH. The effects may be visible within one week from the day of oral administration. More common side effects include gastrointestinal symptoms, hot flashes, low blood pressure, and headache. Depending on the dose, PDE5 inhibitors can also be used to treat erectile dysfunction and erectile dysfunction (ED). However, if you are taking nitrate drugs used to treat heart conditions like high blood pressure or coronary artery disease, these medicines should not be used together as they can cause your blood pressure to drop.
PDE5 inhibitors include drugs such as sildenafil, vardenafil, tadalafil, and avanafil.
This medicine suppresses prostate cell growth caused by male hormones which then leads to shrinking the prostate gland. By shrinking the prostate gland, pressure is relieved on the smooth flow of urine, relieveing symptoms of BPH. The effects usually gradually become noticeable within 1 month to 6 months from the start of oral administration. The main side effects include erectile dysfunction, ejaculation problems, decreased libido, and gynecomastia. Your provider will often check a prostate-specific antigen (PSA) tumor marker when starting this medication to establish a baseline as this medication can lower it.
5α-reductase inhibitors include drugs such as finasteride and dutasteride.
(References)
Langan RC. Benign Prostatic Hyperplasia. Prim Care. 2019 Jun;46(2):223-232. doi: 10.1016/j.pop.2019.02.003. Epub 2019 Apr 1. PMID: 31030823.
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