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Benign prostatic hypertrophy (BPH) - Medications
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alfuzosin (UroXatral ®)
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Oral: Adults: BPH: 10 mg once daily Dosage adjustment in renal impairment: Bioavailability and maximum serum concentrations are increased by ~50% with mild, moderate, or severe renal impairment Note: Safety has not been evaluated in patients with creatinine clearances <30 mL/minute. Dosage adjustment in hepatic impairment: Mild hepatic impairment: Use has not been studied. Moderate or severe hepatic impairment (Child-Pugh class B and C): Clearance is decreased 1 /3 to 1 /4 and serum concentration is increased three- to fourfold; use is contraindicated Administration Tablet should be swallowed whole; do not crush or chew. Administer once daily (with a meal); should be taken at the same time each day. [ Supplied: 10mg extended release tablet.] |
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doxazosin (Cardura ®)
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Mechanism of Action Competitively inhibits postsynaptic alpha-adrenergic receptors which results in vasodilation of veins and arterioles and a decrease in total peripheral resistance and blood pressure; approximately 50% as potent on a weight by weight basis as prazosin Oral: Adults: 1 mg once daily in morning or evening; may be increased to 2 mg once daily. Thereafter titrate upwards, if needed, over several weeks, balancing therapeutic benefit with doxazosin-induced postural hypotension Hypertension: Maximum dose: 16 mg/day BPH: Goal: 4-8 mg/day; maximum dose: 8 mg/day Elderly: Initial: 0.5 mg once daily [Supplied 1 mg, 2 mg, 4 mg, 8 mg tablets] |
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dutasteride (Avodart ®)
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Mechanism: competitive, selective inhibitor of both
reproductive tissues (type 2) and skin and hepatic (type 1)
5alpha-reductase. This results in inhibition of the conversion of
testosterone to dihydrotestosterone and markedly suppresses serum
dihydrotestosterone levels. Adult (usual) - (BPH): 0.5 mg orally once daily. [Supplied: 0.5 mg capsule] |
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finasteride (Proscar ®):
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Use - Propecia®:
Treatment of male pattern hair loss in men only . Safety and efficacy
were demonstrated in men between 18-41 years of age. Proscar®: Treatment of symptomatic benign prostatic hyperplasia (BPH); can be used in combination with an alpha blocker, doxazosin Mechanism of Action- Finasteride is a competitive inhibitor of both tissue and hepatic 5-alpha reductase. This results in inhibition of the conversion of testosterone to dihydrotestosterone and markedly suppresses serum dihydrotestosterone levels Dosing - Oral: Adults: Male: Benign prostatic hyperplasia (Proscar®): 5 mg/day as a single dose; clinical responses occur within 12 weeks to 6 months of initiation of therapy; long-term administration is recommended for maximal response Male pattern baldness (Propecia®): 1 mg daily Female hirsutism (unlabeled use): 5 mg/day Supplied Tablet [film coated]: Propecia®: 1 mg Proscar®: 5 mg |
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tamsulosin (Flomax ®):
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Mechanism of Action Tamsulosin is an antagonist of alpha1A adrenoreceptors in the prostate. Smooth muscle tone in the prostate is mediated by alpha1A adrenoreceptors; blocking them leads to relaxation of smooth muscle in the bladder neck and prostate causing an improvement of urine flow and decreased symptoms of BPH. Approximately 75% of the alpha1 receptors in the prostate are of the alpha1A subtype. Dosage - Oral: Adults: BPH: 0.4 mg once daily ~30 minutes after the same meal each day; dose may be increased after 2-4 weeks to 0.8 mg once daily in patients who fail to respond. If therapy is interrupted for several days, restart with 0.4 mg once daily. Dosage adjustment in renal impairment: Clcr >/= 10 mL/minute: No adjustment needed Clcr<10 mL/minute: Not studied [Supplied: 0.4 mg capsule] |
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terazosin (Hytrin ®):
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Mechanism of Action Alpha1-specific blocking agent with minimal alpha2 effects; this allows peripheral postsynaptic blockade, with the resultant decrease in arterial tone, while preserving the negative feedback loop which is mediated by the peripheral presynaptic alpha2-receptors; terazosin relaxes the smooth muscle of the bladder neck, thus reducing bladder outlet obstruction Oral: Adults: Hypertension: Initial: 1 mg at bedtime; slowly increase dose to achieve desired blood pressure, up to 20 mg/day; usual dose range (JNC 7): 1-20 mg once daily Dosage reduction may be needed when adding a diuretic or other antihypertensive agent; if drug is discontinued for greater than several days, consider beginning with initial dose and retitrate as needed; dosage may be given on a twice daily regimen if response is diminished at 24 hours and hypotensive is observed at 2-4 hours following a dose Benign prostatic hyperplasia: Initial: 1 mg at bedtime, increasing as needed; most patients require 10 mg day; if no response after 4-6 weeks of 10 mg/day, may increase to 20 mg/day [Supplied 1, 2, 5, 10 mg capsule] |
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Listed dosages are for - Adult patients ONLY. PLEASE READ THE
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