Enlarged Prostate: 2 Types of Medication That Work

Reviewed by Brunilda Nazario, MD, March 2006

There are two classes of drugs used to treat symptoms of benign prostatic hyperplasia (BPH), also called enlarged prostate: alpha blockers and 5-alpha reductase inhibitors.

Alpha blockers:

• Flomax (tamsulosin)
• Uroxatral (alfuzosin)
• Hytrin (terazosin)
• Cardura (doxazosin)

These drugs relax the muscles of the prostate and bladder neck. This causes an increased flow of urine, which helps relieve many BPH symptoms. They begin working almost immediately to provide moderate and sometimes dramatic relief. The two newer medications, Flomax and Uroxatral, are more effective with fewer side effects than the older drugs, Hytrin and Cardura.

Side effects can include lightheadedness, fatigue, stomach or intestinal problems, stuffy nose, headache, dizziness, tiredness. In rare cases, patients have low blood pressure.

5-Alpha Reductase Inhibitors:

• Avodart (dutasteride)
• Proscar (finasteride)

These drugs help shrink the enlarged prostate and may prevent further growth. They usually provide modest symptom relief, may help with urinary retention (inability to urinate), and may prevent the need for surgery. However, symptom relief may not occur until after the medication is taken for three to six months.

Side effects can include inability to achieve an erection, decreased sexual desire, and reduced amount of semen. Also, the drugs do change the result of PSA tests, so that test may need to be repeated while you are on the medication. The PSA level will need to be interpreted differently while you are on this medication, usually doubling the result to obtain the true value.

Published March 2006.

SOURCES: American Urological Association: "Benign Prostatic Hyperplasia (BPH): A Patient's Guide," "Benign Prostatic Hyperplasia (BPH)."