Prostate enlargement is another term for the medical condition benign prostatic hyperplasia, or BPH. This condition of older males represents progressive overgrowth of the prostate gland that can eventually lead to partial obstruction of urinary flow. Lower urinary tract symptoms caused by prostate enlargement may include weak urine stream, difficulty initiating urination, increased urinary frequency, nighttime awakenings to urinate, urinary urgency and incontinence. Medicines are one option to control the symptoms of prostate enlargement.
Alfuzosin
Alfuzosin is an alpha-1 receptor blocking agent that inhibits prostate and bladder muscle contraction, thereby decreasing urinary obstruction associated with an enlarged prostate. The U.S. Food and Drug Administration approved alfuzosin for the treatment of benign prostatic hyperplasia in 2003. The recommended dose for alfuzosin is 10 mg once daily. The medication is taken with food to improve absorption into the bloodstream. Alfuzosin tablets are an extended-release formulation; the tablets should not be cut, crushed or chewed. Common side effects include dizziness upon standing and lightheadedness.
Tamsulosin
Tamsulosin is an alpha-1 receptor blocking agent approved by the FDA in 1997 for the treatment of symptoms associated with benign prostatic hyperplasia. The drug inhibits the alpha-1 receptor of the prostate and bladder, leading to muscle relaxation and decreased urinary symptoms. The recommended dose of tamsulosin is 0.4 mg once daily. The manufacturer advises that the medication should be taken approximately 30 minutes after a meal. Common side effects of tamsulosin include dizziness upon standing, vertigo and ejaculation disorders. During clinical trials conducted to evaluate the efficacy of tamsulosin, approximately 8 percent of men taking 0.4 mg of the drug daily reported abnormal ejaculation.
Terazosin and Doxazosin
Terazosin and doxazosin were the first alpha-1 receptor blockers approved by the FDA in 1987 and 1990, respectively, for the treatment of symptoms associated with BPH. These drugs are also approved for the treatment of high blood pressure. Unlike alfuzosin and tamsulosin, the initiation of treatment with doxazosin or terazosin requires a several week period during which the drug dose is slowly increased until the daily therapeutic dose is achieved. This process, known as dose titration, prevents adverse effects related to a sudden decrease in blood pressure that can occur with these medications. The recommended initial dose of terazosin is 1 mg once daily with dose titration to the therapeutic dose of 10 mg once daily. Similarly, doxazosin treatment is initiated at 1 mg once daily with dose titration up to the therapeutic dose of 8 mg once daily.
Finasteride and Dutasteride
Finasteride and dutasteride are 5-alpha reductase inhibitors. These medications cause a gradual reduction in the size of the prostate by preventing the formation of the hormone dihydrotestosterone, which promotes prostate growth. The American Urological Association notes that lower urinary tract symptom relief may not be realized for six to 12 months with finasteride or dutasteride. These medications can cause sexual side effects including ejaculatory abnormalities, erectile dysfunction and loss of interest in sexual activity.
