Benign prostatic hypertrophy: Difference between revisions

Latest revision as of 15:31, 20 February 2023

Non-pharmacologic management:
- Avoid fluids before bedtime or going out
- Decrease caffeine and alcohol intake
- Double voiding to empty the bladder more completely
First-line medications are alpha-1 blockers
- Tamsulosin 0.4 mg p.o. daily, 30 minutes after a meal
  - Can be increased to 0.8 mg p.o. daily if no response after 2 to 4 weeks
- Silodosin 8 mg p.o. daily
- Alfuzosin 10 mg p.o. daily
Second-line medications include:
- 5-alpha-reductase inhibitors (5-ARIs):
  - Dutasteride 0.5 mg p.o. daily
  - Finasteride 5 mg p.o. daily
- PDE-5 inhibitors: tadalafil 5 mg p.o. daily
- Beta-3 adrenergic agonists: mirabegron 25 mg p.o daily, can increase to 50 mg after 4 weeks
- Anticholinergics:
  - Tolterodine IR 1 to 2 mg p.o. twice daily or ER 2 to 4 mg p.o. daily
  - Oxybutynin IR 5 mg p.o. bid to tid, or ER 5 to 10 mg p.o. daily
  - Solifenacin 5 mg p.o. daily, can increase to 10 mg after 2 weeks

@@ Line 5: / Line 5: @@
 ** Decrease caffeine and alcohol intake
 ** Double voiding to empty the bladder more completely
-* First-line medications include alpha-1 blockers
+* First-line medications are alpha-1 blockers
 ** [[Tamsulosin]] 0.4 mg p.o. daily, 30 minutes after a meal
 *** Can be increased to 0.8 mg p.o. daily if no response after 2 to 4 weeks
 ** [[Silodosin]] 8 mg p.o. daily
 ** [[Alfuzosin]] 10 mg p.o. daily
+* Second-line medications include:
+** 5-alpha-reductase inhibitors (5-ARIs):
+*** [[Dutasteride]] 0.5 mg p.o. daily
+*** [[Finasteride]] 5 mg p.o. daily
+** PDE-5 inhibitors: [[tadalafil]] 5 mg p.o. daily
+** Beta-3 adrenergic agonists: [[mirabegron]] 25 mg p.o daily, can increase to 50 mg after 4 weeks
+** Anticholinergics:
+*** [[Tolterodine]] IR 1 to 2 mg p.o. twice daily or ER 2 to 4 mg p.o. daily
+*** [[Oxybutynin]] IR 5 mg p.o. bid to tid, or ER 5 to 10 mg p.o. daily
+*** [[Solifenacin]] 5 mg p.o. daily, can increase to 10 mg after 2 weeks
 [[Category:Urology]]