What is the best tablet for enlarged prostate?

Finasteride and dutasteride are examples of 5-alpha reductase inhibitors. These medications prevent the progression of prostate growth or, in some cases, actively shrink the prostate.

medicalnewstoday.com - Best medications for an enlarged prostate: Types

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An enlarged prostate is benign and usually results from abnormal cell growth. Pharmaceutical treatments include alpha-blockers, inhibitors, and combination medications. Share on Pinterest JGI/Tom Grill/Getty Images The prostate is a gland that produces fluid that carries sperm during ejaculation. The prostate sits around the urethra, the tube that carries urine out of the body. An enlarged prostate is also known as benign prostatic hyperplasia (BPH) — a noncancerous abnormal cell growth. Although the symptoms of BPH sometimes present similarly to those of prostate cancer, doctors do not link the two, and BPH does not increase a person’s chance of cancer. A doctor will help a person choose the appropriate treatment for BPH based on the severity of their symptoms and their overall health. In this article, we look at why a person may need medication for BPH, as well as the available types of medication and some alternative treatment options. Alpha blockers Alpha blockers are drugs that help relax the muscles close to the prostate. This relieves pressure and allows urine to flow more easily. Examples of alpha blockers include : tamsulosin

doxazosin

alfuzosin

prazosin

terazosin These types of alpha-blockers are called selective alpha-1 blockers. They treat BPH by causing the prostate’s smooth muscle to relax, allowing urine to flow freely through the urethra. Potential side effects Potential side effects of alpha blockers include: weakness

rapid heartbeat, or tachycardia

low blood pressure, or hypotension

tremors To help avoid these adverse effects, doctors recommend that people take the medication at night. 5-alpha reductase inhibitors 5-alpha reductase inhibitors block the production of the male sex hormone dihydrotestosterone, which accumulates in the prostate and may cause the prostate to grow. Finasteride and dutasteride are examples of 5-alpha reductase inhibitors. These medications prevent the progression of prostate growth or, in some cases, actively shrink the prostate. Doctors generally prescribe 5-alpha reductase inhibitors for moderately enlarged prostates because they work more slowly than alpha blockers. Potential side effects Side effects of 5-alpha reductase inhibitors may include : decreased libido

erectile dysfunction

decreased ejaculatory volume

growth of breast tissue, or gynecomastia

low blood pressure

weakness

dizziness

decreased fertility

PDE5 inhibitors Doctors typically prescribe phosphodiesterase-5 (PDE5) inhibitors to treat erectile dysfunction. These medications work by relaxing the smooth muscles in the lower urinary tract, which helps relieve symptoms of BPH. Some examples of PDE5 inhibitors are : sildenafil (Viagra)

tadalafil

vardenafil For penile erection, nerve impulses cause the production of nitric oxide, which diffuses into the smooth muscle cells and stimulates the formation of messenger molecules called cyclic guanosine monophosphate (cGMP). This elicits cellular activity. PDE5 inhibitors inhibit an enzyme called PDE5, which prevents the breakdown of cGMP. This allows the smooth muscle in the prostate to relax, promoting the dilation of penile arteries and the increase in blood flow necessary for a sustained erection. Potential side effects Side effects of PDE5 medications may include: flushing of the skin

mild headache

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dyspepsia, or indigestion

low blood pressure

dizziness

altered color vision

back pain

rhinitis, or blocked and stuffy nose

Antimuscarinic drugs Doctors may also prescribe antimuscarinic drugs for BPH. Examples include: mirabegron

oxybutynin

solifenacin

tolterodine

darifenacin

trospium

fesoterodine Potential side effects Several side effects are associated with these drugs, including: dry mouth

pruritus, or itchiness of the skin

constipation

urination difficulties

nasopharyngitis, or the common cold

dizziness However, the most serious side effect of antimuscarinic drugs is acute urinary retention (AUR). According to some research, people who received antimuscarinic treatment for 1 month had a higher incidence of AUR than those who received long-term treatment. Research has also found that anticholinergic and antispasmodic medications may worsen BPH symptoms. The researchers associate anticholinergic drugs with a higher risk of urinary retention in people with BPH. Desmopressin Doctors typically prescribe desmopressin to treat symptoms of a type of diabetes insipidus, which causes the body to overproduce urine. The medication can help with nocturia, the frequent need to urinate during the night. Research associates nocturia with lower urinary tract symptoms in people with BPH. In BPH treatment, doctors may combine the medication with other treatments, such as alpha blockers. Potential side effects of desmopressin may include abnormal thinking and diarrhea. This medication may also cause potentially serious side effects such as: nausea and vomiting

fatigue

confusion

headache

weight gain

restlessness

irritability

slow reflexes

hallucinations

seizures

muscle weakness or spasms

loss of consciousness

Combinations Combining two types of medication can be more effective for treating symptoms than one medication alone. The following medication combinations can be effective: alpha blockers and antimuscarinics, which help manage overactive bladder

dutasteride (a 5-alpha reductase inhibitor) and tamsulosin (an alpha blocker)

finasteride (a 5-alpha reductase inhibitor) and doxazosin (an alpha blocker)

Do all people with BPH require medication? A person may not need treatment for a mildly enlarged prostate that is not causing significant symptoms. In such cases, a person may need to visit a urologist for regular checkups and may need treatment only if the symptoms become problematic. If the symptoms of BPH begin to bother a person, a doctor may prescribe medication to shrink the prostate or stop its growth. This may reduce associated symptoms such as: difficulty when starting to urinate