I’m Taking Medications for BPH (enlarged prostate).  Do I Have to Take Them Forever?

by Alex Shteynshlyuger MD

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Medications Are Effective While You Take Them

Men who are treated with medications such as alpha-blockers (Flomax, Uroxatral, Rapaflo) or alpha-reductase inhibitors such as finasteride (Proscar) or Avodart (dutasteride) typically need to continue taking these medications as long as their symptoms are well-controlled with medications.  These medications work only as long as they are taken.  If these medications are stopped the symptoms will typically recur.

shutterstock_300724364Medications for an enlarged prostate are similar to medications for high blood pressure, which are usually taken as long as they work.  If a medication stops working, other treatment options will need to be discussed which may be combination therapy with different medications or minimally invasive office procedures or surgical treatment.

Alternative Treatments to Taking Medications Every Day

For patients who do not wish to take medications every day or who have side effects or cannot tolerate medications, in-office procedures such as Urolift and Rezum procedure are effective alternatives.  For men with larger prostates laser enucleation of the prostate, bipolar TURP or Greenlight laser are one-time treatments after which you should not need to take medications daily for enlarged prostate.

What Types of Medications are Used for Men with Symptoms of Enlarged Prostate?

Alpha-blockers are the most commonly used medications for enlarged prostate. They are effective and the benefit is often seen within days of starting the medication.  Common alpha-blocker medications include Flomax, Uroxatral, and Rapaflo.

Alpha-reductase inhibitors are medications that block the androgen signaling and decrease the size of the prostate. The most commonly used medication is called Proscar or finasteride.  Avodart is also often used. 

PDE5-inhibitor, in particular, Cialis 5 mg daily is often used for men with mild symptoms of enlarged prostate and BPH. The added benefit is that it helps with getting better erections.

Combination Therapy for Enlarged Prostate

When one medication does not work sufficiently well, combination therapy with an alpha-blocker medication such as Flomax or Rapaflo and an alpha-reductase inhibitor such as finasteride (Proscar) are more effective together than either one alone. 

In addition, other medications can be used in addition to alpha-blockers and alpha-reductase inhibitors, most often medication for overactive bladder symptoms such as oxybutynin, Detrol or Vesicare.

A prostate that is too big or a large median lobe are common reasons for medications to stop working.

For men who do not want to take medications for enlarged prostate, other treatment options available including microwave therapy for enlarged prostate, Greenlight laser and Urolift for BPH.

If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: (646) 663-4044

We offer affordable, highest-quality urology care with or without insurance.   Find out our office hours or directions to our office. We offer weekday, weekend, and evening office hours.