Benign Prostatic Hyperplasia Drug Summary

Last updated: 21 October 2025
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Drugs for Bladder & Prostate Disorders

Drug Dosage Remarks
Alpha Blockers
Alfuzosin HCl 10 mg PO 24 hourly Adverse Reactions
  • CNS effects (dizziness, headache, vertigo); CV effect (postural hypotension); GI effects (abdominal pain, indigestion, nausea, diarrhea, dry mouth); Other effect (asthenia)
Special Instructions
  • Use with caution in patients with severe hepatic impairment, history of marked hypotension with another alpha blocker, acute heart failure and angina, and lactose intolerance
  • Contraindicated in patients with postural hypotension and liver impairment
  • Co-administration with other alpha-1 receptor blockers should be avoided
Doxazosin mesylate Immediate-release:
Initially 1 mg PO 24 hourly, may be increased to 2 mg then to 4 mg and up to max dose of 8 mg
Titration interval: 1-2 weeks
Usual dose: 2-4 mg PO 24 hourly
Max dose: 16 mg/day
Extended-release:
4 mg PO 24 hourly 		Adverse Reactions
  • CNS effects (headache, vertigo); CV effect (postural hypotension)
Special Instructions
  • Use with caution in patients with hepatic impairment, pre-existing severe GI narrowing, postural hypotension, intraoperative floppy iris syndrome (IFIS)
  • Contraindicated in patients with hypersensitivity to quinazolines
Silodosin 4 mg PO 12 hourly Adverse Reactions
  • Genitourinary effect (retrograde ejaculation); GI effects (thirst, diarrhea)
Special Instructions
  • Use with caution in patients with orthostatic hypotension, impaired hepatic and renal function
Tamsulosin HCl 0.2-0.4 mg PO 24 hourly
May increase up to 0.8 mg PO 24 hourly after 2-4 weeks		 Adverse Reactions
  • CNS effects (headache, dizziness); GI effects (diarrhea, nausea/vomiting, constipation); Dermatologic effects (rash, urticaria); CV effects (palpitations, postural hypotension); Genitourinary effect (abnormal ejaculation)
Special Instructions
  • Use with caution in patients with known orthostatic hypotension, hepatic and mild to moderate renal dysfunction
  • Contraindicated in patients with severe hepatic/renal impairment and in IFIS during cataract surgery
Terazosin HCl Initial dose: 1 mg PO 24 hourly at bedtime, increase to 2 mg then to 5 mg or 10 mg
Titration interval: 1 week
Maintenance dose: 5-10 mg PO 24 hourly
Max dose: 20 mg PO 24 hourly 		Adverse Reactions
  • CNS effects (headache, somnolence, nervousness, paresthesia); CV effects (postural hypotension, palpitations); Respiratory effects (dyspnea, nasal congestion, sinusitis); Other effects (blurred vision, asthenia, impotence)
Special Instructions
  • Contraindicated in patients with heart failure due to aortic or mitral valve stenosis, pulmonary embolism and restrictive pericardial disease
  • Monitor BP
5-alpha Reductase Inhibitors
Dutasteride 0.5 mg PO 24 hourly Adverse Reactions
  • Genitourinary effects (impotence, decreased libido, ejaculation disorders); Dermatologic effects (rash, pruritus, urticaria, localized edema, angioedema); Other effects (breast enlargement and/or tenderness)
Special Instructions
  • Contraindicated in patients with severe hepatic impairment, history of orthostatic hypotension
Finasteride 5 mg PO 24 hourly Adverse Reactions
  • Genitourinary effects (decreased libido and volume of ejaculate, erectile dysfunction); Other effect (depressed mood)
Special Instructions
  • Monitor PSA levels in serum before initiating and during therapy
  • Monitor for obstructive uropathy
  • Use with caution in patients with hepatic impairment
Phosphodiesterase Type 5 Inhibitor
Tadalafil 5 mg PO 24 hourly Adverse Reactions
  • CNS effect (headache); GI effects (dyspepsia, gastroesophageal reflux); Other effects (back pain, myalgia, nasal congestion)
Special Instructions
  • Contraindicated in patients with known CV disease, myocardial infarction within the last 90 days, unstable angina or angina occurring during sexual intercourse, NYHA Class ≥2 heart failure in the last 6 months, uncontrolled arrhythmias, hypotension (<90/50 mmHg) or uncontrolled hypertension, stroke within the last 6 months, had loss of vision in one eye due to non-arteritic ischemic optic neuropathy (NAION) and those taking nitrates
  • Use with caution in patients with severe renal or hepatic insufficiency, hematological disorders, galactose intolerance, and those taking antihypertensives and alpha blockers
Combination Products
Dutasteride/Tamsulosin HCl Dutasteride 0.5 mg/Tamsulosin 0.4 mg PO 24 hourly Adverse Reactions
  • Genitourinary effects (ejaculation disorders, impotence, decreased libido); CNS effect (dizziness); Other effects (breast enlargement and/or tenderness)
Special Instructions
  • Monitor for acute/chronic urinary retention
  • Assess PSA levels after 6 months of treatment
  • Contraindicated in patients with history of orthostatic hypotension and severe hepatic impairment
Finasteride/Tamsulosin HCl Finasteride 5 mg/Tamsulosin HCl 0.2 mg PO 24 hourly
May be titrated up to Finasteride 5 mg/Tamsulosin HCl 0.4 mg PO 24 hourly 		Adverse Reactions
  • Genitourinary effects (impotence, decreased libido and ejaculation volume, ejaculation disorders); GI effects (occasionally nausea/vomiting, diarrhea); Other effects (breast enlargement and/or tenderness, rash, hypersensitivity reactions)
Special Instructions
  • Evaluate for prostatic cancer before initiating therapy
  • Use with caution in patients with severe renal impairment and IFIS
  • Contraindicated in patients with orthostatic hypotension and severe hepatic impairment
Other Drugs Used in the Treatment of BPH
Saw palmetto extract1 160 mg PO 12-24 hourly Adverse Reactions
  • CNS effects (headache, dizziness, insomnia); Dermatologic effects (rash, pruritus); GI disturbances; Other effects (breast pain, gynecomastia, bleeding disorder, heart failure, agranulocytosis)
Special Instructions
  • Use with caution in patients with bleeding disorders
  • Should not be used prior to surgical/dental procedures
1Combinations with Urtica dioica or other nutrients are available. Please see the latest MIMS for specific formulations and prescribing information.

Other Antihypertensives

Drug Dosage Remarks
Alpha-adrenoreceptor Antagonist
Prazosin 0.5 mg PO 12 hourly for 3-7 days
Then adjust dose according to clinical response
Max maintenance dose:
2 mg PO 12 hourly 		Adverse Reactions
  • CNS effect (headache); CV effect (postural hypotension); GI effects (GI upset, dry mouth); Other effects (incontinence, edema, impotence, tinnitus, nasal congestion)
Special Instructions
  • Contraindicated in patients with hypersensitivity to quinazolines
  • Use with caution in patients with left ventricular failure due to mechanical obstruction

Disclaimer

All dosage recommendations are for non-pregnant and non-breastfeeding women, and non-elderly adults with normal renal and hepatic function unless otherwise stated.  
Not all products are available or approved for above use in all countries.  
Products listed in the Drug Summary are based on indications stated in the locally approved product monographs.   
Please refer to local product monographs in Related MIMS Drugs for country-specific prescribing information.  

Related MIMS Drugs