Version May 2024
| Pharmacologic class | Medication | Initial dose | Titration interval | Maximum dose |
| Phosphodiesterase-5 (PDE-5) inhibitor* | Tadalafil (Cialis) | 5 mg daily | None | 5 mg daily |
| 5-alpha-reductase inhibitors (5-ARIs)¶ | Finasteride (Proscar) | 5 mg daily | None | 5 mg daily |
| Dutasteride (Avodart) | 0.5 mg daily | None | 0.5 mg daily | |
| Beta-3 adrenergic agonists | Mirabegron (Myrbetriq) | 25 mg daily | May increase dose as needed and tolerated after ≥4 weeks | 50 mg daily |
| Vibegron (Gemtesa) | 75 mg daily | None | 75 mg daily | |
| Anticholinergic agentsΔ | Fesoterodine (Toviaz) | 4 mg daily | May increase dose as needed and tolerated after ≥2 weeks | 8 mg daily |
| Tolterodine IR (Detrol) | 1 to 2 mg twice daily | None | 2 mg twice daily | |
| Tolterodine ER (Detrol LA) | 2 to 4 mg daily | 4 mg twice daily | ||
| Oxybutynin IR (Ditropan◊) | 5 mg 2 to 3 times daily | May increase dose as needed and tolerated in 5 mg increments every 1 to ≥2 weeks | 5 mg 4 times daily | |
| Oxybutynin ER (Ditropan XL) | 5 to 10 mg daily | 30 mg daily | ||
| Darifenacin (Enablex) | 7.5 mg daily | May increase dose as needed and tolerated after ≥2 weeks | 15 mg daily | |
| Solifenacin (Vesicare) | 5 mg daily | 10 mg daily | ||
| Trospium IR (Sanctura◊) | 20 mg twice daily (once daily if >75 years old) | None | 20 mg twice daily | |
| Trospium ER (Sanctura XR◊) | 60 mg daily | 60 mg daily |
IR: immediate-release; ER: extended-release.
* PDE-5 inhibitors are a useful choice in men with erectile dysfunction. Tadalafil is approved by the US Food and Drug Administration (FDA) for treatment of signs and symptoms of BPH. Other PDE-5 inhibitors (eg, sildenafil, vardenafil) that are not FDA-approved for this use may also improve BPH symptoms. Do not prescribe in men who take nitrate therapy. In patients taking alpha-1-receptor antagonists or other drugs that lower blood pressure, additive hypotensive effects may be observed.
¶ Generally used for prevention of BPH progression; treatment for 6 to 12 months is typically needed for symptom improvement.
Δ A post-void residual (PVR) should be measured prior to initiating treatment; not recommended for use with elevated PVR (eg, >300 mL).
◊ Branded product no longer available.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
