5-Alpha-Reductase Inhibitors and Combination Therapy

Claudius Füllhase; Marc P Schneider

doi:10.1016/j.ucl.2016.04.003

5-Alpha-Reductase Inhibitors and Combination Therapy

Urol Clin North Am. 2016 Aug;43(3):325-36. doi: 10.1016/j.ucl.2016.04.003.

Authors

Claudius Füllhase¹, Marc P Schneider²

Affiliations

¹ Department of Urology, University of Rostock, Ernst-Heydemann-Str. 6, Rostock 18057, Germany. Electronic address: Claudius.fuellhase@uni-rostock.de.
² Department of Health Science and Technology, Swiss Federal Institute of Technology Zurich, Brain Research Institute, University of Zurich, Winterthurerstrasse 190, Zürich 8057, Switzerland.

PMID: 27476125
DOI: 10.1016/j.ucl.2016.04.003

Abstract

By inhibiting the conversion from testosterone to dihydrotestosterone 5-Alpha reductase inhibitors (5ARIs) are able to hinder prostatic growth, shrink prostate volumes, and improve BPH-related LUTS. 5ARIs are particularly beneficial for patients with larger prostates (>30-40ml). Generally the side effects of 5ARI treatment are mild, and according to the FORTA classification 5ARIs are suitable for frail elderly. 5ARI / alpha-blocker (AB) combination therapy showed the best symptomatic outcome and risk reduction for clinical progression. Combining Phosphodieseterase type 5 inhbibitors (PDE5Is) with 5ARIs counteracts the negative androgenic sexual side effects of 5ARIs, and simultaneously combines their synergistic effects on LUTS.

Keywords: 5-Alpha-reductase inhibitors; Combination drug therapy; Dutasteride; Finasteride; Lower urinary tract symptoms; Prostatic hyperplasia.

Publication types

Review

MeSH terms

5-alpha Reductase Inhibitors / therapeutic use*
Adrenergic alpha-Antagonists / therapeutic use*
Drug Therapy, Combination
Humans
Male
Prostatic Hyperplasia / drug therapy*
Testosterone / therapeutic use*

Substances

5-alpha Reductase Inhibitors
Adrenergic alpha-Antagonists
Testosterone