Withdrawing α-Blockers in BPH Patients Receiving Combination Therapy

The two most commonly used drug treatments for urinary symptoms related to benign prostatic hyperplasia (BPH) have complementary mechanisms of action. An α-blocker (e.g., tamsulosin, silodosin) relaxes prostatic and bladder-neck smooth muscle tone and thus works quickly; in contrast, 5α-reductase inhibitors (e.g., finasteride, dutasteride) reduce prostate size gradually over many months. Researchers sought to determine whether patients receiving both drugs eventually could drop α-blockers without experiencing symptom relapse.

In a trial from Japan, 140 men with BPH-related symptoms and prostatic enlargement (volume, ≥30 cc) began treatment with both silodosin and dutasteride; significant improvements in mean symptom scores and urodynamic mea…