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Review
. 2016 Aug;43(3):325-36.
doi: 10.1016/j.ucl.2016.04.003.

5-Alpha-Reductase Inhibitors and Combination Therapy

Claudius Füllhase  1 , Marc P Schneider  2
Affiliations
Review

5-Alpha-Reductase Inhibitors and Combination Therapy

Claudius Füllhase et al. Urol Clin North Am. 2016 Aug.

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.

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