Can alphablocker drugs and 5alpha reductase drugs be used together

The short answer to this question is yes. For several years, many urologists used these drugs together with the rationale that because their mechanisms of action were different, their benefits might be additive; however, there was no objective proof that this really was so. In 2003, the MTOPS (The Medical Therapy of Prostate Symptoms) study was published in the New England Journal of Medicine (2003;349). It looked at whether a combination of both kinds of drugs was better than either drug alone.

This study was a double-blind (neither the investigator or study participants knew who received drug(s) or placebo) trial that involved more than 3,000 men who were followed for an average of 4.5 years. The men were divided into four groups: placebo (control group), doxazosin (an alpha blocker) alone, finasteride alone, and doxazosin and finasteride together. These four groups of patients were then followed for signs of progression of BPH. Progression was defined as an increase of urinary symptoms, as measured by the American Urological Association symptom score, acute urinary retention, urinary incontinence, renal insufficiency, or recurrent urinary tract infections. The risk reduction of signs of progression of BPH was 39% with doxazosin, 34% with finasteride, and 66% with combination therapy.

MTOPS proved that the two classes of drugs used together were superior compared with either type of drug alone; however, the practical issue is cost. Obviously, two drugs cost more than one. Therefore, in most cases, the physician will start treatment with one class of drug or the other and add the second drug only if the response to the first drug alone is not satisfactory.

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