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Tadalafil* now carries approval by the Food and Drug Administration to manage signs and symptoms of benign prostatic hyperplasia (BPH). A 5mg daily dose is recommended to manage difficulty urinating, weak stream and frequent (night-time) urination, but should not be combined with alpha blockers (i.e., tamsulosin, terazosin) to treat BPH. In clinical trials, the most common side effects reported were headache and back pain.
According to Pharmacist’s Letter, tadalafil is not a first-line treatment for BPH, but may be beneficial in treating mild-to-moderate BPH in patients who do not respond fully to or cannot tolerate other agents. Long-term studies and overall effect on BPH symptom progression have yet to be determined. Other medications available to manage BPH include: finasteride, Avodart® (dutasteride), Jalyn® (dutasteride/tamsulosin), terazosin, doxazosin, tamsulosin, alfuzosin and Rapaflo® (silodosin).
Secondary to aging, BPH occurs naturally in most men; however, agents used to treat BPH may be used off-label to treat urinary retention and difficulty urinating in some injured parties. The following are examples of when treatment may be appropriate in injured parties:
- those experiencing nerve damage following a spinal cord injury;
- those who recently underwent surgery and were exposed to anesthetics and
are immobile;
- those where a compensable injury caused blockage of the urethra; and/or
- those who experience chronic immobility due to paralysis.
Documentation should be provided by the prescriber verifying causal relationship prior to authorizing these medications. Progressive Medical’s coverage of medications to manage BPH varies based on plan design.
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References:
1. PL Detail-Document, Tadalafil for the treatment of BPH. Pharmacist’s Letter/Prescriber’s Letter. November 2011.
2. Lowes, Robert. FDA Approvals: Tadalafil for benign prostatic hyperplasia. Medscape Education. October 2011. Medscape, LLC. Available online: www.medscape.com.
Disclaimer: This content is intended for informational purposes only and is in no way intended to take the place of proper medical supervision and advice. If you have any questions or concerns about your client's health, please contact a medical prescriber. The information contained herein is known to be correct at the time of posting; however, the content is not guaranteed due to the dynamic nature of healthcare.
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