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Chapter 65. Urology

Which of the following is the brand name for dutasteride?

a. Hytrin®

b. Flomax®

c. Proscar®

d. Avodart®

e. Cardura®

Answer d is the correct answer. The generic name for Avodart® is dutasteride.

Answer a is incorrect. The generic name for Hytrin® is terazosin.

Answer b is incorrect. The generic name for Flomax® is tamsulosin.

Answer c is incorrect. The generic name for Proscar® is finasteride.

Answer e in incorrect. The generic name for Cardura® is doxazosin.

An 82-year old patient is taking 2 mg of terazosin for benign prostatic hyperplasia (BPH) comes into the pharmacy complaining of dizziness and generalized muscle weakness and persistent lower urinary tract symptom (LUTS). What would you recommend to his physician?

a. Add finasteride 5 mg daily to his regimen.

b. Switch his terazosin to doxazosin 4 mg.

c. Switch his terazosin to tamsulosin 0.4 mg daily.

d. Lower the dose of his terazosin to 1 mg.

e. Add saw palmetto twice daily.

Answer c is correct. Tamsulosin may afford better tolerability for this patient and would be expected to provide symptom relief relatively quickly, often within 1 week of therapy, as it does not require titration.

Answer a is incorrect. The patient is complaining of dizziness associated with his α-blocker therapy. Adding finasteride will not ameliorate this and, if a 5-α-reductase inhibitor (5ARI) were added, it may take several months to show benefit in symptom reduction.

Answer b is incorrect. Exchanging one long-acting second-generation agent for another would not be ideal and this patient may continue to experience the same side effects.

Answer d is incorrect. Lowering his dose of terazosin may improve tolerability; however, he still is experiencing symptoms of BPH. If his dose was lowered, he would likely continue to experience his symptoms.

Answer e is incorrect. Based on lack of clinical outcomes, phytotherapy is not recommended by the American Urological Association for treatment of BPH.

What pregnancy category is finasteride?

a. A

b. B

c. C

d. D

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