Commonly Prescribed Urological Medications



Commonly Prescribed Urological Medications

Eric Yarnell, ND, RH(AHG)

last updated 26 Sept 2015

All doses are adult doses and oral unless otherwise noted.

BENIGN PROSTATIC HYPERPLASIA

|Generic (Trade) Names |Dose |Key Clinical Info |

|Alpha Blockers (Alpha-1 adrenergic antagonists) |

|Alfuzosin (Uroxatral) $ |Start 5 mg bid (SR: 10 mg qd) |Postural hypotension. Give first dose seated in office to avoid fainting. |

|Doxazosin (Cardura) |Start 4 mg qd; Range: 4-8 mg qd |Postural and nonpostural hypotension. Give first dose seated in office to avoid fainting. |

|Prazosin (Minipress) |Start 10 mg bid |Postural and nonpostural hypotension, H2O & Na+ retention. Give first dose seated in office to avoid fainting. |

|Tamsulosin (Flomax) $ |Start 0.2 mg qd; Range 0.2-0.8 mg qd |Retrograde ejaculation, rhinitis, postural hypotension (rare) |

|Terasozin (Hytrin) |Start 2 mg qd; Range 2-20 mg qd |Postural and nonpostural hypotension. Give first dose seated in office to avoid fainting. |

|5-alpha-reductase inhibitors (5aRi) |

|Finasteride (Proscar) |5 mg qd |Minimum 6 mon to work ED, low libido, lowers PSA by half |

|Dutasteride (Avodart) $ |0.5 mg qd |Minimum 6 mon to work ED, low libido, lowers PSA by half |

BLADDER CANCER

|Generic (Trade) Names |Dose |Key Clinical Info |

|Immunomodulator |

|BCG vaccine, intravesical | | |

|Chemotherapy |

| | | |

CHRONIC PROSTATITIS

Alpha Blockers: see BPH above

|Generic (Trade) Names |Dose |Key Clinical Info |

|Antibiotics |

|Ciprofloxacin (Cipro) |500 mg bid x 14-28 d |Can cause long-lasting tendon/ligament weakness and damage (consider giving magnesium contemporaneously but not simultaneously |

| | |to prevent), give with probiotics |

|Levofloxacin (Levaquin) |500 mg qd x 14-28 d |Can cause long-lasting tendon/ligament weakness and damage (consider giving magnesium contemporaneously but not simultaneously |

| | |to prevent), give with probiotics |

|Trimethoprim-sulfamethoxazole (TMP-SX, |160 mg-800 mg bid x 10-14 d |CI in those with sulfa allergies, give with probiotics |

|Bactrim) | | |

|Urothelial Repair Agent |

|Pentosan polysulfate (Elmiron) |100 mg tid away from food | |

CHRONIC RENAL FAILURE

|Generic (Trade) Names |Dose |Key Clinical Info |

|Phosphate Blockers |

|Niacinamide |Start 250 mg cc Later 500 mg cc if |Monitor platelet levels monthly for three months (stop testing if no decline; stop the vitamin if levels decline to below |

| |tolerated |normal), particularly in Asian patients. May occasionally cause flushing. Target serum phosphorous: ................
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