Top 300 Drugs – Men’s Health and Genitourinary Agents

Finasteride

Brands = Proscar, Propecia

Drug Class = 5-α-Reductase Inhib.

Typical Uses = BPH; male pattern alopecia

Dutasteride

Brands = Avodart

Drug Class = 5-α-Reductase Inhib.

Typical Uses = BPH

Alfuzosin

Brands = Uroxatral

Drug Class = α-1 Blocker

Typical Uses = BPH

Doxazosin

Brands = Cardura / XL

Drug Class = α-1 Blocker

Typical Uses = HTN; BPH

Prazosin

Brands = Minipress

Drug Class = α-1 Blocker

Typical Uses = HTN

Tamsulosin

Brands = Flomax

Drug Class = α-1 Blocker

Typical Uses = BPH (uro-selective)

Testosterone

Brands = AndroGel, Testim

Drug Class = Androgen

Typical Uses = Hypogonadism

Sildenafil

Brands = Viagra; Revatio

Drug Class = PDE-5 Inhibitor

Typical Uses = ED; PAH (Revatio)

Vardenafil

Brands = Levitra; Staxyn ODT

Drug Class = PDE-5 Inhibitor

Typical Uses = ED

Tadalafil

Brands = Cialis; Adcirca

Drug Class = PDE-5 Inhibitor

Typical Uses = ED; PAH (Adcirca)

Tolterodine

Brands = Detrol / LA

Drug Class = Anticholinergic

Typical Uses = OAB

Darifenacin

Brands = Enablex

Drug Class = Anticholinergic

Typical Uses = OAB

Oxybutynin

Brands = Ditropan; Oxytrol OTC patch

Drug Class = Anticholinergic

Typical Uses = OAB

Solifenacin

Brands = Vesicare

Drug Class = Anticholinergic

Typical Uses = OAB

Mechanism / Therapeutic Rationale

• 5-α-Reductase Inhib. – ↓ DHT synthesis ➜ prostate shrinkage.

• α-1 Blockers – relax prostatic & bladder-neck smooth muscle ➜ ↑ flow.

• PDE-5 Inhibitors – ↑ cGMP in corpus cavernosum/pulmonary vasculature ➜ vasodilation.

• Anticholinergics – M3 receptor blockade ➜ ↓ bladder over-activity.

• Androgen (Testosterone) – physiologic hormone replacement.

Hallmark Common SEs

✓ 5-α-RIs: ↓ libido, ED

✓ α-1-Bs: dizziness, orthostatic hypotension

✓ PDE-5s: headache, flushing

✓ Anticholinergics: dry mouth, constipation, blurred vision

✓ Testosterone: acne, mood swings

Serious / Black-Box Risks

5-α-RIs: teratogenic (male fetus)

α-1-Bs: syncope (first-dose effect)

PDE-5s: priapism; sudden vision loss

Anticholinergics: urinary retention

Testosterone: ↑ BP, thrombotic events; secondary exposure in children

High-Yield Interactions & Contra-Indications

• Absolute: PDE-5 + nitrates → profound ↓ BP; Finasteride/Dutasteride & Testosterone in pregnancy (handling precautions).

• Additive hypotension: α-1-B + PDE-5.

• CI: Anticholinergics in uncontrolled narrow-angle glaucoma, gastric/urinary retention.