| Nonselective alpha blockers | | | |
| Doxazosin (Cardura) | 1 mg; titrate to maximum of 8 mg daily | $20 ($80) | Orthostatic hypotension | Requires blood pressure monitoring and dose titration; less expensive |
| Terazosin | 1 mg; titrate to maximum of 20 mg daily | $10 (NA) | | |
| Selective alpha blockers | | | |
| Alfuzosin (Uroxatral) | 10 mg | $20 ($400) | — | Low risk of hypotension; no blood pressure monitoring or dose titration |
| Silodosin (Rapaflo) | 8 mg | NA ($170) | Retrograde ejaculation | |
| Tamsulosin (Flomax) | 0.4 mg; titrate to maximum of 0.8 mg daily | $30 ($190) | Decreased ejaculation; highest risk of intraoperative floppy iris syndrome | |
| 5-alpha reductase inhibitors | | | |
| Dutasteride (Avodart) | 0.5 mg | NA ($155) | Ejaculation disorder, decreased libido, erectile dysfunction | No dose titration; three to six months to take effect; decreases prostate-specific antigen by 50%; combination therapy with an alpha blocker recommended in patients with an enlarged prostate |
| Finasteride (Proscar) | 5 mg | $10 ($135) | | |
| Anticholinergic agents† | | | | |
| Fesoterodine (Toviaz) | 4 to 8 mg | NA ($210) | Dry mouth and eyes, constipation | Assess postvoid residual urine before starting; for patients with predominantly irritative symptoms |
| Oxybutynin extended release (Ditropan XL) | 10 mg | $40 ($175) | | |
| Solifenacin (Vesicare) | 5 mg | NA ($240) | | |
| Tolterodine extended release (Detrol LA) | 4 mg | $150 ($265) | | |
