An update on the use of 5alpha-reductase inhibitors

Twelve years ago, finasteride, the first 5alpha-reductase inhibitor, was introduced as drug therapy for benign prostatic hyperplasia, and more recently dutasteride has emerged as an alternative. The efficacy, safety and ability of these 5alpha-reductase inhibitors to reverse the natural progression of benign prostatic hyperplasia have been convincingly demonstrated and both drugs are now well established in the medical armamentarium against the disease. Given the multifactorial etiology of benign hyperplasia, the usefulness of 5alpha-reductase inhibitors in combination with alpha adrenergic blockers has also been investigated and justified in select patients. Wider applications of 5alpha-reductase inhibitors are also emerging, though their perhaps most important new role as chemopreventive agents remains unclear.