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Which medication is most commonly used for benign prostatic hyperplasia as a 5-alpha reductase inhibitor?

  1. Dutasteride

  2. Finasteride

  3. Terazosin

  4. Tamsulosin

The correct answer is: Finasteride

Finasteride is the most commonly used medication for benign prostatic hyperplasia (BPH) as a 5-alpha reductase inhibitor. It works by inhibiting the enzyme 5-alpha reductase, which is responsible for converting testosterone into dihydrotestosterone (DHT). DHT is the hormone that contributes to prostate growth in BPH. By reducing DHT levels, finasteride helps to decrease the size of the prostate, alleviate symptoms of urinary obstruction, and improve urinary flow in men with BPH. Dutasteride is also a 5-alpha reductase inhibitor, similar to finasteride, but it is less widely recognized as the first-line therapy for BPH compared to finasteride. Terazosin and tamsulosin, although effective in managing BPH symptoms, are alpha-blockers rather than 5-alpha reductase inhibitors; they work differently by relaxing the muscles in the prostate and bladder neck to improve urine flow but do not affect prostate size directly. Thus, finasteride remains the primary medication of choice in this class for treating BPH.