Graminex SP63 Proprietary Blend containing: Graminex G63 Flower Pollen Extract, Standardized Saw Palmetto Extract
Graminex Prostanex G63 Flower Pollen Extract + Saw Palmetto Dietary Supplement – 90 Capsules
Graminex Prostanex – Prostate Health Support Supplement with Flower Pollen Extract, Saw Palmetto and Nutrients -Supports a Healthy Prostate and Healthy Urinary Flow – Supports Normal Hormone Metabolism in Men – 90 Capsules
The natural choice for prostate health:
- A NATURAL WELLNESS BOOST – Give your body the nutrients it needs to stay in peak shape as you age with the help of Prostanex, a supplement containing pure concentrated flower pollen extracts.
- SUPPORTS PROSTATE HEALTH – The combination of G63 and G60 flower pollen extracts plus Saw Palmetto makes this prostate support formula highly beneficial for men, and has been clinically shown to help manage the symptoms of BPH.
- ALL-NATURAL INGREDIENTS – Enjoy complete peace of mind! We have made sure to keep this supplement entirely natural by avoiding the use of solvents during the pollen extraction process.
- INCREASED POTENCY – Our supplement is purer and more potent than other flower pollen extracts on the market, ensuring that you get the most benefits and the best value from every capsule.
- GENTLE & FAST ACTING – Our supplement is formulated to be highly bioavailable, ensuring that your body can absorb its contents fast and easily, while supporting your system gently.
Have you been staying on top of your body’s condition?
As men get older, there are many health issues that may start cropping up. This is especially true in regards to the prostate gland. It’s estimated that approximately one-third of men over the age of 50 will experience BPH, and that number climbs to a staggering 90% by the age of 85.
In the US alone, there are 14 million men suffering from the effects of an enlarged prostate. But it’s also important to note that lifestyle factors can make an immense difference in managing prostate health.
Keep the prostate gland in great shape with Prostanex by Graminex!
Our supplement is formulated for the needs of men. It contains a blend of concentrated G63 and G60 flower pollen extracts plus Saw Palmetto, a plant with well-documented benefits for the prostate. This results in a unique supplement that is believed to work synergistically to support wellness.
Flower pollen extract has been used as a natural alternative to pharmaceuticals for over fifty years in Europe, and has been tested in placebo-controlled, double-blinded clinical trials. It can help to improve the symptoms of BPH by reducing the frequency of urination both during the day and night.
All of our ingredients are grown in carefully selected farm locations, chosen for their fertile soil. We don’t use chemicals during the growing process, and the pollen is extracted using a solvent-free process. This means our customers always get a pure, healthy, and all-natural product.
Ingredients:
Graminex SP63 Proprietary Blend containing: Graminex G63 Flower Pollen Extract, Standardized Saw Palmetto Extract
Other Ingredients: Microcrystalline cellulose, maltodextrin, silicon dioxide colloidal and colloidal anhydrous silica, tricalcium phosphate, silicon dioxide, calcium stearate, monocalcium phosphate, rice flour, gelatin capsule
Suggested Usage:
As a dietary supplement take 3 capsules daily before meals with a glass of water.
Even though the formula for Prostanex contains natural ingredients that may have some effect on reducing the size of the prostate gland, there are very limited details provided by the manufacturer other than a general overview of how it’s supposed to work. Without seeing any results from clinical studies performed on the formula, consumers have to rely solely on information from the manufacturer, which may not always be reliable. With so many other brands of natural prostate supplements on the market, consumers would be advised to opt for an alternative product preferably with free samples to try.
Prostanex – The Overview
Problems with an enlarged prostate gland can not only be distressing and embarrassing, but also have a very detrimental effect on the quality of life. While most men will experience some issues with their prostate gland as they get older, symptoms can be controlled using natural supplements such as Prostanex. This particular brand of prostate support supplement is one of many available to men without a prescription and it is sold directly from the manufacturer’s website.
While the official website of the of Prostanex is present, there is no purchase option available on their site. Package deals or special bulk-purchasing discounts aren’t offered and there are no free samples available. Additionally, free samples are not offered and there are no details regarding any kind of refund policy or money back guarantee is mentioned on the official website.
To avoid all these changes that occur as a result of low levels of testosterone, use of a product that can help boost virility levels which in turn would help prevent the prostate from enlarging further is recommended. One product that can help men get better prostate function and boost virility levels is Prostanex.
Prostanex Claims & Features – What You Need To Know?
This product manufacturer claims that Prostanex helps boost prostate health. This it claims is done through the use of a proprietary flower pollen that goes by the name Graminex. The manufacturer also claims that this product also helps boost virility in men. The product claims to achieve all the said issues through the use of a 100% natural blend which helps boost body function.
*All individuals are unique. Your results can and will vary.
The fact is that flower pollen extract may be the only active ingredient in the formula. It may help with hormone changes that could have a negative impact on prostate health.
Who Is The Manufacturer Of Prostanex?
Prostanex is produced by a company called Graminex. Graminex specializes in creating supplements built around a specific ingredient: flower pollen extract. They have trademarked a certain type of flower pollen extract.
The company claims that all of its products are produced to the highest standards of manufacturing regulation. Almost all of their products feature their specific brand of flower pollen extract.
Prostanex Review – Health Web Magazine Images
Prostate complete support supplement by eternal zen is ideal to take if you are in your forties or fifties, and your prostate health has not yet begun to decline. We were interested in studying the impact of any exposure to mhss in relation to the history of prostate cancer rather than focusing on a particular time with respect to imrt. In ad after ad it promises to relieve the frequent or painful urination that sends many men rushing to the bathroom multiple times per night. Men on saw palmetto may have improvement in urinary symptoms and have false reassurance that the mhss are also treating their prostate cancer. It comprises vital nutrients that help to improve the prostate as well as urinary health. He is also concerned that the supplements can suppress your body’s potentially normal production of dhea. Screening, diagnosis, and management of prostate cancer can be complicated, with no clear consensus about key issues. As the name implies, urinozinc contains zinc, a trace element that is essential for a healthy immune system. Nsf certification is your key to making sure that the products you use meet strict standards for public health protection.
Graminex, Prostanex, 90 Capsules: Men’s Formulas, Prostate, Men’s Health, Supplements
Saw palmetto is the most common supplement used for boosting prostate health. Sesso, which helped propel the launch of the select trial, the largest prostate cancer prevention study to date that tested the effects of selenium and vitamin e. 37 Long-term supplementation may be required to affect clinically relevant markers of disease, but further research is needed to identify the most appropriate dose, duration and method of administration of lycopene. Cocci a, di maida f, russo gi, di mauro m, cito g, falcone m, minervini a, cacciamani g, campi r, mari a, sessa f, mondaini n. The dietary supplement comes in the form of capsules, and in each pack, you will find 90 capsules. Different prostate supplements have different ingredients, and you should avoid those that have chemicals and gmo related products. Free-radical exposure is an unavoidable aspect of our lives, as these radicals are produced as a natural by-product of many biological processes, such as cellular respiration and inflammation, in addition to coming from our environment, particularly cigarette smoke. Chu yang said, have seen li the best prostate supplement on the market mens health penis growth qingyun the best prostate supplement on the market mens health mens health is hand gambling, carefully at first glance, suddenly widened his eyes. Lycopene: A biologically important carotenoid for humans?
In our patient population, the rate of mhs use was 10%, and this rate did not include the use of general multivitamins, fish oil, and minerals, although these items were typically used more frequently by men who were taking mhss than by men who were not taking mhss (Table 1). But since you probably spend more time basking in your office’s florescent lights, it’s a good idea to supplement with 2,000 iu a day, says stephen dahmer, m. If your symptoms of an enlarged prostate gland (Benign prostatic hyperplasia, or bph for short) are mild and not particularly bothersome, your doctor will recommend a conservative approach called watchful waiting. And despite the problem that has existed for decades, if not centuries, a good number of men are yet to embrace precautionary measures. On the other hand, you only absorb about 15 to 18 percent of the l-carnitine from oral supplements. This is all designed to aid prostate health, ease and prevent problems with frequent urination and bladder control, and aid sexual function. The bad news is prostatitis, prostate cancer, and other associated ailments are real. These ingredients are expertly blended to provide holistic support for your prostate health. Effects of tomato sauce consumption on apoptotic cell death in prostate benign hyperplasia and carcinoma. The gels are easy to swallow and contain active compounds that will provide healing as well as improving health in general.
Meanwhile, b12 keeps you sharp: A recent study at rush university medical center in chicago found that people deficient in vitamin b12 were more likely to suffer from cognitive impairment, possibly because homocysteine also damages the brain. The trials summarized in this systematic review do not provide sufficient evidence to recommend the use of lycopene supplements in routine clinical practice for patients diagnosed with prostate cancer, although the studies do indicate that lycopene is unlikely to be harmful to such patients. This goes to show that they do work well and should help prevents any possibility of the prostate gland becoming large, getting infected, and also lower the possibility of you falling victim to cancer. One tablet contains 100% of the recommended daily intakes (Rdis) for nearly all essential vitamins and minerals. This chewable multivitamin contains 15 essential nutrients for men in six fruit-flavored chews. Featuring a potent blend of herb extracts, this supplement supports your prostate health from many different angles. There is a risk of prostate cancer across the world, and it is especially high among men above 40 years. In addition to these confusing screams, some people came to inquiry, saying that such a large haidongqing is rare, the best prostate supplement on the market mens health best reviews guide and so smart, really want to buy this haidongqing is descendants, and ask for a quote.
Prostate complete support supplement by eternal zen is ideal to take if you are in your forties or fifties, and your prostate health has not yet begun to decline. We were interested in studying the impact of any exposure to mhss in relation to the history of prostate cancer rather than focusing on a particular time with respect to imrt. In ad after ad it promises to relieve the frequent or painful urination that sends many men rushing to the bathroom multiple times per night. Men on saw palmetto may have improvement in urinary symptoms and have false reassurance that the mhss are also treating their prostate cancer. It comprises vital nutrients that help to improve the prostate as well as urinary health. He is also concerned that the supplements can suppress your body’s potentially normal production of dhea. Screening, diagnosis, and management of prostate cancer can be complicated, with no clear consensus about key issues. As the name implies, urinozinc contains zinc, a trace element that is essential for a healthy immune system. Nsf certification is your key to making sure that the products you use meet strict standards for public health protection.
Avoid excessive amounts of saturated fat, such as those found in red meat, fried foods, and dairy products.
Benign Prostatic Hyperplasia
Integrative Therapy
Nutrition
Soy is thought to work in two ways. It is an inhibitor of 5α-reductase as well as a low-potency estrogen. Soy may block the receptor sites that the stronger estrogens use to increase the accumulation of DHT. Its consumption has also been found to result in a lower incidence of prostate cancer. 6
β-Sitosterol (a major phytosterol found in soy) was found to increase urinary flow and decrease residual volume in the bladder in a double-blinded, placebo-controlled study using a dose of 20 mg. 7 A 3.5-ounce serving of soybeans, tofu, or other soy food preparation provides approximately 90 mg of β-sitosterol. 8 A 1-ounce preparation (which is a portion about the size of the palm of the hand) equals approximately 25 mg.
Cholesterol
Cholesterol has been associated not only with BPH but also with prostate cancer. Its metabolites (epoxycholesterols) have been found to accumulate in the hyperplastic and cancerous prostate gland. This is the reason that hypocholesterolemic drugs (3-hydroxy-3-methylglutaryl coenzyme A [HMG-CoA] reductase inhibitors or “statins”) have been associated with a lower risk of BPH and prostate cancer. 9 There is limited evidence at this time to use these drugs to lower the risk of BPH, but a diet low in cholesterol is beneficial not only for the prostate but also for general health.
Omega-3 Fatty Acids
A diet rich in omega-3 fatty acids helps reduce the influence of prostaglandins and leukotrienes on the inflammatory component of BPH (see Chapter 88 , The Anti-Inflammatory Diet). The patient should consume foods rich in omega-3 fatty acids, such as cold-water fish (salmon, mackerel, and sardines), vegetables, and ground flaxseed or flaxseed oil. Flaxseed oil can also be given in capsule form, as lignan-rich flaxseed oil 2 to 4 500-mg capsules twice a day. Patients may also buy whole flaxseeds and then grind 2 tbsp to sprinkle on salads or yogurt or in a smoothie. Flaxseed has the added benefit of lignan fiber, which helps bind estrogen in the gut, promoting its removal.
Supplements
β-Sitosterol
β-Sitosterol is a sterol found in almost all plants. It is one of the main subcomponents of a group of plant sterols known as phytosterols, which are very similar in composition to cholesterol. These plant sterols are the active ingredients in popular margarine spreads (Take Control, Benecol) used to lower cholesterol. β-Sitosterol is found in rice bran, wheat germ, peanuts, corn oils, and soybeans. High levels are also found in botanicals such as saw palmetto, rye grass pollen, pygeum, and stinging nettle, which have been found to be beneficial for BPH. Unlike cholesterol, β-sitosterol cannot be converted to testosterone. It is also inhibits aromatase and 5α-reductase. β-Sitosterol is likely one of the many reasons that eating vegetables is good for health. Adequate consumption of these plants in the diet should be encouraged.
Two randomized studies have shown β-sitosterol to have benefit with little potential harm in treating BPH. 7,10 A Cochrane Review found β-sitosterol to improve urinary symptoms and flow measures; it does not, however, appear to reduce the size of the prostate gland. 11
Dosage
60 mg twice daily; the dose can be lowered to 30 mg twice daily after symptoms improve.
Precautions
β-Sitosterol is well tolerated, with gastrointestinal side effects being most common. It can enhance the cholesterol-lowering effects of antihyperlipidemic medications.
Intestinal uptake of zinc is inhibited by estrogen. Because estrogen levels rise in the aging male, zinc levels may be low. In fact, marginal zinc deficiency is common in the elderly and in men may worsen the symptoms of BPH. In the 1970s, research showed that supplementing with zinc resulted in a reduction in the size of the prostate gland and the severity of symptoms of BPH. 12 Further research has shown that zinc inhibits 5α-reductase 13 and inhibits the binding of androgens to their receptors in the prostate. 14 This latter effect is thought to be due to zinc’s ability to inhibit prolactin, which like estrogen increases the receptors for DHT in the prostate. Therefore zinc not only decreases the production of DHT but also inhibits binding of DHT to its receptors.
Coffee can decrease zinc absorption by 50%. And because caffeine stimulates the adrenergic nervous system (smooth muscle of the prostate), patients with BPH should be encouraged to limit their caffeine intake.
Prescription drugs that can cause low serum zinc levels include thiazide diuretics, steroids, methotrexate, tetracyclines, and fluoroquinolones. Zinc supplementation should be considered in patients with BPH who are taking these medications. It should not be used, however, in patients taking tetracycline or fluoroquinolone antibiotics, because zinc can affect their absorption.
Dosage
In prescribing zinc supplementation, the clinician must be aware that zinc competes with copper, calcium, and iron absorption. The patient must not take more than the recommended dose or take calcium and iron supplements with zinc.
Botanicals
Saw Palmetto (Serenoa repens)
The exact mechanism of action of saw palmetto remains elusive. It has been found to be a weak inhibitor of 5α-reductase but may have a more active role in reducing the number of estrogen and androgen (DHT) receptors as well as having an anti-inflammatory effect on the prostate. Its principal ingredient is the sterol β-sitosterol, which as described is also found in soy products and other herbs that have been used to treat diseases of the prostate, including pygeum, stinging nettle root, and pumpkin seed extract. Although the mechanism of action of sterols on the prostate gland remains to be found, saw palmetto compound seems to be a recurring theme in the herbal treatment of BPH.
Saw palmetto reduces the inner prostatic epithelium but does not reduce the size of the gland. Nevertheless, it has been found to improve symptom scores, nocturia, residual urine volume, and urinary flow in patients with BPH. It was found to be as effective as finasteride (Proscar) without the side effects. 15 Granted, finasteride has not been an “all-star” in the treatment of BPH; it does not affect levels of prostate-specific antigen (PSA). 16
In a study of 225 men, saw palmetto did not improve symptoms when compared to placebo for moderate to severe BPH. 16a
In summary, saw palmetto has three positive influences on the prostate gland; it is antiandrogenic, antiproliferative, and anti-inflammatory. These properties appear to be responsible for improving symptoms of BPH.
Dosage
60 mg twice daily; therapeutic benefit takes 8 weeks to appear.
Precautions
Mild adverse effects of saw palmetto have included headache, nausea, diarrhea, and dizziness. It does not influence the cytochrome P-450 enzyme system of the liver, and drug interactions are rare.
The most beneficial saw palmetto extract is composed of at least 85% fatty acids and 0.2% sterols. For example, a 160-mg pill should have a minimum of 136 mg fatty acids and 0.32 mg sterols.
Product lines that have proved to be composed of at least 85% fatty acids and 0.2% sterols include those of the following manufacturers: Nature’s Way, CVS, Centrum, Natrol, Bayer, Quanterra, Sundown Herbals, NaturPharma (Wal-Mart), and Walgreen’s.
Rye Grass Pollen (Secale cereale)
Rye grass pollen is also known as grass pollen and grass pollen extract. Clinical studies used a form called Cernilton (flower pollen), a proprietary formulation manufactured by Cernitin .
This extract has been used in Europe for BPH for more than 35 years. Double-blind clinical studies have found it to be effective, with an overall response rate near 70%. 17 Rye grass contains a substance that has been found to inhibit prostatic cell growth 18 as well as to reduce inflammation of the prostate by inhibiting prostaglandins and leukotrienes. 19
Studies have shown the greatest improvement in nocturia, urinary frequency, and residual urine volume. 20 Rye grass and flower pollen are also used for symptomatic relief of prostatitis and prostatodynia.
Dosage
A typical dose of rye grass pollen is 126 mg 3 times/day.
A company called Graminex has obtained the rights to cernitin . It now sells this product under the name Pollen Aid. The dose is 126 mg, one before each meal. Graminex also makes a product called Prostanex. It contains 213 mg of flower pollen extract that is combined with 213 mg of saw palmetto. The dose is one capsule three times a day before meals. The cost is $ 35-40 for 90 capsules ( www.graminex.com ).
Precautions
Abdominal distention, heartburn, and nausea.
Pygeum (Prunus africana)
Pygeum is obtained from the bark of the African plum tree. Like those of saw palmetto, its benefits are thought to come from fatty acids (sterols), which reduce inflammation through the inhibition of prostaglandins as well as prostatic cholesterol levels that are precursors to testosterone production. Pygeum also increases prostatic and seminal fluid secretions.
A meta-analysis showed that men taking pygeum had a 19% reduction in nocturia with a 24% reduction in residual urine volume. Peak urine flow was improved by 23%, and side effects were mild and similar to those of placebo. 21 Pygeum is more expensive than saw palmetto, and over-harvesting of the bark is threatening the survival of the species.
Dosage
100 to 200 mg/day.
Precautions
Pygeum can cause nausea and abdominal pain.
Pharmaceuticals
α-Adrenergic Blocking Agents
Of the therapies discussed here, the class of drugs known as α-adrenergic blocking agents (alpha-blockers) will likely give the most subjective improvement. Blocking the α-adrenergic system results in relaxation of the smooth muscle fibers of the prostate gland, leading to a reduction of symptoms and improved urinary flow. The response is rapid (within hours) and studies have shown long-term efficacy.
The most commonly used agents, terazosin (Hytrin) and doxazosin (Cardura), require dose titration to avoid postural hypotension. The newer, more expensive α1 antagonist tamsulosin (Flomax) is more specific for the prostatic tissue, reducing the incidence of hypotension and the need to titrate the dose.
Dosage
Terazosin (Hytrin): Start at 1 mg at bedtime, and titrate each week to effect. Maximum dose is 20 mg. Available in 1-, 2-, 5-, and 10-mg capsules.
Doxazosin (Cardura): Start 1 mg at bedtime, and titrate each week to effect. Maximum dose is 8 mg. Available in 1-, 2-, 4-, and 8-mg capsules
Tamsulosin (Flomax): 0.4 mg 30 minutes after a meal daily. Maximum dose is 0.8 mg/day. Available in 0.4-mg capsules.
Precautions
Postural hypotension, dizziness, fatigue, headache, nasal stuffiness, and retrograde ejaculation.
5α-Reductase Inhibition
Finasteride (Proscar, Propecia) prevents the conversion of testosterone to DHT and lowers DHT serum levels. It can take as long as 6 months to work but does appear to halt the progression of prostate growth. In regard to patient satisfaction and symptom reduction, finasteride is not a great choice unless the patient also has male-pattern baldness. Because finasteride causes a 50% reduction of PSA, PSA levels must be monitored during treatment; if the levels rise, further evaluation for prostate cancer should be performed.
Dosage
5 mg/day; available as 5-mg tablets.
Precautions
Decreased ejaculatory volume (in 2.8% of patients), impotence (3.7%), and decreased libido (3.3%).
Surgery
When severe symptoms of BPH are not controlled with the therapies already described, the clinician should consider urologic referral for minimally invasive therapy or surgical resection, as follows:
Transurethral microwave thermotherapy (TUMT): In this procedure, a microwave antenna generates heat in the transition zone, resulting in coagulation necrosis. It is performed as an outpatient therapy.
Transurethral needle ablation (TUNA): This procedure involves the placement of small needles in the prostate via cystoscopy that emit radiofrequency energy, resulting in necrosis of prostatic tissue.
TUMT and TUNA, which are minimally invasive procedures, have a lower morbidity than TURP but are not as effective in reducing symptoms, and they do not produce tissue for pathologic evaluation.
Transurethral resection of the prostate (TURP): As the gold standard for treatment of BPH, TURP will likely result in the greatest symptomatic improvement. Complications such as incontinence (in 1% of patients), blood transfusion (3% to 5%), retrograde ejaculation (20% to 75%), and stricture formation (5%) are becoming less severe with the use of laser prostatectomy, which results in less bleeding. TURP is the most invasive procedure (except for open prostatectomy) and requires a hospital stay.
Avoid excessive amounts of saturated fat, such as those found in red meat, fried foods, and dairy products.
Replace vegetable oils with olive or canola oil for cooking.
Consume omega-3 rich fats found in cold-water fish, nuts, greens, and ground flaxseed.
Consider light to moderate (but not heavy) alcohol consumption.
Eat plenty of natural plants, particularly those rich in β-sitosterol, such as green leafy vegetables, rice bran, wheat germ, peanuts, corn oils, nuts, and soybeans.
Eat soy-based foods such as soymilk, edamame, tempeh, miso, soy nuts, and tofu. Try to consume 1-2 oz/day, and consider substituting soy milk for dairy milk.
Avoid dietary supplements or environmental exposures that may increase circulating hormone levels, such as pesticides and herbicides, dairy products rich in recombinant bovine growth hormone (rBGH), drugs that include dehydroepiandrosterone (DHEA), androstenedione, testosterone, and human growth hormone.
Maintain appropriate weight and regular aerobic exercise.
This is a summary of the therapeutic options for BPH. A patient presenting with severe symptoms (American Urologic Association [AUA] score > 19) would be benefited by initiation of a more aggressive therapy, such as alpha-blockers or referral to surgery. But for the patient who has mild to moderate symptoms, this ladder approach is appropriate. Table 58-1 presents the mechanisms of action of pharmaceuticals, botanicals, and supplements commonly used for BPH. Table 58-2 lists the products that can worsen symptoms of BPH.
▪ Remove Exacerbating Factors
Have the patient stop taking over-the-counter cold remedies, diet aids (phenylpropanolamine [PPA]), nasal decongestants (pseudoephedrine), herbs (ma huang, Ephedra), and caffeinated products that contain sympathomimetics, which increase prostatic muscle tone.
Consider having the patient stop taking pharmaceutical products that have anticholinergic effects leading to urinary retention, such as antihistamines, bowel antispasmodics, bladder antispasmodics, tricyclic antidepressants, and antipsychotics.
▪ Nutrition
Have the patient increase his consumption of soy-rich foods. A 1-oz serving each day (about the size of the palm of the hand) will provide approximately 25 mg.
Encourage a low-fat, cholesterol-free diet.
Encourage foods rich in omega-3 fatty acids (salmon, nuts, flaxseed) or have patient take 1 tbsp of flaxseed oil twice a day or 1 or 2 500-mg capsules of flax oil bid.
▪ Supplements
β-Sitosterol 60 mg bid.
Zinc 30-40 mg/day.
▪ Botanicals
Start with saw palmetto 160 mg bid.
If no improvement after 8 weeks, consider adding one of the following:
Rye grass or flower pollen 126 mg tid.
Pygeum 100-200 mg/day.
Other herbal products that have potential benefit are stinging nettle and pumpkinseed extract.
▪ Pharmaceuticals
If no improvement with the use of botanicals, discontinue them and start an alpha-blocker.
Terazosin 2mg qhs, titrate to max of 20 mg.
Doxazosin 1 mg qhs, titrate to max of 8 mg.
Tamsulosin 0.4 mg, titrate up to max of 0.8 mg.
If patient is unable to tolerate an alpha-blocker, consider finasteride 5 mg/day.
Combination therapy: A Veterans Cooperative Study showed no additional benefit when finasteride was added to an alpha-blocker. 22 The combination of alpha-blockers and botanicals has not been studied, but there are no contraindications to using them together.
▪ Surgery
If the patient’s symptoms persist or worsen despite the preceding measures, refer him for urologic evaluation and treatment: