Month/Year of Review: May 2014 Date of Last Review: November 2012 PDL Classes: BPH Source Document: OSU College of Pharmacy Current Status of PDL Class: Preferred Agents: DOXAZOSIN MESYLATE, FINASTERIDE, TAMSULOSIN HCL, TERAZOSIN HCL

Previous Conclusions and Recommendation:  Evidence does not support a difference in efficacy/effectiveness  Evidence does not support a difference in harms/adverse events  Tadalfil demonstrated improvements in urinary symptoms compared to placebo in patients with lower urinary tract symptoms, but demonstrated no difference in post void residual volume or urinary flow rate.  Tadalafil is also indicated for patients with concurrent BPH and erectile dysfunction. Erectile dysfunction is not a covered diagnosis under the Oregon Health Plan.  There is insufficient evidence to demonstrate superiority of tadalafil over standard treatment.  Recommend including at least one Alpha-Blocker and one Alpha Reductase Inhibito as preferred on the PDL.r  Consider PA criteria to limit cosmetic use