Q: Can a pill called Avodart really reduce the size of an enlarged prostate? I have been prescribed an alpha blocker pill like Cardula but my doctor told me that these alpha blocker pills do not reduce the size of an enlarged prostate but reduce the pressure inside the bladder and thus making urinating easier. If Avodart does reduce the size, can we take this pill together with the alpha blocker pill?

A:Avodart is a 5-alpha-reductase inhibitor (5-ARIs), a group of drugs that inhibit the effect of testosterone on the prostate gland. There was much hype regarding these drugs in late eighties, when it was hoped that such a drug could eliminate the need of surgery for prostate by reducing its size. The enthusiasm waned in early nineties since reduction in size, as well as symptoms, was slow and unpredictable. There is re-emergence of role these drugs in treatment of prostate disease in 21st century since large studies revealed that these drugs may indeed reduce the risk of long term complications of prostate, like retention of urine, especially if initial size of prostate is more than 30 ml. There is little or no effect of 5-ARIs on smaller glands. If symptoms are significant, alpha-blockers are combined with 5-ARIs for larger glands, while alpha-blockers alone would suffice for smaller prostates.