Benign prostatic hyperplasia (BPH), also known as an enlarged prostate, is a medical condition that occurs in men with a prostate. It is a common occurrence as men age and can lead to symptoms of difficulty urinating, like frequency of urination, weak urine stream, or inability to completely empty the bladder.
What is Entadfi?
In December 2021, the food and drug administration (FDA) approved a new combination medication for the treatment of BPH symptoms – called Entadfi. Entadfi contains two medications which are already available on the market but have never been marketed as a combination pill for BPH symptoms before. The first ingredient is called finasteride. Finasteride is part of a class of medications called 5 α-reductase inhibitors. It works by stopping an enzyme that converts testosterone into dihydrotestosterone (DHT) in the body. DHT can build up in the prostate and lead to prostate enlargement. The second ingredient in Entadfi is tadalafil. Tadalafil is part of a class of medications called phosphodiesterase 5 (PDE5) inhibitors. PDE5 inhibitors were first developed and studied for use in high blood pressure and heart problems but were quickly found to be more effective for inducing erections. Thus, PDE5 inhibitors are mostly used for erectile dysfunction these days (ex. Viagra and Cialis). Tadalafil is the same active ingredient found in Cialis. Though, there has still been use for PDE5 inhibitors at lower doses in other diseases too, like pulmonary hypertension and BPH. It is thought that PDE5 inhibitors help with relaxation of the muscles in the urinary tract and help improve BPH symptoms in the same way.
Entadfi is taken as one capsule by mouth once daily on an empty stomach at about the same time each day. This medication should not be taken for more than 26 weeks because the benefit beyond this time is not currently known. Each capsule contains 5mg of finasteride and 5mg of tadalafil.
Some of the side effects associated with Entadfi included decreased libido, breast enlargement or tenderness, rash, headache, or pain.
Warnings and precautions
You should not take Entadfi together with any medications containing nitrates (ex. Nitrostat/nitroglycerin, isosorbide mono- or di-nitrate), as the combination is contraindicated for risk of very low blood pressure. Don’t take this medication if you have had a reaction to finasteride or tadalafil in the past. Use caution taking Entadfi if you’re on other blood pressure lowering medications, including other medications for BPH like alpha-blockers (ex. tamsulosin, alfuzosin, doxazosin, terazosin).