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Tadalafil + alpha1 blocker is a combination therapy investigated by Eli Lilly and Company for the treatment of benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms (LUTS). Tadalafil is a small molecule phosphodiesterase type 5 (PDE5) inhibitor that works by increasing cyclic GMP levels, leading to smooth muscle relaxation in the prostate and bladder. Alpha1 blockers, such as tamsulosin or silodosin, are antagonists of alpha-1 adrenergic receptors that relax the smooth muscle of the bladder neck and prostate by blocking sympathetic stimulation. Clinical studies, including Phase 4 crossover trials (e.g., NCT02431754), have evaluated the safety and efficacy of adding tadalafil 5 mg once daily to stable alpha1 blocker therapy, demonstrating that the combination is generally well-tolerated and effective in improving symptoms without causing clinically meaningful changes in blood pressure.
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