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When to change BPH meds?

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I am getting worsening BPH symptoms and recently asked the GP to up the dose of Doxasozin to 8mg /day but its made no difference. i understand the next stage is meds to reduce prostate size. My prostate is about 75cc and last PSA was 5 in June 22. Had a PCa template biopsy in August last year which was negative. When did others change meds, did you get the prostate shrinkers added to the alpha-blockers or change completely and does your GP prescribe them or a urologist?

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