The exact treatment protocol for BPH, or swollen prostate, depends on factors such as the prostate gland size, patient’s age, overall health, and severity of symptoms.
Medications play an important role in the management of enlarged prostate.
However, it’s not just about medications prescribed to treat BPH.
You also need to pay attention to other prescribed or over-the-counter drugs you’re taking.
Some medicines may worsen your condition.
Read on to learn more about medications to avoid with an enlarged prostate.
What is BPH?
Benign prostatic hyperplasia, BPH, or prostate gland enlargement, is common in men, especially as they get older.
Numbers show about 14 million men in the US have symptoms of enlarged prostate. On a global level, 30 million men are affected.
Besides prostate cancer, it is one of the most common conditions affecting men across the globe.
A swollen prostate gland may induce uncomfortable urinary symptoms. This prostate problem can block urine flow out of the bladder. Prostate enlargement is associated with kidney damage, bladder and urinary problems.
The exact BPH symptoms and severity vary from one person to another. In most cases, symptoms worsen gradually.
The most common signs and symptoms include:
- Frequent urination
- Nocturia (urination at night)
- Difficulty starting urination
- Inability to void the bladder completely
- Dribbling after urinating
- Weak urinary stream or stops and starts
Less common and more severe prostatic hyperplasia symptoms include urinary tract infection (UTI), inability to urinate, and blood in the urine. Generally speaking, men are less likely to have UTIs due to longer urethra.
Some men may even develop urinary incontinence at some point. The exact cause of prostate enlargement is not certain. The main culprit could be the changes in sex hormones as you’re getting older.
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Prescription medications to avoid
As mentioned above, some medications can worsen symptoms of prostate enlargement.
Make sure to consult your doctor if you use any of the drugs outlined below. They may need to prescribe a different medication or adjust the dosage to reduce the severity of urinary symptoms you’re experiencing.
Diuretics, or water pills, are medications that remove extra fluid from the body. They work by pulling more water out of the bloodstream into the urine.
Since you need to urinate more often when you take diuretics, these medications can worsen the symptoms of benign prostate hyperplasia.
These medications treat high blood pressure, heart failure, liver disease, or glaucoma.
Antidepressants are specifically formulated to alleviate symptoms of depression, anxiety disorders, social anxiety disorder, and other conditions.
Antidepressant treatment, when used alongside standard prostate drug treatment, can effectively manage the symptoms of depression in BPH patients. A study shows that antidepressants can be useful for enhancing the quality of life in men with BPH and depression.
Some antidepressants even aid the treatment of chronic bacterial prostatitis when used in combination with rectal electrostimulation.
But, older generation antidepressants known as Tricyclic antidepressants should be avoided with BPH. This older type of antidepressant drug decreases contractions of the bladder muscle. As a result, tricyclic antidepressant drugs can amplify symptoms of enlarged prostate tissue.
Tricyclic antidepressants include amoxapine or Asendin, nortriptyline or Pamelor, imipramine or Tofranil, and doxepin or Sinequan.
Evidence confirms antidepressants are among several medications that worsen lower urinary tract symptoms through effects on detrusor muscle and urinary sphincter function.
If you are taking antidepressants and have BPH, you shouldn’t discontinue using antidepressants on your own. Consult your doctor first.
Just like any other medication, antidepressant use can come with side effects. In men with BPH and depression, the use of antidepressants may also contribute to a higher risk of sexual problems such as erectile dysfunction and retrograde ejaculation.
Over-the-counter medications to avoid
Some prescription-based medications are not the only types of drugs to avoid if you have excess prostate tissue.
Some over-the-counter (OTC) medications can also aggravate symptoms of your condition and act on prostate tissue.
For that reason, you should always read the label to learn as much as you can about the medication and see whether the potential harmful impact on BPH is written already on the box.
In some cases it is, but in others, it is not. This, therefore, shows why talking to your doctor is crucial.
Below, you can take a look at OTC medications that may not be such a good idea for men with benign prostate enlargement.
Non-steroidal anti-inflammatory drugs (NSAIDs)
Widely used, these drugs alleviate pain and decrease the use of prescription pain relievers.
Common NSAIDs include Aspirin and Ibuprofen (Advil, Motrin). These OTC drugs may not be the most beneficial thing for a man with an enlarged prostate.
In fact, these drugs may act as a double-edged sword when it comes to prostate function.
You see, NSAIDs may decrease the risk of an enlarged prostate, but aggravate urinary symptoms in men who already have this condition. In men with BPH, these drugs may worsen urinary symptoms because they inhibit the production of prostaglandins.
The bladder produces these chemicals to improve the contraction of surrounding muscles.
Factors affecting this process may make it even harder to empty your bladder and thereby contribute to acute urinary retention.
But, how can NSAIDs help prevent enlarged prostate? This effect could be down to the fact the inflammation contributes to the formation of this common disease in men.
Antihistamines are a type of medication formulated for symptom relief from allergies, motion sickness, and cold and flu in some cases. One of the most commonly used antihistamines is diphenhydramine (Benadryl).
What many people don’t know is that antihistamines can aggravate symptoms of a swollen or enlarged prostate. First-generation antihistamines carry a label that warns patients against using these drugs if they struggle with difficulty urinating due to BPH.
Antihistamines may worsen symptoms of enlarged prostate and make it even more complicated to urinate.
However, second-generation antihistamines such as Claritin do not carry that warning and may be a safer option for men with BPH.
How do antihistamines cause these problems? They don’t allow the prostate and bladder to relax correctly and thereby slow or inhibit urine flow. In some cases, a patient needs a transurethral incision to treat urinary symptoms of BPH.
Decongestants are a type of medication that provides temporary relief from nasal congestion (stuffed nose) when you have a cold.
These mediations may tighten muscles and increase muscular tone in the prostate gland and bladder neck. As a result, urine can’t exit the bladder properly.
Inability to empty the bladder properly can cause bladder infection and bacterial infection.
Both topical and oral decongestants carry a warning against use by men with BPH.
The safest option for men with a swollen or enlarged prostate is to use external nasal dilators that act through mechanical means to dilate the nostrils and generally do not affect your condition.
Some ingredients in decongestants, e.g., phenylephrine, may constrict the prostatic capsule and lead to urinary retention. Long-term urinary retention may cause an array of problems, including bladder stones.
Other drugs that may aggravate BPH
Besides these, many other medications could aggravate swollen prostate symptoms.
Motion sickness products
All safe and effective motion sickness medications contain antihistamines.
Some may contain vasoconstrictors and thereby reduce urine flow.
They may contain ephedrine or epinephrine, both of which carry prostate warning.
OTC drugs for allergic conjunctivitis contain antihistamine.
Talking to your doctor
Above all, if you have prostate gland enlargement, you need to be careful about the medications you use.
Avoid medicating yourself based on the information you find on forums and other similar platforms. The best thing to do is to talk to your doctor about medications you need to take.
For some medications, it’s necessary to adjust the dosage. This is something only your doctor can (and should do).
If you feel like you’re not getting better, express your concerns to a healthcare provider, and they may prescribe the most suitable medications for your condition.
Feel free to ask your doctor or dietitian for tips about the diet that is the best for you, the best foods to eat or drink to help you to feel better, and what to avoid.
Above all, regular checkups at the doctor’s office are important. The doctor may order a PSA test to evaluate for the presence of various problems ranging from prostate cancer to acute bacterial prostatitis.
Some medications can aggravate symptoms of an enlarged or swollen prostate.
These include antidepressants and diuretics, as well as OTC drugs such as antihistamines and decongestants.
So, you should consult your doctor about the medications you’re taking and adhere to their instructions to avoid their impact on prostate cells.
Management of enlarged prostate depends on your treatment, but also whether you’re taking medications that worsen your symptoms or not.
But do keep in mind transurethral resection prostate surgery may be necessary in some cases of BPH.