By: Kandace L. West, PharmD, CGP
Consultant Pharmacist, Geriatrics
Prominent mustaches are on display for Movember (November), but June is men’s health month and a great opportunity to discuss prostate health. It’s a topic that needs more open discussion, because as men age the cumulative lifetime exposure to testosterone increases prostate size. Most men by the age of 80 have an enlarged prostate that can affect quality of life, the condition is referred to as benign prostatic hypertrophy (BPH). The term “benign” indicates that the enlargement is not cancerous, but rather an expected part of the aging process for men. Most men will live with an enlarged prostate (BPH) for the remainder of their lives, and the medications used to treat BPH are primarily used to reduce symptoms (e.g. urinary hesitancy, incomplete urinary evacuation). As a geriatric consultant pharmacist, my focus is on identifying any medications that could be exacerbating BPH symptoms in my male patients, ensuring they understand how the medications work and their potential side effects. Below is a list of the classes of medications that are used to treat BPH and what are some key facts about the medication that are especially important for older male patients:
-Alpha Blockers, generic (i.e. alfuzosin, doxazosin, tamsulosin and silodosin): this class of medications are helpful right away to promote urination by relaxing bladder neck and muscles in the prostate. The side effect to be cautious of in older adult men is dizziness. Therefore, be careful and slowly rise when going from a laying down/seated position to a standing position, pausing as needed.
-5 Alpha Reductase Inhibitors, generic (i.e. dutasteride, finasteride): this class of medications take up to six months to effectively ‘shrink’ the prostate by focusing on preventing hormonal changes that affect prostate enlargement. Be sure to swallow pill whole, to prevent irritation in mouth and throat.
-Combination drug therapy: for some men, a combination of alpha blocker and 5-alpha reductase inhibitors are recommended to increase effectiveness.
Please keep in mind that treatment is based on a number of factors (e.g. prostate size, age, overall health, and symptoms, etc). Remember to always discuss concerns regarding new or worsening symptoms, length of treatment and side effects with your physician and pharmacist. You can also find more information on the links below: