Nearly 14 million American men have symptoms related to an enlarged prostate gland. Nearly 50% of men over age 50 will have symptoms. OTC cold medications such as diphenhydramine (Benadryl), brompheniramine (Dimetapp), and loratadine (Claritin), pseudoephedrine (Sudafed) and phenylephrine (Sudafed PE) may worsen your prostate symptoms.
The prostate gland is a walnut sized organ at the base of bladder and surrounds the urethra or the tube in the penis that transports urine from the bladder to the outside of the body. For reasons not entirely known, the prostate gland enlarges after age 50 and compresses the urethra making urination difficult and rarely impossible. Often men who have enlargement of the prostate gland have the cold or the flu and will take cold medications containing antihistamines and decongestants, which can worsen prostate symptoms.
It’s very important that men with enlarged prostate avoid cold medicines with pseudoephedrine or phenylephrine. Those are ingredients in decongestants and they constrict the prostatic and cause more compression on the urethra thus aggravating men’s urinary symptoms. Antihistamines aren’t quite as bad, because they work more on the bladder muscle, but they can decrease bladder contractility thus making it difficult for men to empty their bladder of urine.
Enlargement of the prostate is more common in older men, because as men age their prostate continues to grow. Nearly 80 percent of men age 50 and older will be diagnosed with some degree of the disease. Sometimes men need to get up every hour at night. I recommend against waiting too long to visit a doctor for this problem as urinary retention can occur and can cause kidney damage and other serious issues.
If a man is already having a little difficulty and his stream is already slow, and then you (make it worse) it by adding one of these OTC cold medicines, it’s the recipe for causing retention.
Cold remedies that are inhaled, such as a nasal corticosteroid, will not have the same side effects as an oral agent. Mentholated ointments are a safer alternative to decongestants.
If men notice problems with urination after taking certain medicines, they may need to weigh the risks and benefits of the OTC medications.
Bottom Line: I urge men to carefully read over-the-counter drug labels. You have to be aware of what a medication’s potential side-effects are. Unfortunately, the package insert for most medications is quite lengthy. Men need to have a relationship with a primary care doctor or a urologist, doctor who specializes in treatments of the enlarged prostate gland.
Dr. Neil Baum's Urology Blog 