Enlarged Prostate (BPH) Medications and Alcohol Interactions
Introduction
Benign prostatic hyperplasia (BPH) is a male condition in which the prostate gland grows larger than normal, but it is not cancerous. The prostate gland is a small gland that is part of the male reproductive tract found below the bladder and in front of the rectum. This gland produces a fluid that mixes with sperm to make semen.
Drug classes and combinations used for treatment of BPH:
Alcohol has a mild effect to increase vasodilation and lead to low blood pressure, fainting or other effects. When combined with medications that can also lead to low pressure or vasodilation, these side effects can be magnified.
Alpha blockers
When combined with alcohol, alpha blockers like tamsulosin (Flomax) and silodosin (Rapaflo) may increase the risk of low blood pressure and possible fainting upon standing (orthostatic hypotension). Headache, dizziness, lightheadedness, fainting, and/or changes in pulse or heart rate may occur. These effects may be most common at the beginning of treatment, when a dose is increased, or when treatment is restarted after an interruption.
Some patients may experience warmth, redness flushing or a tingly feeling after using alcohol with an alpha blocker. Patients of Asian descent may be especially prone to this interaction due to an aldehyde dehydrogenase deficiency. If they experience this interaction they should be advised to limit or avoid alcohol. Aldehyde dehydrogenase is a primary enzyme involved in breaking down alcohol (metabolism) in the body.
PDE5 inhibitors
Tadalafil (Cialis), a phosphodiesterase 5 (PDE5) inhibitor used for erectile dysfunction, is also approved for treatment of BPH. Tadalafil can have an additive effect in lowering blood pressure when combined with alcohol. You may also experience symptoms such as dizziness, lightheadedness, fainting, flushing, headache, and heart palpitations with this drug. These effects may be more prominent at the beginning of therapy. You should avoid or limit use of alcohol with tadalafil treatment.
When tadalafil is used for BPH treatment, alpha 1-blockers should not be used at the same time and are not recommended by the manufacturer. As noted in labeling, patients on alpha-blocker therapy for BPH should discontinue their alpha-blocker at least one day prior to starting tadalafil for once daily use for the treatment of BPH. However, discuss this interaction with your doctor before stopping your alpha blocker.
5-alpha-reductase inhibitors
The 5-alpha-reductase inhibitors such as finasteride (Proscar) and dutasteride (Avodart) prevent the conversion of testosterone to dihydrotestosterone (DHT) in the body. DHT is involved in the development of benign prostatic hyperplasia (BPH). In product labeling, these drugs are not noted to interact with alcohol.
Jalyn, a combination alpha blocker (tamsulosin) and 5-alpha-reductase inhibitor (dutasteride) is also available for BPH treatment and may have similar interactions to either agent alone. Low blood pressure and feeling dizzy or faint may occur when you stand up from sitting or lying down (orthostatic hypotension).
Common Benign Prostatic Hyperplasia (BPH) Medications
| Generic Name | Common Brand Names |
|---|---|
| alfuzosin | Uroxatral |
| doxazosin | Cardura, Cardura XL |
| dutasteride | Avodart |
| dutasteride and tamsulosin | Jalyn |
| finasteride | Proscar |
| finasteride and tadalafil | Entadfi |
| silodosin | Rapaflo |
| tamsulosin | Flomax |
| terazosin | Hytrin |
| tadalafil | Cialis |
*Note: This is not a complete drug list; always check with your pharmacist for possible drug-alcohol interactions. Tell your healthcare providers about all the other medications you use, including prescription, over-the-counter (OTC) drugs, vitamins, dietary supplements and herbal products.
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Learn more
- Anticholinergic Drugs to Avoid in the Elderly
- Benign Prostatic Hyperplasia (BPH): Symptoms and Treatment
Treatment options
Care guides
Symptoms and treatments
Medicine.com guides (external)
Sources
- Tadalafil (Cialis). Product Information. Feb. 2018. Eli Lilly. https://pi.lilly.com/us/cialis-pi.pdf
- Kawano Y, Abe H, Kojima S, et al. Interaction of alcohol and an alpha 1-blocker on ambulatory blood pressure in patients with essential hypertension. Am J Hypertens 2000;13: 307-12.
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.