What medications can increase PSA levels?
Some medications can increase levels of prostate-specific antigen (PSA) in the blood, falsely indicating the presence of prostate cancer.
Medications that may raise PSA levels include:
- Betamethasone, a steroid prescribed to reduce inflammation
- Testosterone replacement therapy, including Jatenzo, a testosterone capsule for men with certain forms of hypogonadism, a condition that occurs when your sex glands produce little or no sex hormones.
Other drugs may lower PSA levels in patients, which may indicate a false-negative result. These include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen
- Cholesterol-lowering statins, such as Lipitor (atorvastatin) and Zocor (simvastatin)
- High blood pressure drugs known as thiazide diuretics
- Medications used to treat an enlarged prostate or male pattern baldness, such as Proscar and Propecia (finasteride) and Avodart (dutasteride).
Researchers are still looking at how medications affect PSA levels in patients with and without prostate cancer and what this means for screening and PSA testing during cancer treatment.
More on high PSA levels
PSA is considered elevated if it is 4 nanograms per milliliter (ng/mL) of blood or higher. About 25% of men who end up having a prostate biopsy because of increased PSA levels are diagnosed with prostate cancer, according to the National Cancer Institute.
In addition to certain medications, noncancerous conditions may also cause increases in PSA, including:
- Benign prostatic hyperplasia (an enlarged prostate)
- Urinary tract infections
- Prostatitis (an inflamed prostate gland).
PSA can also be elevated after a prostate biopsy and prostate surgery.
- National Cancer Institute (NCI). Prostate-Specific Antigen (PSA) Test. February 24, 2021. Available at: https://www.cancer.gov/types/prostate/psa-fact-sheet. [Accessed February 16, 2022].
- Kazuhiro I, Hashimoto M, Kubota M, et al. Effects of 14 frequently used drugs on prostate-specific antigen expression in prostate cancer LNCaP cells. Oncol Lett.2014; 7(5): 1665–1668. https://doi.org/10.3892/ol.2014.1936.
- Cunningham GR, Ellenberg SS, Bhasin S, et al. Prostate-Specific Antigen Levels During Testosterone Treatment of Hypogonadal Older Men: Data from a Controlled Trial. JCEM. 2019; 104(12): 6238–6246. https://doi.org/10.1210/jc.2019-00806.
- U.S. Food and Drug Administration (FDA). FDA approves new oral testosterone capsule for treatment of men with certain forms of hypogonadism. March 27, 2019. Available at: https://www.fda.gov/news-events/press-announcements/fda-approves-new-oral-testosterone-capsule-treatment-men-certain-forms-hypogonadism. [Accessed February 16, 2022].
- Chang SL, Harshman LC, Presti Jr JC. Impact of Common Medications on Serum Total Prostate-Specific Antigen Levels: Analysis of the National Health and Nutrition Examination Survey. Journal of Clinical Oncology. 2010; 28(25): 3951–3957. https://dx.doi.org/10.1200%2FJCO.2009.27.9406.
- U.S. Food and Drug Administration. Propecia. April 2012. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020788s020s021s023lbl.pdf. [Accessed February 22, 2022].
- U.S. Food and Drug Administration (FDA). Avodart. June 2011. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/021319s023s025lbl.pdf. [Accessed February 22, 2022].
- Beckmann K, Crawley D, Nordström T, et al. Association Between Antidiabetic Medications and Prostate-Specific Antigen Levels and Biopsy Results. JAMA Netw Open. 2019;2(11):e1914689. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2753984.
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