Safety of anticholinergics in patients with benign prostatic hyperplasia

Expert Opin Drug Saf. 2008 Jul;7(4):473-9. doi: 10.1517/14740338.7.4.473.

Abstract

Background: Storage lower urinary tract symptoms (LUTS) or overactive bladder (OAB) often coexist with voiding symptoms in patients with benign prostatic obstruction (BPO). Anticholinergic medications to treat storage LUTS are often withheld in such patients for fear of significantly increasing post-void residual urine volumes or provoking acute urinary retention (AUR).

Objective: To assess the clinical validity of concerns regarding urinary safety of anticholinergics in patients with benign prostatic hyperplasia.

Methods: Review of indexed literature and congress abstracts.

Results/conclusions: Existing urinary and non-urinary safety data on BPO patients administered anticholinergics, either alone or in combination with alpha-blockers, do not seem to support the above-mentioned concerns. Nevertheless, precise criteria for patient and drug selection to ascertain safe and effective administration are not yet established and need to be investigated in future trials.

Publication types

  • Review

MeSH terms

  • Adrenergic alpha-Antagonists / adverse effects
  • Adrenergic alpha-Antagonists / therapeutic use
  • Cholinergic Antagonists / adverse effects*
  • Cholinergic Antagonists / therapeutic use
  • Clinical Trials as Topic
  • Drug Therapy, Combination
  • Humans
  • Male
  • Patient Selection
  • Prostatic Hyperplasia / drug therapy*
  • Prostatic Hyperplasia / physiopathology
  • Urinary Bladder, Overactive / drug therapy
  • Urinary Bladder, Overactive / etiology
  • Urination Disorders / drug therapy
  • Urination Disorders / etiology

Substances

  • Adrenergic alpha-Antagonists
  • Cholinergic Antagonists