The standard gold care medications for benign prostatic hyperplasia (BPH) are the alpha-1-adrenergic antagonists, they are an effective medications and are generally well tolerated.
However, at this time, no data have been published concerning the development of severe rhinorrhea with a great impact on quality of life in patients treated with alpha-1-adrenergic antagonists. We report two men with BPH treated with two different alpha-adrenergic antagonists; alfuzosin and doxazocin. The naranjo quality scale documented a probable adverse drug reaction (score 7) between rhinorrhea and treatmenr with alpha-1-adrenergic antagonists. In conclusion we reported that alpha-1-adrenergic antagonists are able to induce rhinorrhea in patients with BPH. Benign prostatic hyperplasia (BPH) is a common disorder that increases in frequency progressively with age in men older than 50 years. The main clinical manifestations of BPH are lower urinary tract symptoms (LUTS) that include increased frequency of urination, nocturia, hesitancy, urgency, and weak urinary stream. These symptoms typically appear slowly and progress gradually over a period of years (1). The decision to treat is usually based on the severity of symptoms, patient's tolerance for her symptoms and the impact of these symptoms on patient's quality of life (2-3). The bladder outlet obstruction of BPH has two components: a dynamic (physiologic, reversible) component related to the tension of prostatic smooth muscle in the prostate, prostate capsule, and bladder neck and a fixed (structural) component related to the bulk of the enlarged prostate impinging upon the urethra. Two classes of drugs are mainly used in the treatment of BPH, alpha-adrenergic antagonists and 5-alpha-reductase inhibitors, both acting upon the dynamic and fixed components of bladder outlet obstruction (4); nonetheless, alpha-adrenergic antagonists remain the fist line treatment of BPH (5). Alpha-adrenergic antagonists are generally well tolerated, the main side effects are orthostatic hypotension and dizziness. In the present paper, we present two case reports of two men with BPH treated with two different alpha-adrenergic antagonists; alfuzosin and doxazocin. Both patients experienced a severe watery rhinorrhea with a great impact on their quality of life.
Written by:
Shahar E, Nassar L, Kedem E, Hassoun G. Are you the author?
Institute of Allergy, Clinical Immunology & AIDS, Rambam Health Care Campus, Israel.
Reference: Curr Drug Saf. 2014 May 27. Epub ahead of print.
doi: 10.2174/1574886309666140527112408
PubMed Abstract
PMID: 24861992
