Home' Australian Pharmacist : April 2011 Contents Vol.30–April#04
The articles in this series are independently researched and compiled by PSA commissioned authors and peer reviewed.
Where can I find more
information on BPH?
The following websites contain useful
information about BPH and urinary
• Andrology Australia:
(Tel: 1300 303 878)
• Australian Government
Bladder & Bowel Website:
• Department of Health and Ageing
• Continence Foundation of Australia:
(Tel: 1800 330 066)
• The National Kidney and
Urologic Diseases Information
Clearinghouse (NKUDIC); National
Institutes of Health: http://kidney.
• University of Maryland Medical
Center (UMMC): www.umm.edu/
Case study continued
Mr Edkins should be offered a
tamsulosin CMI and provided with
advice on how to take the tablets
and possible side effects. He should
be warned about potentially serious
side effects which require medical
attention (e.g . angioedema, priapism,
palpitations and skin rashes). He should
be cautioned that the tamsulosin may
initially cause him to feel faint or dizzy,
and that the combination of tamsulosin
and his blood pressure medicines may
increase the risk of dizziness and light-
headedness. To minimise this effect,
he should get up slowly from a sitting
or lying position and, if he feels faint
on standing up, he should lie down for
a short while. Taking the tamsulosin at
bedtime may be helpful, but he should
be careful if he gets up during the night
as he might feel dizzy. He should avoid
driving a car or operating machinery
if he feels dizzy. If the dizziness or
light-headedness persists, he should
see his doctor and have his blood
pressure checked. He can be reassured
that the tamsulosin is unlikely to
affect his sertraline. He should be
warned that, if he needs to have
cataract surgery in the future, he must
inform his ophthalmologist that he
is taking, or has taken, tamsulosin.
Lifestyle modifications which may help
to alleviate his symptoms can also
Key learning points
• BPH becomes increasingly common
as men get older, and is present
in approximately 90% of men over
the age of 80. For some men the
symptoms are quite mild or non-
existent, however, many men
experience a range of lower urinary
tract symptoms (LUTS). These can
include hesitancy, urinary retention,
overflow incontinence, urgency,
frequency and nocturia.
• Drugs used for BPH include
blockers (tamsulosin, alfuzosin,
prazosin and terazosin) and 5-alpha-
reductase inhibitors (finasteride and
• Men with severe symptoms which
have not responded to drug therapy
may require surgical intervention.
Non-drug therapies which are
available include transurethral
resection of the prostate (TURP),
laser therapy, transurethral
microwave thermotherapy (TUMT)
and open prostatectomy.
• Men can also try certain lifestyle
modifications which may help to
alleviate the symptoms of BPH.
Because LUTS can also be caused by
other disorders, including infections,
prostate cancer, neurological disease
or renal disease, men with these
symptoms should be referred to a
doctor for investigation.
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(BPH) [online]. Andrology Australia. Mar 2006.
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Healthcare Professionals [online]; last updated Oct
2008. At: www.merckmanuals.com/professional/sec17/
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[online]. National Kidney and Urologic Diseases
Information Clearinghouse (NKUDIC); National Institutes
of Health US. Jun 2006. At: http://kidney.niddk.nih.gov/
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[online]. American Urological Association of Education
and Research, Inc. 2010. At: www.auanet.org/content/
7. Rossi S, ed. Australian Medicines Handbook [online].
Adelaide: Australian Medicines Handbook; 2011.
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St Leonards: CMPMedica Australia, Nov 2010.
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Phoenix Medical Publishing; 2011.
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handbook (APF). 21st edn. Canberra: Pharmaceutical
Society of Australia; 2009.
11. Baxter K, ed. Stockley’s drug interactions. 8th edn.
London: Pharmaceutical Press; 2008.
12. Andrology Australia. Clinical summary guide 7:
prostate disease [online]. May, 2010.
13. Goldstraw MA, Kirby RS, Dasgupta P. The role of
botulinum toxin in benign prostatic hyperplasia [online].
British Journal of Urology International. Dec 2006;
98(6):1147–8. At: http://onlinelibrary.wiley.com/
14. Tacklind J, MacDonald R, Rutks I, et al. Serenoa repens
for benign prostatic hyperplasia [online]. Cochrane
Database of Systematic Reviews 2009, Issue 2.
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(UMMC). 2011. At: www.umm.edu/patiented/articles/
counselling in practice
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