Can You Take Cough Medication With An Enlarged Prostate?

In our latest question and answer, the pharmacist discusses which cough medications are safe if you have an enlarged prostate.

Question

What is the best over-the-counter cough medicine if you have an enlarged prostate?

Asked by Mickey On Nov 27, 2022

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Nov 27, 2022
Last updated Apr 24, 2024

Key points

  • Most over-the-counter cough medications, like dextromethorphan, are safe if you have been diagnosed with an enlarged prostate.
  • You have to be cautious with a number of other OTC medications though, including antihistamines, NSAIDs (e.g., ibuprofen), and nasal decongestants.
  • Prescription opioid cough medications (e.g., codeine) need to be used cautiously as well.

Answer

Most over-the-counter (OTC) cough medications are safe to take if you have an enlarged prostate or have been diagnosed with BPH (benign prostatic hyperplasia).

What you do need to be careful of is taking prescription cough medicine that contains an opioid, like codeine.

Opioid cough medications are not recommended for those with an enlarged prostate since they can exacerbate symptoms of urinary retention and can decrease urine output due to increased tension of the detrusor muscle in the bladder.

Additionally, you want to watch out for OTC combination drug products that contain cough medication since the other drugs in these products could cause problems (such as antihistamines and nasal decongestants).

OTC Cough Medications Safe With An Enlarged Prostate

There are numerous cough suppressants available over the counter, ranging from natural remedies (e.g. honey) to drug products like Delsym (dextromethorphan).

Most are safe to take if you have an enlarged prostate but you do need to watch out for combination ingredient drug products.

Cough suppressants are often used in combination with other drugs that may not be safe to take. For example, antihistamines can make symptoms of BPH worse and should not be taken unless your doctor recommends them.

Dextromethorphan

Dextromethorphan is the most commonly used over-the-counter cough suppressant.

It is the active ingredient in numerous products, including:

  • Delsym
  • Robitussin DM

Dextromethorphan is safe to take if you have an enlarged prostate and should not make any symptoms (e.g. urinary retention) worse.

It is fairly well tolerated overall, but the most common side effects include:

  • Drowsiness
  • Dizziness
  • Fatigue

Other Cough Medications

Aside from dextromethorphan, there are other options available to you to help suppress a cough.

All of the following are considered safe if you have an enlarged prostate:

  • Menthol cough drops
  • Anesthetic cough drops (e.g. Cepacol, Sucrets)
  • Honey-based cough suppressant
  • Mucinex (guaifenesin)

Additionally, while not a cough suppressant, Mucinex (guaifenesin) is safe to take if you have an enlarged prostate. It is commonly included in dextromethorphan-containing products.

OTC Medications To Use With Caution With An Enlarged Prostate

Three classes of medication should be used cautiously, or not at all unless you speak with your doctor if you have been diagnosed with an enlarged prostate.

They are:

  • Antihistamines
  • Nasal decongestants
  • NSAIDs

Antihistamines

Antihistamines, like Benadryl, Claritin, and Zyrtec, have anticholinergic properties, which can worsen symptoms of an enlarged prostate. They have 'drying' effects and can reduce muscle contractility in the bladder which can, in turn, reduce urine flow.

Some antihistamines are certainly safer than others though.

First-generation antihistamines, like Benadryl, have the strongest anticholinergic properties, while second-generation antihistamines, like Claritin, are weaker in this regard.

If your doctor does recommend an antihistamine, you will likely find second-generation antihistamines, like Claritin or Zyrtec, having less of an effect on any symptoms you are experiencing from an enlarged prostate when compared to something like Benadryl.

Nasal Decongestants

Over-the-counter nasal decongestants are well known to potentially exacerbate symptoms of an enlarged prostate. They can tighten the muscles in the bladder and prostate, reducing urine flow. This can make it even more difficult to go to the bathroom.

The two nasal decongestants to avoid (unless otherwise recommended) are:

  • Sudafed (pseudoephedrine)
  • Sudafed PE (phenylephrine)

NSAIDs

Over the counter NSAIDs include:

  • Advil (ibuprofen)
  • Aleve (naproxen)

These pain relievers have mixed evidence regarding whether or not they can make symptoms of BPH worse.

If you need a pain reliever, Tylenol (acetaminophen) may be your best choice as it is not associated with any adverse effects on the bladder, prostate or urine flow.

Prescription Cough Medication

Opioid cough medications should not be used if you have an enlarged prostate unless your doctor recommends it.

Prescription cough medications include:

  • Tussionex (hydrocodone; chlorpheniramine)
  • Cheratussin AC (guaifenesin; codeine)

Opioids can make enlarged prostate symptoms worse as they increase the tension of the detrusor muscle, which contracts to release urine. A tightening of this muscle can make it more difficult to urinate.

Additional Information

Be sure to talk to your doctor regarding which cough medications are safe to use in your particular medical situation.

As mentioned, dextromethorphan and other natural remedies are generally safe in those with an enlarged prostate but check with your doctor first.

Final Words

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References

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

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