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.

Can You Take Cough Medication With An Enlarged Prostate?
Mar 20, 2019

Mickey asked

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

At a glance

  • Dextromethorphan (Delsym) is considered safe to take if you have been diagnosed with an enlarged prostate and should not make symptoms (e.g. difficulty urinating) worse. Most natural remedies (e.g. honey) are safe as well.
  • Be sure to check with your doctor first if you are considering other classes of medication like antihistamines or nasal decongestants.


Text Over Pouring Bottle Of Cough Medication

Most over the counter cough medications are safe to use 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.

Over The Counter 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 dextromethorphan.

Most are safe to take if you have 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 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)

Over The Counter 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, 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 decongestant to avoid (unless otherwise recommended) are:

  • Sudafed (pseudoephedrine)
  • Sudafed PE (phenylephrine)


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.

  • Elsevier ClinicalKey: Dextromethorphan Monograph
  • Elsevier ClinicalKey: Pseudoephedrine Monograph
  • Elsevier ClinicalKey: Diphenhydramine Monograph
  • Drug-Related Problems in Patients with Benign Prostatic Hyperplasia: A Cross Sectional Retrospective Study. PubMed
  • American Urological Association (AUA) (2010) Guideline on the management of benign prostatic hyperplasia (BPH). UAU Guidelines

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