Why Zyrtec Can Make BPH Symptoms Worse

cody asked

Dr. Brian Staiger, Thanks for your helpful answer. However, I would still like if you kindly elaborate a bit on "Antihistamines, like Zyrtec (cetirizine), are recommended to be used cautiously in those with an enlarged prostate or have been diagnosed with BPH. What do you mean by "cautiously"? Will it be too much if a man of 74 takes about 2-3 Cetirizine Hydrochloride 10mg/day in a year?

Answer

Antihistamines, like Benadryl and Zyrtec, are recommended to be used cautiously as they simply can exacerbate symptoms of BPH (benign prostatic hyperplasia).

One of the primary symptoms of BPH is weak urine flow due to prostate enlargement constricting the urethra. Other associated symptoms include:

• Increased urinary frequency
• Urinary retention
• Urinary incontinence

Antihistamine Anticholinergic Effects

Many over the counter antihistamines have 'anticholinergic' effects, including Zyrtec (cetirizine). Anticholinergic effects include:

• Sedation
• Dry mouth
• Dry eyes
• Constipation
• Urinary retention
• Impaired cognitive performance
• Inability to regulate temperature

An over-generalization, albeit somewhat accurate description, of anticholinergic effects is that they cause an overall 'drying' effect on the body...hence constipation, dry mouth, dry eyes, etc... symptoms.

Typically, the risk of BPH symptom exacerbation increases with the use of older antihistamines. For example, the 'first-generation antihistamine' Benadryl is thought to have more anticholinergic effects than Claritin, a 'second-generation antihistamine', and is, therefore, is typically recommended to be used cautiously if you have BPH.

Zyrtec BPH Effects

The overall severity of anticholinergic effects as it relates to Zyrtec is relatively low, but could certainly exacerbate certain symptoms in those susceptible. In your case, if you have BPH and already have some issues as it relates to urination, there is a chance Zyrtec could make it worse.

Zyrtec is a 'second-generation' antihistamine and certainly does have less anticholinergic effects than something like Benadryl. Nevertheless, as somewhat of a 'blanket warning', it is just recommended to use antihistamines cautiously due to the risk of making BPH symptoms worse.

Certain populations are more susceptible to the anticholinergic effects of drugs, including the elderly as they already are predisposed to have a decrease in endogenous cholinergic activity. So that needs to be taken into account as well.

Final Words

There don't appear to be long term effects if you take an antihistamine like Zyrtec if you have BPH.

It won't cause your condition to worsen over time. What it may do is make acute symptoms that much worse. However, once it is metabolized and eliminated from the body, there shouldn't be any lingering effects of the drug.

Taking Zyrtec once in a while is most likely safe, but just be aware that when you do take the drug, your BPH symptoms may temporarily get worse. It is important to speak with your doctor regarding whether or not Zyrtec is the best option for you or if there are possible alternatives.