Mon Feb 9, 2015 | 4:16 PM EST

Men with prostate trouble should avoid some cold medicines


By Daniel Gaitan
With cold and flu season in full swing, experts are warning men who have an enlarged prostate to avoid medicines containing antihistamines and decongestants.

“It’s very important that men with enlarged prostate avoid cold medicines with pseudoephedrine or phenylephrine. Those are ingredients in decongestants and they constrict the prostatic capsule” and lead to urine retention, said Dr. Gregory T. Bales,
a urologist at the University of Chicago Medical Center. “Antihistamines aren’t quite as bad, because they work more on the bladder muscle, but they can cause bladder contractility.”

Enlargement of the prostate, formally known as benign prostate hyperplasia (BPH), results from increased cell growth in and around the prostate gland. The increased growth can constrict the urethra (the tube that carries urine out from the bladder) and
decrease urine flow. Men with the progressive disease often have difficulty urinating and the urge to go more frequently.

BPH is more common in older men, because as men age their prostate continues to grow. Nearly 80 percent of men age 50 and older will be diagnosed with some degree of the disease, said Dr. William Catalona, a urologist with Northwestern University’s
Feinberg School of Medicine in Chicago.

“We don’t know what causes benign prostatic enlargement, it’s one of the great mysteries, and we really wish we did because it’s such a prevalent condition,” Catalona told Reuters Health. “Sometimes men need to get up every hour at night.”

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Bales has treated hundreds of patients struggling with BPH, and he warns against waiting too long to visit a doctor during complete retention. Severe retention can cause kidney damage and other serious issues.

“If a man is already having a little difficulty and his stream is already slow, and then you (make it worse) it by adding one of these medicines, it’s the recipe for causing retention. All it takes is one dose,” Bales told Reuters Health. “If you
haven’t urinated in six hours or so, you have to go to the hospital and get a catheter put in to drain that liquid. Then we wait a couple days to let the medicine get out of his system and then do a urine test. It’s painful.”

Cold remedies that are inhaled, such as a nasal corticosteroid, will not have the same side effects as an oral agent, Bales added. Mentholated ointments are a safer alternative to decongestants.

“If men notice problems with urination after taking certain medicines, they may need to weigh the risks and benefits,” Dr. Dan R. Gralnek, a urologist with the University of Wisconsin School of Medicine and Public Health, told Reuters Health. Nearly
15 percent of his patients have complications associated with BPH.

Dr. Matthew Johnson, a urologist with Aurora Health Care in Milwaukee, Wisconsin, urges men to carefully read over-the-counter drug labels.

“You have to be aware of what a medication’s potential side-effects are. Unfortunately, the package insert for most medications is quite lengthy,” he told Reuters Health. “Men need to have a relationship with a provider who can monitor these
things and individualize their care.”


http://mobile.reuters.com/article/idUSKBN0LD2EK20150209

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GUAIFENESIN AC
Side Effects
List Guaifenesin AC side effects by likelihood and severity.
The following side effects are associated with Guaifenesin AC:

Common side effects of Guaifenesin AC:

DrowsinessLess Severe
Incomplete or Infrequent Bowel MovementsLess Severe
Inducing of a Relaxed Easy StateLess Severe
Stomach CrampsLess Severe
Infrequent side effects of Guaifenesin AC:

Abnormal Nervous System Function Affecting Mental AlertnessSevere
Collapsed Portion of LungSevere
Decreased Lung FunctionSevere
Trouble BreathingSevere
Abnormally Low Blood PressureLess Severe
ConfusedLess Severe
DizzyLess Severe
Dry MouthLess Severe
Excessive SweatingLess Severe
False Sense of Well-BeingLess Severe
Feel Like Throwing UpLess Severe
Feeling FaintLess Severe
Feeling Unhappy or UnwellLess Severe
Feeling WeakLess Severe
Head PainLess Severe
Heart Throbbing or PoundingLess Severe
HivesLess Severe
ItchingLess Severe
Kidney Problems Causing a Decreased Amount of Urine to be PassedLess Severe Loss of AppetiteLess Severe
NervousLess Severe
Problems with EyesightLess Severe
RashLess Severe
Throwing UpLess Severe
Ureteral SpasmLess Severe
Rare side effects of Guaifenesin AC:

Adrenal Gland ProblemsSevere
Blocked Bowels with Decreased Peristaltic MovementSevere
Complete Stoppage of the HeartSevere
Lung Failure causing Loss of BreathSevere
PancreatitisSevere
Problems with CirculationSevere
SeizuresSevere
ShockSevere
Slow HeartbeatSevere
Altered Interest in Having Sexual IntercourseLess Severe
AnxiousLess Severe
Chronic Trouble SleepingLess Severe
DiarrheaLess Severe
Extreme Sense of Well BeingLess Severe
Inability to have an ErectionLess Severe
Involuntary QuiveringLess Severe
Irritation of the Stomach or IntestinesLess Severe
Low EnergyLess Severe
Problems Getting PregnantLess Severe
Sensation of Spinning or WhirlingLess Severe
Spasm of a Bile Duct TractLess Severe
Temporary Redness of Face and NeckLess Severe
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Treatment by Condition Related to Guaifenesin AC

Cold Symptoms Medications
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http://www.webmd.com/drugs/2/drug-1004/guaifenesin-ac-oral/details/list-sideeffects

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Guaifenesin/dextromethorphan: Indications, Side Effects, Warnings - Drugs.com


Guaifenesin/ dextromethorphan
Generic Name: guaifenesin/dextromethorphan (gwye-FEN-e-sin/DEX-troe-meth-OR-fan and a-SEET-a-MIN-oh-fen/KLOR-fen-IR-a-meen/DEX-troe-meth-OR-fan)
Brand Name: Coricidin HBP Day/Night Multi-Symptom Cold


Overview
Side Effects
Interactions
More
Guaifenesin/ dextromethorphan is used for:
Temporarily relieving symptoms of minor aches and pains, fever, headache, runny nose, sneezing, and cough due to colds, upper respiratory infections, and allergies. It may also be used for other conditions as determined by your doctor.

Guaifenesin/dextromethorphan is an expectorant, analgesic, antihistamine, and cough suppressant combination. The antihistamine works by blocking the action of histamine, which helps reduce symptoms such as watery eyes and sneezing. The expectorant works
by loosening mucus and lung secretions in the chest and making coughs more productive. The analgesic and cough suppressant work in the brain to decrease pain and fever, and to reduce a dry or unproductive cough.

Do NOT use guaifenesin/ dextromethorphan if:

you are allergic to any ingredient in guaifenesin/dextromethorphan
you are unable to urinate or are having an asthma attack
you are taking another medicine (prescription or nonprescription) that contains acetaminophen
you take sodium oxybate (GHB) or you have taken furazolidone or a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) within the last 14 days
Contact your doctor or health care provider right away if any of these apply to you.

See also
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Before using guaifenesin/ dextromethorphan:
Some medical conditions may interact with guaifenesin/dextromethorphan. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are pregnant, planning to become pregnant, or are breast-feeding
if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
if you have allergies to medicines, foods, or other substances
if you have a history of asthma, chronic obstructive pulmonary disease (COPD), or other lung or breathing problems (eg, chronic bronchitis, emphysema, sleep apnea); if you have a chronic cough; or if your cough occurs with a large amount of mucus
if you have a history of glaucoma or increased pressure in the eye, heart problems, liver or kidney problems, seizures, or thyroid problems
if you have a blockage of your bladder, stomach, or bowels; an enlarged prostate or other prostate problems; or trouble urinating
if you drink alcohol or have a history of alcohol abuse or dependence
Some MEDICINES MAY INTERACT with guaifenesin/dextromethorphan. Tell your health care provider if you are taking any other medicines, especially any of the following:

Anticoagulants (eg, warfarin) because the risk of bleeding may be increased Abiraterone, furazolidone, MAOIs (eg, phenelzine), or sodium oxybate (GHB) because they may increase the risk of guaifenesin/dextromethorphan's side effects
Medicines that may harm the liver (eg, methotrexate, ketoconazole, isoniazid, certain medicines for HIV infection) because the risk of liver side effects may be increased. Ask your doctor if you are unsure if any of your medicines might harm the liver
This may not be a complete list of all interactions that may occur. Ask your health care provider if guaifenesin/dextromethorphan may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the
dose of any medicine.


How to use guaifenesin/ dextromethorphan:
Use guaifenesin/dextromethorphan as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Take guaifenesin/dextromethorphan by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation.
This product contains 2 different medicines, one for the morning and one for the evening. Be sure you understand how to take guaifenesin/dextromethorphan. Check with your doctor or pharmacist if you are not sure which to take in the morning and which to
take in the evening.
If you miss a dose of guaifenesin/dextromethorphan and you are taking it regularly, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.
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Ask your health care provider any questions you may have about how to use guaifenesin/dextromethorphan.

Important safety information:
Guaifenesin/dextromethorphan may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you take it with alcohol or certain medicines. Use guaifenesin/dextromethorphan with caution. Do not drive or perform other possibly unsafe
tasks until you know how you react to it.
Do not drink alcohol while you take guaifenesin/dextromethorphan.
Check with your doctor before you use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are taking guaifenesin/dextromethorphan; it may add to their effects. Ask your pharmacist if you have questions about which medicines
may cause drowsiness.
Guaifenesin/dextromethorphan has acetaminophen, chlorpheniramine, guaifenesin, and dextromethorphan in it. Before you start any new medicine, check the label to see if it has any of these medicines in it too. If it does or if you are not sure, check with
your doctor or pharmacist.
Do not use guaifenesin/dextromethorphan for a cough with a lot of mucus. Do not use it for a long-term cough (eg, caused by asthma, emphysema, smoking). However, you may use it for these conditions if your doctor tells you to.
Do NOT take more than the recommended dose or take guaifenesin/dextromethorphan for longer than prescribed without checking with your doctor.
Contact your doctor if your pain or cough does not improve within 7 days, gets worse, goes away and then comes back, or occurs along with fever, rash, or persistent headache.
Contact your doctor if redness or swelling is present, or if new symptoms occur.
Contact your doctor if you have a fever that gets worse or lasts for more than 3 days.
Guaifenesin/dextromethorphan may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to guaifenesin/dextromethorphan. Use a sunscreen or wear protective clothing if you must be outside for
more than a short time.
Guaifenesin/dextromethorphan may harm your liver. Your risk may be greater if you drink alcohol while you are taking guaifenesin/dextromethorphan. Talk to your doctor before you take guaifenesin/dextromethorphan or other fever reducers if you drink
alcohol.
A very bad skin reaction (Stevens-Johnson syndrome/toxic epidermal necrolysis) may happen. It can cause very bad health problems that may not go away and sometimes death. Get medical help right away if you have signs like red, swollen, blistered, or
peeling skin (with or without fever); red or irritated eyes; or sores in your mouth, throat, nose, or eyes.
Contact your doctor right away if you take more than 4,000 mg of acetaminophen per day, even if you feel well.
Guaifenesin/dextromethorphan may interfere with skin allergy tests. If you are scheduled for a skin test, talk to your doctor. You may need to stop taking guaifenesin/dextromethorphan for a few days before the tests.
Tell your doctor or dentist that you take guaifenesin/dextromethorphan before you receive any medical or dental care, emergency care, or surgery.
Use guaifenesin/dextromethorphan with caution in the ELDERLY; they may be more sensitive to its effects, especially confusion, constipation, dizziness, drowsiness, dry mouth, or trouble urinating.
Caution is advised when using guaifenesin/dextromethorphan in CHILDREN; they may be more sensitive to its effects, especially excitability.
Guaifenesin/dextromethorphan should not be used in CHILDREN younger than 12 years old without first checking with the child's doctor; safety and effectiveness in these children have not been confirmed.
PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of taking guaifenesin/dextromethorphan while you are pregnant. It is not known if this medicine is found in breast milk. Do not
breast-feed while taking guaifenesin/dextromethorphan.
Possible side effects of guaifenesin/ dextromethorphan:
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

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Constipation; diarrhea; dizziness; drowsiness; dry mouth, nose, or throat; excitability; headache; nausea; trouble sleeping; upset stomach.

Seek medical attention right away if any of these SEVERE side effects occur: Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision or other vision changes; confusion; difficulty urinating or inability to urinate; fast or
irregular heartbeat; fever, chills, or persistent sore throat; hallucinations; mental or mood changes; seizures; severe or persistent dizziness, drowsiness, light-headedness, or headache; symptoms of liver problems (eg, dark urine, loss of appetite, pale
stools, stomach pain, yellowing of the skin or eyes); tremor; unusual bruising or bleeding; unusual tiredness or weakness.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please
read the Guide to Reporting Problems to FDA.


If OVERDOSE is suspected:
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include blurred vision; confusion; hallucinations; seizures; severe dizziness, drowsiness, light-
headedness, or headache; symptoms of liver problems (eg, dark urine, loss of appetite, pale stools, stomach pain, yellowing of the skin or eyes); tremors; unusually fast, slow, or irregular breathing; unusually fast, slow, or irregular heartbeat;
vomiting.

Proper storage of guaifenesin/dextromethorphan:
Store guaifenesin/dextromethorphan at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not freeze. Do not store in the bathroom. Keep guaifenesin/dextromethorphan out of the reach of
children and away from pets.

General information:
If you have any questions about guaifenesin/dextromethorphan, please talk with your doctor, pharmacist, or other health care provider.
Guaifenesin/dextromethorphan is to be used only by the patient for whom it is prescribed. Do not share it with other people.
If your symptoms do not improve or if they become worse, check with your doctor.
Check with your pharmacist about how to dispose of unused medicine.
This information should not be used to decide whether or not to take guaifenesin/dextromethorphan or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not
endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about guaifenesin/dextromethorphan. It does NOT include all information about the possible uses,
directions, warnings, precautions, interactions, adverse effects, or risks that may apply to guaifenesin/dextromethorphan. This information is not specific medical advice and does not replace information you receive from your health care provider. You
must talk with your healthcare provider for complete information about the risks and benefits of using guaifenesin/dextromethorphan.

Review Date: February 1, 2017

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not
endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings,
precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider
for complete information about the risks and benefits of using this medicine.

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