Drug offers relief for enlarged prostate

Q. I have heard that the Food and Drug Administration has approved a new drug to treat symptoms of prostate enlargement. The trouble is that I didn’t catch the name. If it is less likely to cause sexual difficulties than finasteride or an alpha-blocker like terazosin, I am very interested.

A. The new drug has actually been on the market for several years for another purpose. Cialis (tadalafil) was the third erectile-dysfunction medication approved by the FDA (after Viagra and Levitra).

The recent approval is for benign prostatic hypertrophy (BPH). An enlarged prostate can make it difficult for men to urinate. Drugs like finasteride (Proscar) and terazosin (Hytrin) can help with this symptom, but both may interfere with sexual performance.

Because Cialis is used to treat erectile dysfunction, it should overcome this problem while easing urinary symptoms due to BPH. Side effects associated with Cialis include headache, indigestion, nasal congestion, back or muscle pain, flushing, cough, stomachache and diarrhea. Changes in hearing or vision are rare but should be reported to a doctor immediately.

Q. I am a physician. Often, we are afraid to stop medications because if something bad happens, we could be sued. I love it when my patients stop their medications themselves or refuse to take more, because then I am safe from our culture of blame. Many of my geriatric patients are on far too many medications and would be better off without them. It takes enormous moral courage to do the right thing in our current litigious environment.

A. Older people often take a handful of pills every day. Some are prescribed to treat side effects from other medications. Far too many senior citizens may be overmedicated. In some cases, this can lead to depression, confusion or a false diagnosis of dementia.

We discuss this dilemma and list drugs that are inappropriate for older people in our book, “Top Screwups Doctors Make and How to Avoid Them.” We recognize that individual doctors are under tremendous time pressure and are doing the best they can for their patients. That said, it is critical for patients and their family members to be vigilant against overmedication and drug interactions that could be harmful.

Q. I want to get all the written, credible medical information possible about my prescription. In the old days, the pharmacist would include printed information from the manufacturer along with the drug. That version was FDA-approved. These days, we usually get a one-page summary with the Rx. These are prepared by an outside service, and they are not the fine-print detailed version that I trust. I have repeatedly asked my pharmacists for the more detailed printed form, and I’ve been told it’s not available. Can you tell us where we can find the FDA-vetted information?

A. You can get the prescribing information online. Go to dailymed.nlm.nih.gov, and you will find the detailed version you seek for most of the drugs now available. You can also check the Physicians’ Desk Reference at the library. It contains the same information.

2011 King Features Syndicate, Inc.