Phenylephrine causes anuria in a patient with benign prostatic hyperplasia
DOI:
https://doi.org/10.18203/2320-6012.ijrms20244150Keywords:
Anuria, BPH, Phenylephrine, OTC medicineAbstract
Phenylephrine is classified as an alpha-adrenergic agonist and used as a nasal decongestant. Benign prostatic hyperplasia (BPH) is a common progressive disease in males over the age of 40, leading to urethral constriction. Alpha-1A (α1A) receptor blockers such as Silodosin are commonly prescribed to manage BPH symptoms. They relax the smooth muscle around the bladder exit, in the lower urinary tract and prostate gland to facilitate the passage of urine in BPH. However, when combined with alpha-adrenergic agonists such as Phenylephrine, this mechanism may be disrupted. This case report highlights contraindication of Phenylephrine in patients with BPH. It may induce anuria in patients with BPH. We present a case report of a diabetic, hypertensive and hypothyroidism patient with BPH suffering from anuria due to administration of an over-the-counter medicine containing Phenylephrine. Caution should be taken while prescribing Phenylephrine in BPH patients on medication with alpha-1A (α1A) receptor blockers.
Metrics
References
Schmitz DG. Toxins affecting the urinary system. Veterinary Clinics of North America: Equine Practice. 2007;23(3):677-90.
HolleyJL: Clinical Approach to the Diagnosis of Acute Renal Failure. Primer on Kidney Diseases. 5th ed. Philadelphia: Saunders; 2009: 277–283.
Jóźwiak-Bebenista M, Nowak JZ. Paracetamol: mechanism of action, applications and safety concern. Acta Pol Pharma. 2014;71(1):11-23.
Andrawis NS, Craft NO, Abernethy DR. Calcium antagonists block angiotensin II-mediated vasoconstriction in humans: comparison with their effect on phenylephrine-induced vasoconstriction. J Pharmacol Exp Therap. 1992;261(3):879-84.
Rizvi SA, Ferrer G, Khawaja UA, Sanchez-Gonzalez MA. Chlorpheniramine, an old drug with new potential clinical applications: a comprehensive review of the literature. Current Rev Clin Exp Pharmacol Form Curr Clin Pharmacol. 2024;19(2):137-45.
Dewani AP, Barik BB, Chipade VD, Bakal RL, Chandewar AV, Kanungo SK. RP-HPLC-DAD method for the determination of phenylepherine, paracetamol, caffeine and chlorpheniramine in bulk and marketed formulation. Arabian J Chem. 2014;7(5):811-6.
Chughtai B, Forde JC, Thomas DD, Laor L, Hossack T, Woo HH, et al. Benign prostatic hyperplasia. Nature reviews Disease primers. 2016;2(1):1-5.
Jindan L, Xiao W, Liping X. Evolving role of silodosin for the treatment of urological disorders–A narrative review. Drug Design Develop Ther. 2023;3:2861-84.
Wang D, Zha X, Nagase K, Akino H, Muramatsu I, Ito H, Yokoyama O. Effects of the 5α-reductase inhibitor dutasteride on rat prostate α1A-adrenergic receptor and its mediated contractility. Urol. 2015;85(3):704-9.
Sharma P, Yadav SK, Shah SD, Javed E, Lim JM, Pan S, et al. Diacylglycerol kinase inhibition reduces airway contraction by negative feedback regulation of GQ-signaling. Am J Respir Cell Mol Biol. 2021;65(6):658-71.
Kiran M, Pawaskar ML, Sheikh MS, Waghambare MP. Post-marketing surveillance study to substantiate the efficacy and safety for the combination of paracetamol, phenylephrine, chlorpheniramine maleate, sodium citrate and menthol in indian patients of common cold. IJIRMS. 2021;6(7):430-4.