The appropriate management of benign prostatic hyperplasia (BPH) includes the counseling of patients regarding not only the interactions with different medications, but also between medications and food.

Here, researchers reviewed the potential effects of food, alcohol, and fruit juices on the characteristics and pharmaceutical effects of drugs used in the treatment of BPH. Their findings reveal that this knowledge is important for effective therapy because, for example, alcohol and grapefruit juice tend to significantly impact the effectiveness and safety of the drug therapy, as well as drug intake in relation to meals.

The review article, “Interactions between medications employed in treating benign prostatic hyperplasia and food:
A short review,” was published in Biomedicine & Pharmacotherapy.

The most important drugs employed in the treatment of BPH are alpha-1 adrenergic receptor antagonists and 5 a-reductase inhibitors. Alpha-1 adrenergic receptor antagonists are a group of medications that lead to smooth muscle relaxation in the prostate. The 5 a-reductase inhibitors suppress the conversion of testosterone to dihydrotestosterone, an important factor in prostate growth, which ultimately leads to prostate shrinkage. Some patients require a combination of different medications.

Effective management of BPH should include patient education on pharmacotherapy, especially the interactions between medications and the food patients consume. In this study, researchers reviewed the literature on this subject published between 1991 and 2015.

On the subject of alpha-1 adrenergic receptor antagonists, the researchers found relevant information regarding alfuzosin, doxazosin, silodosin, tamsulozin and terazosin. Drinking grapefruit juice was found to have potential interactions with alfuzosin, silodosin, and tamsulozin, so caution with this particular juice is advised while on these medications. Also, alcohol was found to possibly increase the hypotensive effect of the medications, so researchers recommend either abstinence or greatly reducing alcohol consumption.

The researchers also summarize important information, such as the most recommended time of the day when meals should be eaten.

Studies on possible food and beverage interactions with  5 a-reductase inhibitors, such as finasteride and dutasteride, are scarce and indicate that a potential impact of food on the drugs’ characteristics is of no clinical relevance. Consequently, medications can be taken regardless of meals.

“Knowledge of the subject, especially with respect to alpha-1 adrenergic receptor antagonists, is, however, necessary to educate patients properly, which is the key element of pharmaceutical care,” the researchers concluded.