Why Cold Medicine May Affect a Man's Ability to Pee

OTC Meds and Urinary Symptoms in Men With Enlarged Prostates

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You may have heard that urinary problems, such as the inability to pee, can occur when you take cold medications. Or, perhaps, you took a cold medication and are wondering why you aren't able to urinate.

Prostate problems and medications for an enlarged prostate don't always mix with medications for the cold or flu, as these common over-the-counter cold meds can cause urinary retention, making it harder for your body to release urine.

Man blowing his nose
Chris Ryan / Getty Images

Cold and Flu Medications That Cause Urinary Retention

Flu season and colds hit every winter, and even with a flu shot, many people still experience those days of a cough, runny nose, and congestion.

Since the symptoms of the cold or flu can make it hard to work or play, a lot of people choose over-the-counter cold medications to fight the symptoms. Keep in mind that other than Tamiflu (oseltamivir phosphate), which is a prescription drug for people who have tested positive for the influenza virus, these over-the-counter medications available help with symptoms alone. They do nothing to treat the actual virus.

Common medicines like pseudoephedrine work by constricting the muscles in the nasal passages and sinuses to help the sufferer breathe better. The muscle fibers in the nose and sinuses are under the control of alpha adrenergic receptors.

These alpha receptors also can be found in the muscles surrounding the bladder and prostate. When a male takes a cold medicine, these same muscle fibers may contract around the prostate and narrow the urine flow. If a person has an enlarged prostate (which is the norm rather than the exception as males tend to age), the urinary channel may be narrowed even more, causing painful urinary retention.

While urinary retention in response to cold and flu medications most often occurs in older men with benign prostatic hypertrophy, it has been reported in children as young as age 3.

Medications to Use for a Cold if You Have Prostate Problems

If you have an enlarged prostate or other prostate or urinary tract problems such as prostate cancer, what can you take to get relief from that stuffy, runny nose?

It may be best to stay away from pseudoephedrine, ephedrine, and phenylephrine products. Even topicals such as Afrin can be problematic for the prostate. If you read carefully through the active ingredients in cold and flu medications you will find these compounds listed often. One study found that 6 percent of men aged 50 to 69 had experienced an aggravation of an enlarged prostate due to taking cold medications. Not surprisingly, visits to the emergency room with urinary retention are more common during the winter months.

Options which won't cause prostate problems include:

  • Putting eucalyptus and camphor products under your nose and on your chest. This doesn't work physically—it doesn't reduce congestion—but it may trick your brain into thinking you are breathing better. This is especially true for those who used these treatments as a child.
  • Hot baths are an easy option and are readily available.
  • Steam humidifiers are cumbersome but can also provide symptomatic relief without interfering with the prostate.

Prostate Medications and Cold Medications May Not Mix Well

If you are taking a medication for an enlarged prostate, it's important to know which category of medication you are using, whether it is an alpha-blocker or a 5-alpha-reductase inhibitor.

If you are taking an alpha-blocker, combining these drugs with cough or flu medications isn't a good idea. Since cold medications such as pseudoephedrine work on alpha-adrenergic receptors, taking a cold medication that blocks the receptors negates any effect of your prostate drug. The cold medicine blocks the signal to the smooth muscle in the prostate to keep the channel open. In essence, you're waging a pharmaceutical war against yourself! As an example, alpha agonists like Sudafed (pseudoephedrine), work directly against alpha-blockers like Flomax.

Medications that are classified as alpha-blockers (and used both for prostate problems and high blood pressure) include:

  • Cardura (doxazosin)
  • Hytrin (terazosin)
  • Minipress (prazosin)

Those that are used only for prostate issues include:

  • Flomax (tamsulosin)
  • Rapaflo (silodosin)
  • Uroxatral (alfuzosin)

Side effects of alpha-blockers include a stuffy and runny nose and sexual dysfunction due to relaxation of the bladder neck, which can affect ejaculation.

Prostate Medications That Don't Interfere Directly With Cold Medications

There are prostate medications which do not directly interfere with cold medications. These drugs, known as 5-alpha reductase inhibitors include:

  • Proscar or Propecia (finasteride)
  • Avodart (dutasteride)

Keep in mind that these drugs will not interfere directly with cold medicines (by canceling out their actions), but taking cold medications could still result in urinary retention.

Problems May Be a Warning Sign

If you find that your prostate is sensitive to cold medicines, the news may not be all bad. In some ways, having urinary symptoms due to a cold medication can be the warning sign you need to seek medical attention.

If you have experienced urinary symptoms (such as hesitancy or retention) on cold medications, it's probably a good time to see a urologist who can evaluate your prostate and potentially recommend treatment. After all, most males do not have problems taking cold medications and peeing.

If You Can't Urinate After Taking a Cold Medication

If you've taken a cold medication and can't pee, stop the cold medication immediately, and call your healthcare provider. Sometimes the problem will resolve on its own, but this does not always occur.

Your healthcare provider may suggest that you go to the office or the emergency room for a bladder ultrasound, which may indicate the need for a catheter to drain your bladder until the effects of the drug wear off. If you are experiencing extreme discomfort, go to the emergency room right away.

If you've just had some minor problems with urinating after taking a cold or flu medication, make an appointment to see a urologist. Your symptoms may just be the warning sign you need to seek treatment for a prostate problem.

A Word From Verywell

Cold and flu medications can be a problem for people with prostate problems (even if they don't know they have them) in more than one way.

The commonly prescribed alpha-blockers for prostate problems (and high blood pressure) can interact directly with cough and cold medications. Other medications may not interact directly, but the fact that you are taking a medication for your prostate places you at a higher risk of developing urinary retention in response to a cold and flu medication in the first place.

The cold and flu run rampant in the winter, though cold viruses occur year-round. Understanding the problems that may occur when cold medications are combined with prostate medications illustrates the importance of considering drug interactions and potential side effects of any medication you use, whether prescription or over-the-counter.

This is a good reminder as well that sometimes the old standby remedies of rest, fluids, and taking a hot shower are sometimes the safest option for managing your symptoms.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Pray WS and Pray GE. Prostate and kidney precautions with nonprescription products. June 20, 2011.

  3. Sasaki K, Ohbayashi M, Kohyama N, Kobayashi Y, Yamamoto T. Descriptive study on the circumstances concerning confirmation of contraindications and careful administration upon purchasing over-the-counter cold medication and manifestation of after-use urinary disorders. Yakugaku Zasshi. 2008;128(9):1301-9. doi:10.1248/yakushi.128.1301.

  4. Holt JD, Garrett WA, Mccurry TK, Teichman JM. Common questions about chronic prostatitis. Am Fam Physician. 2016;93(4):290-6.

Additional Reading

By Jesse Mills, MD
Jesse Mills, MD, is a board-certified urologist trained in male reproductive medicine, and an associate clinical professor of urology at UCLA.