Chapter 7: Genito-urinary system

Polypharmacy guidance: realistic prescribing
Scottish Government Effective Prescribing & Therapeutics Division
Polypharmacy icon of two pills

Alpha-blockers

Generally not indicated if patient has a long term catheter

Need

Finasteride

Generally not indicated if a patient has a long term catheter – discuss with Urology re: stopping

Need

Antimuscarinics

Review continued need/effectiveness after 3 to 6 months

Need

CAUTION: Anticholinergic ADRs (oxybutynin may decrease MMSE score in people with dementia)

Safety

Female Hormones

NOTE: There is no cardio-protective effect or cognitive protection in older women

Need

CAUTION: Carcinogenic potential in breast and endometrium

Safety

Discuss with patient individual balance of benefits and risk

Aims