By Lilian Anekwe
GPs are set for more referrals from pharmacists after the drugs regulator approved the sale of a treatment of lower urinary tract symptoms in men with benign prostatic hyperplasia (BPH) over the counter at pharmacies.
From March 31st men with lower urinary tract symptoms can consult a pharmacist who will assess their suitability for treatment using a screening questionnaire, and will initially receive a two week trial pack, followed by a four week supply if they respond to treatment.
While treatment will be initiated and largely supervised by pharmacists, the legislation requires pharmacists to advise patients to see their GP during the first six weeks of treatment for a BPH diagnosis, and pharmacists will have to recommend men visit their GP for an annual prostate health check.
Pharmacists are also required to refer patients back to their GP at any time if symptoms worsen or change or they experience any problems with the medication, according to rules set out by the Medicines and Healthcare products Regulatory Agency (MHRA).
Dr Jonathan Rees, a urology GPSI in Bristol, said men with an irritable bladder may be missed if they presented at pharmacies.
But he added: ‘Whilst men with overactive bladder will not benefit from an alpha-blocker, if it is prescribed they will not be harmed by it, and at least trialling this medication may also begin a pathway towards correct diagnosis and treatment.’
‘There is clearly a problem with a huge number of untreated men in the community with significant lower urinary tract symptoms due to BPH. We need to find ways to make these men aware of potential treatment, and hopefully the reclassification of Flomax to over the counter will provide a mechanism for some men to commence treatment.
• Last week the MHRA also approved the reclassification of tranexamic acid – the first over the counter medicine for heavy menstrual bleeding – under the name Cyklo-F, for women aged 18 to 45 with a history of regular heavy menstrual bleeding over several menstrual cycles.
Pharmacists to refer men with prostate symptoms to GPs