PSA level and Acetaminophen

Q: Regular use of acetaminophen may cause falsely ____________ level of Prostate Specific Antigen (PSA). - Select one

A) elevated

B) lowered

Answer: B

Although it is known that a regular intake of 5-alpha-reductase inhibitors (like finasteride and dutasteride) decreases PSA by almost 50 percent, it is less known that regular use of NSAIDs and acetaminophen can also give lower PSA levels when compared with men not taking these drugs. This correlation is time-dependent, meaning longer duration of use may cause even lower PSA values, particularly in patients who are habitual users of NSAIDs, possibly due to the anti-inflammatory properties of these drugs.

Similarly, statin or thiazide use for over a year may lower PSA levels.

Either adjust PSA levels in these patients or interpret them with more caution.

#Urology

#pharmacology

References:

1.Etzioni RD, Howlader N, Shaw PA, et al. Long-term effects of finasteride on prostate specific antigen levels: results from the prostate cancer prevention trial. J Urol 2005; 174:877.

2. Singer EA, Palapattu GS, van Wijngaarden E. Prostate-specific antigen levels in relation to consumption of nonsteroidal anti-inflammatory drugs and acetaminophen: results from the 2001-2002 National Health and Nutrition Examination Survey. Cancer 2008; 113:2053.

3. Chang SL, Harshman LC, Presti JC Jr. Impact of common medications on serum total prostate-specific antigen levels: analysis of the National Health and Nutrition Examination Survey. J Clin Oncol 2010; 28:3951