Use drugs judiciously when managing therapeutic competition in patients with co-morbid heart failure and lower urinary tract symptoms


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Abstract

Patients with co-morbid heart failure and lower urinary tract symptoms may experience the drug-disease interaction of therapeutic competition (i.e. treatment for heart failure brings on urinary incontinence and the withdrawal of treatment to relieve urinary incontinence worsens heart failure). Management strategies to avoid therapeutic competition and improve urinary outcomes include reducing diuretic dosages, switching treatment from ACE inhibitors to angiotensin receptor blockers, treating lower urinary tract infections, avoiding caffeine, managing fluids, monitoring weight and initiating pelvic floor muscle exercises.

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