Our patient was taking tamsulosin for his benign prostatic hypertrophy, and while posaconazole may increase serum concentrations of this drug due to its inhibitory effects on CYP3A4, the major metabolic pathway for tamsulosin, tamsulosin does not have any known musculoskeletal side effects.13 Similarly, carvedilol is partly metabolized by CYP3A4, so drug concentration alterations of carvedilol may also have been possible.14 Of note, prior to the patient’s presentation to the emergency room, he was noting low blood pressures at home, and so he was holding his carvedilol. This evidence concerns the gene CYP3A4 and benign prostatic hyperplasia.