HWN Suggests

Urologists no longer primary initiator of tamsulosin

Tamsulosin is the most widely prescribed alpha-blocker for the treatment of lower urinary tract symptoms attributable to BPH, but alpha-blockers are increasingly being used in patients with urolithiasis, prostatitis, and even female voiding dysfunction. As the primary gatekeepers for the medical management of BPH, urologists had been responsible for most alpha-blocker prescriptions. “The off-label use of tamsulosin has grown tremendously, as 20% of the dispensations for tamsulosin are for female patients...

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 Another Failure for Tamsulosin

As has been described more than once on this blog, the evidence favoring use of tamsulosin for renal colic has been grossly overstated. The vast majority of the trial evidence collated by the Cochrane Review has been distorted by small trials and those biased by pharmaceutical manufacturers. Every time a reasonably-designed randomized-controlled trial has been performed, the magnitude of effect has been dramatically lower – or non-existent.

Articles of Interest

Can Tamsulosin Get That STONE to Drop?

“Tamsulosin did not significantly increase the stone passage rate compared with placebo. Our findings do not support the use of tamsulosin for symptomatic urinary stones smaller than 9 mm. Guidelines for medical expulsive therapy for urinary stones may need to be revised.”

FDA adds warning to tamsulosin labeling

FDA issued a labeling change for the drug tamsulosin HCl (Flomax, Boehringer Ingelheim) warning of the possibility of intraoperative floppy iris syndrome (IFIS), stating "The patient's ophthalmologist should be prepared for possible modifications to their surgical technique."

Flomax: 7 things you should know

Flomax restores urine flow in men with BPH but may cause a drop in blood pressure when going from a sitting to a standing position.

Has Flomax (tamsulosin) been proven to cause increased mortality in any studies?

No, there is no evidence from clinical studies indicating that Flomax (tamsulosin) causes increased mortality or deaths. The available research and guidelines do not demonstrate any association between tamsulosin use and increased risk of death.

How common are tamsulosin side effects?

Tamsulosin belongs to a class of drugs called alpha blockers that work by relaxing the smooth muscles in the urethra, allowing urine to flow more freely. Also sold as brand-name Flomax, tamsulosin is often prescribed with other drugs that reduce the size of the prostate gland such as Avodart (dutasteride) or Propecia (finasteride).

How Does Flomax Work

Flomax is primarily known for its role in treating benign prostatic hyperplasia (BPH), a condition where the prostate gland enlarges and causes issues with urination. However, it has also found its way into the toolkit of urologists dealing with kidney stones—a problem that affects millions of people worldwide.

Long-Term Efficacy and Safety of Tamsulosin for Benign Prostatic Hyperplasia

Adrenergic receptor antagonists are the primary therapy for patients with benign prostatic hyperplasia presenting with lower urinary tract symptoms and are used by 80% of physicians as the first-line agent to treat this common condition in the aging male.

Off-label prescribing of tamsulosin: A nationwide retrospective study combining prescription and regulatory data

Off-label use of medicines raises important safety and regulatory concerns. Tamsulosin, an alpha-1 adrenergic receptor blocker originally approved for benign prostatic hyperplasia (BPH) in men, is also prescribed beyond licensed indications.

Sex Problems Result from Tamsulosin for Urination

Tamsulosin is prescribed to men with an enlarged prostate so urination is less of a problem. Sexual side effects can be a downside of such alpha blockers.

Stop Taking Flomax Tonight! – Eat These 6 Nuts Instead (32% Smaller Prostate in 3 Months)

I’m Dr. Anna, board-certified urologist with 19 years experience — and tonight I’m DONE staying silent. My patients were suffering erectile dysfunction, dizziness, and zero libido from Flomax & Finasteride… until I put them on these 6 nuts. Average result after 90 days? Prostate volume down 32%. PSA down 28%. Many threw their pills in the trash.

Tamsulosin (Flomax): everything you need to know

Alpha blockers, like tamsulosin, improve urine flow, and decrease the symptoms associated with an enlarged prostate (DailyMed, 2015). Other examples of alpha blockers include alfuzosin (brand name Uroxatral), doxazosin (brand name Cardura), silodosin (brand name Rapaflo), and terazosin (brand name Hytrin).

Tamsulosin-Induced Atrial Fibrillation With Rapid Ventricular Response

Tamsulosin, sold under the brand name Flomax, is a commonly prescribed medication for benign prostatic hypertrophy (BPH). While generally well-tolerated, this medication can induce life-threatening tachyarrhythmias.

Top 5 Testable Pearls – Alpha Blockers

Not all alpha-blockers are created equal. Some alpha-blockers tend to affect the vasculature more than others. doxazosin, prazosin, and terazosin will have a greater effect on the vessels compared to tamsulosin, alfuzosin, and silodosin. When treating BPH symptoms like urinary retention, we tend to avoid the agents that have more effects on vessels to avoid hypotension.

What are the alternatives to Flomax (tamsulosin)?

The most effective alternative to Flomax (tamsulosin) for treating benign prostatic hyperplasia (BPH) or urinary symptoms is alfuzosin (Uroxatral), as it has been shown to be equally effective in terms of IPSS. Other alpha-blockers such as doxazosin (Cardura), silodosin (Rapaflo), and terazosin (Hytrin) are also viable options, as they work similarly to Flomax by relaxing muscles in the prostate and bladder neck, improving urine flow

What is the safest option in the alpha-blocker (Flomax (tamsulosin)) class?

Tamsulosin is the safest option in the alpha-1 blocker class for treating benign prostatic hyperplasia (BPH) due to its better urinary selectivity and lower risk of orthostatic hypotension compared to other alpha blockers like doxazosin or terazosin. The recommended dose is 0.4 mg taken once daily, about 30 minutes after the same meal each day 1 . This selective action makes it particularly suitable for elderly patients or those with cardiovascular concerns.

Resources

Flomax

FLOMAX capsules 0.4 mg once daily is recommended as the dose for the treatment of the signs and symptoms of BPH. It should be administered approximately one-half hour following the same meal each day.