What is tamsulosin?

Tamsulosin (Flomax) is an alpha-blocker that relaxes the muscles in the prostate and bladder neck,
making it easier to urinate.
Tamsulosin is used to improve urination in men with benign prostatic hyperplasia (enlarged prostate).
Tamsulosin is not approved for use in women or children.

Important information
You should not use this medication if you are allergic to tamsulosin. Do not take tamsulosin with
other similar medicines such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress),
silodosin (Rapaflo), or terazosin (Hytrin).
Tamsulosin may cause dizziness or fainting, especially when you first start taking it or when you start
taking it again. Be careful if you drive or do anything that requires you to be alert. Avoid standing for
long periods of time or becoming overheated during exercise and in hot weather. Avoid getting up too
fast from a sitting or lying position, or you may feel dizzy.
If you stop taking this medicine for any reason, call your doctor before you start taking it again. You
may need a dose adjustment.
Tamsulosin can affect your pupils during cataract surgery. Tell your eye surgeon ahead of time that
you are using this medication. Do not stop using tamsulosin before surgery unless your surgeon tells
you to.
There are many other drugs that can interact with this medicine. Tell your doctor about all
medications you use.
Follow all directions on your medicine label and package. Tell each of your healthcare providers
about all your medical conditions, allergies, and all medicines you use.

Before taking this medicine

You should not use tamsulosin if you are allergic to it. Do not take tamsulosin together with similar
medicines such as alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), silodosin
(Rapaflo), or terazosin (Hytrin).
To make sure tamsulosin is safe for you, tell your doctor if you have:

liver or kidney disease;

a history of prostate cancer;

low blood pressure; or

an allergy to sulfa drugs.

Tamsulosin can affect your pupils during cataract surgery. Tell your eye surgeon ahead of time that
you are using this medicine. Do not stop using tamsulosin before surgery unless your surgeon tells
you to.
Although this medicine is not for use in women, tamsulosin is not expected to harm an unborn baby.
If you are a woman using this medication, tell your doctor if you are pregnant or breast-feeding.
This medicine is not approved for use by anyone younger than 18 years old.
\

Tamsulosin (rINN) (/tmsulsn/ or /tmslosn/) is used in the treatment of difficult

urination, a common symptom of enlarged prostate. Tamsulosin, and other medications in the
class called alpha blockers, work by relaxing bladder neck muscles and muscle fibers in the
prostate itself and make it easier to urinate.[1]
More specifically, tamsulosin is an 1aadrenergic receptor antagonist used in the symptomatic
treatment of benign prostatic hyperplasia (BPH). Tamsulosin was developed by Yamanouchi
Pharmaceuticals (now part of Astellas Pharma) and was first marketed in 1996 under the trade
name Flomax, and also under the name Omnic.
The U.S. patent for Flomax expired in October 2009.[2] The U.S. Food and Drug Administration
(FDA) approved generic Flomax in March 2010.[3]

Mechanism[edit]
Main article: Alpha blocker
Tamsulosin is a selective 1 receptor antagonist that has preferential selectivity for the 1A
receptor in the prostate versus the 1B receptor in the blood vessels.[4]
When alpha 1 receptors in the bladder neck and the prostate are blocked, this causes a relaxation
in smooth muscle and therefore less resistance to urinary flow. Due to this the pain associated
with BPH can be reduced.
Selective action of tamsulosin in alpha 1A/D receptors is controversial and over three quarters of
tamsulosin registered human studies are unpublished.[5]

Clinical uses[edit]

Flomax 0.4 MG Oral Capsule

Tamsulosin is primarily used for benign prostatic hyperplasia, but can also assist the passage of
kidney stones by the same mechanism of smooth muscle relaxation via alpha antagonism.[6][7]
Tamsulosin is also used as adjunct treatment of acute urinary retention. Multiple studies have
shown patients will void more successfully after catheter removal if they are taking tamsulosin
vs. placebo. Patients taking tamsulosin are also less likely to need re-catheterization.[8][9][10] An
additional use for tamsulosin is its use in medical explusive therapy for some cases of
nephrolithiasis.

Adverse effects[edit]

Immunologic: It contains a sulfa moiety, thus causing typical reactions to sulfa drugs.[citation
needed]

Ophthalmologic: Patients taking tamsulosin are prone to a complication known as floppy

iris syndrome during cataract surgery. Adverse outcomes of the surgery are greatly
reduced by the surgeon's prior knowledge of the patient's history with this drug, and thus
having the option of alternative techniques.[11]

Severe hypotension.[12][13]

Tamsulosin has also affected sexual function in men. It can cause males to experience retrograde
ejaculation.[14] In males, retrograde ejaculation occurs when the fluid to be ejaculated, which
would normally exit the body via the urethra, is redirected to the urinary bladder. Normally, the
bladder sphincter contracts and the ejaculate goes to the urethra, the area of least pressure. In
retrograde ejaculation, this sphincter does not function properly. This side affect can be mitigated
by exercising the sphincter muscle; this is done by practicing a pumping action during
ejaculation and urination - some semen fluid can then be ejaculated.

Clinical comparison[edit]
Although prostate specific, it does not have the prostate apoptotic effects of other prostate drugs
such as the 5 alpha-reductase inhibitors such as dutasteride and finasteride.[citation needed]

Use in combination therapy[edit]

The results of the CombAT (Combination of Avodart and Tamsulosin under the brand name
Duodart) trial in 2008 demonstrated that treatment with the combination of dutasteride (Avodart)
and tamsulosin provides greater symptom benefits compared to monotherapy with either agent
alone for treatment of benign prostatic hyperplasia. [15] The CombAT trial became the medication
Jalyn. It was approved by the FDA on June 14, 2010.[16] This combination can be useful as it can
take up to six months for any symptomatic relief to be found by 5-alpha-reductase inhibitors
such as dutasteride compared to alpha-1 receptor blockers which can provide relief in some cases
within 48 hours.[17]

Brand names[edit]
Tamsulosin was first marketed in 1996 under the trade name Flomax. It is now marketed by
various companies under licence, including Boehringer-Ingelheim and CSL. Tamsulosin
hydrochloride extended-release capsules are marketed under the trade names Urisurge(India),
Flomax, Flomaxtra, Contiflo XL,bestflo, Urimax and Pradif,[18] although generic, non-modifiedrelease capsules are still approved and marketed in many countries (such as Canada). In Mexico,
it is marketed as Secotex and as Harnal D in Japan and Indonesia.[19] In Egypt,[20] Italy and
Iceland, it is marketed under the trade name Omnic by Astellas Pharma Europe. The largest
manufacturer of tamsulosin, drug substance, is Synthon.

Systematic (IUPAC) name

(R)-5-(2-{[2-(2-ethoxyphenoxy)ethyl]amino}propyl)-2-methoxybenzene-1sulfonamide

Clinical data
Trade names

Flomax

AHFS/Drugs.com

monograph

MedlinePlus

a698012

Licence data

US FDA:link

Pregnancy
category

Legal status

Routes

AU:

B2

US:

AU:

Prescription Only (S4)

UK:

POM

US:

-only

oral
Pharmacokinetic data

Bioavailability

100% (oral)

Metabolism

hepatic

Half-life

913 hours

Excretion

76% renal
Identifiers

CAS number

106133-20-4

ATC code

G04CA02

PubChem

CID 129211

IUPHAR ligand

488

DrugBank

DB00706

ChemSpider

114457

UNII

G3P28OML5I

KEGG

D08560

ChEBI

CHEBI:9398

ChEMBL

CHEMBL836
Chemical data

Formula

C20H28N2O5S

Molecular mass

408.51

SMILES[show]
InChI[show]
(what is this?) (verify)

Tamsulosin (rINN) (/tmsulsn/ or /tmslosn/) is used in the treatment

Why is this medication prescribed?

Tamsulosin is used in men to treat the symptoms of an enlarged prostate (benign prostatic
hyperplasia or BPH) which include difficulty urinating (hesitation, dribbling, weak stream, and
incomplete bladder emptying), painful urination, and urinary frequency and urgency. Tamsulosin
is in a class of medications called alpha blockers. It works by relaxing the muscles in the prostate
and bladder so that urine can flow easily.
How should this medicine be used?

Tamsulosin comes as a capsule to take by mouth. It is usually taken once a day. Take tamsulosin
30 minutes after the same meal each day. Follow the directions on your prescription label
carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take
tamsulosin exactly as directed. Do not take more or less of it or take it more often than
prescribed by your doctor.
Swallow tamsulosin capsules whole; do not split, chew, crush, or open them.
Your doctor will probably start you on a low dose of tamsulosin and may increase your dose after
2 to 4 weeks.
Tamsulosin may help control your condition, but it will not cure it. Continue to take tamsulosin
even if you feel well. Do not stop taking tamsulosin without talking to your doctor.
Other uses for this medicine
Return to top

This medication may be prescribed for other uses; ask your doctor or pharmacist for more
information.
What special precautions should I follow?
Return to top
Before taking tamsulosin,

tell your doctor and pharmacist if you are allergic to tamsulosin, sulfa
medications, or any other medications.

tell your doctor and pharmacist what prescription and nonprescription

medications, vitamins, nutritional supplements and herbal products you are
taking or plan to take. Be sure to mention any of the following: other alpha
blocker medications such as alfuzosin (Uroxatral), doxazosin (Cardura),
prazosin (Minipress), and terazosin (Hytrin); anticoagulants ('blood thinners')
such as warfarin (Coumadin); cimetidine (Tagamet); and medications for
erectile dysfunction (ED) such as sildenafil (Viagra), tadalafil (Cialis), or
vardenafil (Levitra); Your doctor may need to change the doses of your
medications or monitor you more carefully for side effects.

tell your doctor if you have or have ever had prostate cancer or liver or
kidney disease.

you should know that tamsulosin is only for use in men. Women should not
take tamsulosin, especially if they are pregnant or could become pregnant or
are breast-feeding. If a pregnant woman takes tamsulosin, she should call her
doctor.

if you are having surgery, including dental surgery, tell the doctor or dentist
that you are taking tamsulosin. If you need to have eye surgery at any time
during or after your treatment, be sure to tell your doctor that you are taking
or have taken tamsulosin.

you should know that this medication may make you drowsy or dizzy. Do not
drive a car, operate machinery, or perform dangerous tasks until you know
how this medication affects you.

you should know that tamsulosin may cause dizziness, lightheadedness, a

spinning sensation, and fainting, especially when you get up too quickly from
a lying position. This is more common when you first start taking tamsulosin
or after your dose is increased. To help avoid this problem, get out of bed
slowly, resting your feet on the floor for a few minutes before standing up.
Call your doctor if these symptoms are severe or do not go away.

What should I do if I forget a dose?

Return to top

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose,
skip the missed dose and continue your regular dosing schedule. Do not take a double dose to
make up for a missed one. If you interrupt your treatment for several days or longer, call your
doctor before restarting the medication, especially if you take more than one capsule of
tamsulosin a day.
What side effects can this medication cause?
Return to top
Tamsulosin may cause side effects. Tell your doctor if any of these
symptoms or those in the SPECIAL PRECAUTIONS section are severe or do
not go away:

sleepiness

difficulty falling asleep or staying asleep

weakness

back pain

diarrhea

runny or stuffy nose

pain or pressure in the face

sore throat, cough, fever, chills, or other signs of infection

blurred vision

difficulty ejaculating

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Take one tablet or capsule each day.

Your first dose of tamsulosin may make you feel faint. If this happens, lie
down and do not get up again until the dizziness has passed.

Do not drive or use tools or machines if you feel tired or dizzy.

About tamsulosin
Type of
Alpha-blocker
medicine
Used for

Enlargement of the prostate gland in men

Also
called

Cositam, Contiflo, Diffundox, Faramsil, Flomax Relief,

Flomaxtra, Galebon, Losinate, Maxtron, Pamsvax, Petyme,
Pinexel, Prosurin, Stronazon, Tabphyn,Tamurex
Also Combodart (this contains tamsulosin in combination with
dutasteride)

Available
Prolonged-release tablets and capsules
as

The prostate gland commonly becomes larger in older men. Prostate gland enlargement is also
called benign prostatic hyperplasia (BPH). It can cause problems with passing urine, such as
having to wait before your urine starts to flow, taking longer at the toilet, dribbling, and a feeling
that your bladder is not quite empty.
Tamsulosin works by relaxing the muscles around your bladder and prostate so that you can pass
urine more easily. It is available on prescription, or you can buy it at pharmacies without a
prescription.
Sometimes, more than one type of medicine is needed to control the symptoms of prostate
enlargement. Tamsulosin is available in combination with another medicine for prostate
enlargement, called dutasteride.

Before taking tamsulosin

Some medicines are not suitable for people with certain conditions, and sometimes a medicine
may only be used if extra care is taken. For these reasons, before you start taking tamsulosin it is
important that your doctor or pharmacist knows:

If you have liver or kidney problems.

If you ever feel dizzy or faint when you stand up, or if you have ever fainted
after passing urine.

If you are are due to have cataract eye surgery.

If you have ever had an allergic reaction to this or to any other medicine.

If you are taking any other medicines, including those available to buy
without a prescription, herbal and complementary medicines.

How to take tamsulosin

Before you start this treatment, read the manufacturer's printed information
leaflet from inside your pack. The leaflet will give you more information about
the specific brand of tamsulosin you have been given, and a full list of
possible side-effects from taking it. Take tamsulosin exactly as your doctor or
pharmacist has told you.

Take one tablet or capsule each day. Try to take your doses at the same time
of day, as this will help you to remember to take them. Swallow each dose
with a drink of water - do not crush, break, or chew the tablets or the
capsules.

Your first dose of tamsulosin may make you feel dizzy of faint. If you are
affected in this way (or if you start sweating), lie down and do not get up
again until these symptoms have gone.

You can take tamsulosin tablets before or after your meals.

If you forget to take a dose, do not worry, just take the next dose when it is
due and carry on as before. Do not take two doses together to make up for a
forgotten dose.

Getting the most from your treatment

Tamsulosin can cause dizziness, particularly when you first start taking it.
Make sure your reactions are normal before you drive or do things which
would be dangerous if you were not fully alert.

You are advised not to drink alcohol while you are on tamsulosin. Alcohol will
increase the side-effects of tamsulosin, such as feeling faint and dizzy.

Keep your regular appointments with your doctor so your progress can be
monitored.

If you are a smoker, stopping smoking may significantly improve your

symptoms. This is because nicotine irritates the bladder. Ask your doctor for
advice on quitting.

If you are having an operation or any medical treatment, tell the person
carrying out the treatment that you are taking tamsulosin. This is because
some men who have had cataract surgery while they are on tamsulosin have
developed an eye problem known as 'floppy iris syndrome', so your doctor
may advise you to stop taking tamsulosin for a short while. Also, if you have
an anaesthetic while you are on tamsulosin, your blood pressure may drop
suddenly.

Can tamsulosin cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not
everyone experiences them. These usually improve as your body adjusts to the new medicine,
but speak with your doctor or pharmacist if any of the following side-effects continue or become
troublesome.
Common tamsulosin sideeffects - these affect less
What can I do if I experience this?
than 1 in 10 people who take
this medicine
Feeling tired, dizzy, faint, or
weak, blurred vision

If any of these happen, do not drive or use tools

or machines. Do not drink alcohol

Getting up more slowly may help. If you begin to

Feeling light-headed when
feel dizzy, lie down so that you do not faint, then
getting up from a lying or sitting
sit for a few moments to prevent the dizziness
position
returning
Constipation or diarrhoea, feeling Eat a well-balanced diet and avoid spicy foods.
sick
Drink plenty of water
Headache

Ask your pharmacist to recommend a suitable

painkiller

Palpitations, dry mouth, rash,

ejaculation problems

If any of these become troublesome, speak with

your doctor

If you experience any other symptoms which you think may be due to this medicine, discuss
them with your doctor or pharmacist.
How to store tamsulosin

Keep all medicines out of the reach and sight of children.

Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

If you buy any medicines check with a pharmacist that they are safe to take
with your other medicines.

Never take more than the prescribed dose. If you suspect that someone has
taken an overdose of this medicine, go to the accident and emergency
department of your local hospital at once. Take the container with you, even
if it is empty.

This medicine is for you. Never give it to other people even if their condition
appears to be the same as yours.

Never keep out-of-date or unwanted medicines. Take them to your local

pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist