TamsulosinTamsulosin Hydrochloride

About Tamsulosin

Tamsulosin blocks alpha-1A receptors in the prostate and bladder neck, relaxing the smooth muscle there so urine flows more easily. Its only labeled use is the signs and symptoms of BPH; the label says it is not for high blood pressure, not for women and not for children. The usual dose is 0.4 mg once a day, taken about 30 minutes after the same meal each day. If symptoms have not improved after 2 to 4 weeks, the prescriber may raise it to 0.8 mg once a day (two capsules). If doses stop for several days, treatment restarts at 0.4 mg. MedlinePlus notes that tamsulosin is sometimes used to treat kidney stones; that use is not on the FDA label, and the prescriber decides.

There is no boxed warning. Anyone who has had an allergic reaction to tamsulosin or a capsule ingredient, such as rash, hives, itching, swelling or breathing trouble, must not take it, and a serious sulfa allergy calls for caution. It can lower blood pressure on standing and cause dizziness, a spinning feeling or fainting, most often when starting or after a dose increase, so driving and hazardous tasks wait until the effect is known. Priapism, a painful erection that lasts for hours, is rare but can lead to permanent impotence if not treated properly. Because prostate cancer and BPH often occur together and cause similar symptoms, men are screened for prostate cancer before starting and at regular intervals. Common side effects include dizziness, headache, a runny or stuffy nose, infections, abnormal ejaculation, weakness, back pain and diarrhea; serious skin reactions and irregular or fast heartbeats have been reported since approval.

Intraoperative floppy iris syndrome, which complicates cataract and glaucoma surgery, has occurred in some people taking or previously treated with alpha-1 blockers, including tamsulosin, so the eye surgeon needs to know about any current or past use; the label says starting tamsulosin before a scheduled cataract or glaucoma operation is not recommended. The capsules are swallowed whole, never crushed, chewed or opened. Tamsulosin is not combined with another alpha-blocker such as alfuzosin, doxazosin, silodosin or terazosin. Flomax, the original brand, is listed as discontinued in Drugs@FDA. Jalyn and its generics put 0.4 mg tamsulosin and 0.5 mg dutasteride in one capsule, a separate product for men with an enlarged prostate.

Taking Tamsulosin

How to take it

Once a day, about 30 minutes after the same meal each day. Swallow the capsule whole; do not split, chew, crush or open it. Get up slowly from sitting or lying down, especially at the start or after a dose increase, and do not drive until you know how it affects you. Keep taking it even if you feel well.

If you miss a dose

Take it as soon as you remember, unless it is almost time for the next dose; then skip the missed dose and carry on as usual. Do not take a double dose. After a break of several days or longer, call the prescriber before restarting; the label restarts treatment at 0.4 mg.

Storage

At room temperature in a tightly closed container, away from excess heat and moisture (not in the bathroom), out of reach of children.

Interactions to know about

Ketoconazole and other strong CYP3A4 inhibitors are not used with it; erythromycin, paroxetine, terbinafine, cimetidine and warfarin call for caution. Other alpha-blockers are not combined with it, and sildenafil, tadalafil or vardenafil can add to its blood pressure lowering.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Tamsulosin differs from pharmacy to pharmacy

Tamsulosin comes in one strength from many makers, so quotes for the same number of capsules differ by each pharmacy’s fee and markup and by whether tamsulosin is on its flat-price generic list. A 0.8 mg dose is two capsules a day, so the quantity written changes the quote.

It is usually taken long term, so a thirty-day and a ninety-day supply are quoted differently. The capsule that combines tamsulosin with dutasteride is a separate product with fewer makers, and a pharmacist cannot switch between it and the two single-ingredient capsules without the prescriber.

Ways to pay less for Tamsulosin without insurance

• Ask whether tamsulosin is on the pharmacy’s flat-price generic list, and compare more than one pharmacy.
• Once the dose is settled, ask the prescriber for a ninety-day supply.
• If you take 0.8 mg, check that the prescription’s quantity covers two capsules a day, so the quote matches how you take it.
• If you also take dutasteride, ask the prescriber whether two separate medicines or the combination capsule would suit you; the pharmacist cannot make that switch alone.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Tamsulosin

1. 1.How long after a meal should I take my capsule?
2. 2.Will my blood pressure or erectile dysfunction medicine make the dizziness worse?
3. 3.What should I tell my eye surgeon before cataract surgery?
4. 4.What should I do if I have missed several days of doses?

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