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Tamsulosin, sold under the trade names Alna and Flomax, is a medication used to treat symptomatic benign prostatic hyperplasia (BPH) and chronic prostatitis and for urinary retention along with other measures.
Tamsulosin, and other medications in the class called alpha blockers, work by relaxing bladder neck muscles and muscle fibers in the prostate itself and making it easier to urinate. It is an α 1a adrenergic receptor antagonist.
Tamsulosin was developed by Yamanouchi Pharmaceuticals (now part of Astellas Pharma ) and was first marketed in 1996. The U.S. patent expired in October 2009.
Contents
1 Medical uses
2 Adverse effects
3 Combination therapy
4 Mechanism
5 Brand names
6 References
7 External links
Medical uses
Flomax 0.4 MG Oral Capsule
Tamsulosin is primarily used for benign prostatic hyperplasia and to help with the passage of kidney stones.
Tamsulosin is also used as an add-on treatment for acute urinary retention. People may void more successfully after catheter removal if they are taking tamsulosin. People taking tamsulosin also are less likely to need re-catheterization.
Adverse effects
Immunologic: Higher risk of allergic reaction in those with sulfa allergies.
Eyes: People 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.
Severe hypotension.
Persons with cardiac conditions including hypotension, mechanical heart failure (valvular, pulmonary embolism, pericarditis) and congestive heart failure should be monitored carefully while taking tamsulosin.
In a retrospective analysis of 388 patients with HF (heart failure) and benign prostatic hypertrophy receiving alpha blockers, including prazosin, terazosin, doxazosin, or tamsulosin, Dhaliwal and colleagues found no significant increase in all-cause mortality and HF re-hospitalization in those also receiving β-blockers. However, in those not receiving β-blockade, α-blockade exposure was associated with an increase in HF hospitalization (HR, 1.94; 95% CI, 1.14–3.32). Of note, the majority of patients were receiving tamsulosin (58%). It has been hypothesized that unopposed α1 blockade could lead to β1-receptor stimulation with increases in renin and aldosterone, leading to edema and weight gain. Chronic α1 antagonism may lead to tachyphylaxis according to the American Heart Association (
Tamsulosin can also cause retrograde ejaculation, which occurs when semen is redirected to the urinary bladder instead of being ejaculated normally. This is because tamsulosin relaxes the muscles of the urethral sphincters, which are normally closed during ejaculation. This side effect can be mitigated by regular pelvic floor (Kegel) exercise and contracting the pelvic floor during ejaculation.
Combination therapy
The results of the CombAT (combination of dutasteride ( Avodart ) and tamsulosin, under the brand name Duodart ) trial in 2008 demonstrated that treatment with the combination of dutasteride and tamsulosin provides greater symptom benefits compared to monotherapy with either agent alone for treatment of benign prostatic hyperplasia.
The CombAT trial became the medication Jalyn. It was approved by the FDA on 14 June 2010.
Mechanism
Main article: Alpha blocker
Tamsulosin is a selective α 1 receptor antagonist that has preferential selectivity for the α 1A receptor in the prostate versus the α 1B receptor in the blood vessels.
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.
Brand names
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 Urimax 0.4(India), Flomax, Flomaxtra, Contiflo XL, bestflo, Mecir LP (France), Urimax and Pradif,

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