Tamsulosin dosage: what’s right for me?
LAST UPDATED: Nov 11, 2020
4 MIN READ
HERE'S WHAT WE'LL COVER
Tamsulosin is available in generic form or as the brand name medication Flomax. It is prescribed for benign prostatic hyperplasia (BPH), more popularly—and infamously—known as an enlarged prostate.
Always follow your healthcare provider's advice about taking tamsulosin. Below are the general recommendations regarding tamsulosin dosage.
The recommended starting dose of tamsulosin (or tamsulosin hydrochloride) is 0.4 mg once a day. It should be taken 30 minutes after the same meal each day. Tamsulosin should be swallowed whole. Don't crush, chew, or open tamsulosin capsules. If tamsulosin 0.4 mg doesn't work for you after two to four weeks of consistent use, your healthcare provider might increase your dosage (DailyMed, 2020)
Suppose you need to discontinue tamsulosin for several days. In that case, your healthcare provider will likely restart you at the 0.4 mg dose, regardless of whether you had been taking a higher dose before stopping (DailyMed, 2020). You may experience significant low blood pressure (hypotension) when you begin retaking the medication, which is why it is usually restarted at the lowest dose.
You should store tamsulosin at room temperature and not in areas with high heat or moisture (like the bathroom). In the event of a missed dose, take the medication as soon as possible, unless it's almost time for your next dose. In that case, take the next dose as scheduled. Never take two doses of tamsulosin at once (MedlinePlus, 2018).
Most prescription plans cover tamsulosin. The cost of a 30-day supply ranges between $9 to $35 (GoodRx, n.d.).
What is tamsulosin used for?
Tamsulosin is used to treat the symptoms of benign prostatic hyperplasia (BPH), commonly known as an enlarged prostate. BPH can cause urinary retention and other potentially uncomfortable symptoms.
Tamsulosin is part of a class of drugs known as alpha-blockers. It relaxes muscles in the prostate and bladder. This relaxation improves both the flow of urine and BPH symptoms.
chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)
kidney stones in the urethra—by relaxing urethra muscles, tamsulosin can help dislodge those stones, allowing them to pass during urination
What is BPH?
As men age, the prostate naturally increases in size. For some men, this can put pressure on the urethra and bladder, partially obstructing the flow of urine and causing symptoms.
Common symptoms of BPH include:
Greater need to urinate
Frequent nighttime urination
Straining while urinating
Frequent starting and stopping of urination
Weak urine stream
Trouble starting urination
BPH is a common condition. Experts estimate that about half of all men between the ages of 51 and 60 are affected by BPH (AUA, 2020). In men older than 60, that number rises to above 70 percent and 90 percent in men over age 80 (Narayan, 2005; AUA, 2020). Since BPH and prostate cancer often exist together, talk to your healthcare provider about prostate cancer screening before starting treatment and at regular intervals afterward.
What is urinary retention?
Urinary retention is the inability to empty your bladder fully; it's often caused by BPH. Urinary retention can also be caused by prostatitis (inflammation of the prostate), urinary tract infections, urinary stones, and scars or tumors that block urine outflow (NIDDK, 2019).
Tamsulosin works by relaxing the smooth muscles in the prostate and bladder, making urination easier.
Side effects of tamsulosin
Studies indicate that tamsulosin is generally safe and well-tolerated for long-term use (Narayan, 2005). However, like all medications, you might experience side effects while on tamsulosin, which can range from mild to severe. These side effects include (DailyMed, 2020):
Orthostatic hypotension: low blood pressure and symptoms of dizziness/lightheadedness or fainting (syncope) when standing up after sitting. This is more likely to occur after taking your first dose or an increased dose.
Abnormal ejaculation, including retrograde ejaculation
Runny nose or stuffy nose (rhinitis)
Intraoperative floppy iris syndrome (IFIS), a complication during cataract surgery or glaucoma surgery
Priapism, a painful erection lasting four or more hours
Tamsulosin drug interactions
Tell your healthcare provider about any other drugs you're taking before starting tamsulosin, including prescription drugs, over-the-counter medications, and supplements. Potential drug interactions with tamsulosin include (DailyMed, 2020):
CYP3A4 and CYP2D6 inhibitors
CYP3A4 and CYP2D6 are two enzymes that help the liver metabolize tamsulosin. Any drug that blocks or inhibits CYP3A4 and CYP2D6 can increase the concentration of tamsulosin in the body. Examples include cimetidine, ketoconazole, erythromycin, terbinafine, and paroxetine. If you're taking those drugs, your healthcare provider may adjust your dose of tamsulosin to avoid potential adverse effects.
Phosphodiesterase-5 (PDE5) inhibitors are oral medications commonly used to treat erectile dysfunction (ED). They include sildenafil (brand name Viagra; see Important Safety Information), tadalafil (brand name Cialis; see Important Safety Information), vardenafil (brand name Levitra), and avanafil (brand name Stendra). Like tamsulosin, PDE5 inhibitors work by dilating blood vessels to improve blood flow into the penis. This also has the effect of lowering your blood pressure. Therefore, taking both tamsulosin and PDE5 inhibitors may cause your blood pressure to drop too low (hypotension).
This is not a complete list. Talk to your healthcare provider or pharmacist for more information about potential drug interactions with tamsulosin.
Who should not take tamsulosin or use it with caution
People with certain medical conditions should be careful when using tamsulosin or even avoid it altogether. Tamsulosin is not approved for use in women. Consult with your healthcare provider for additional information.
People with low blood pressure
Since one of the side effects of tamsulosin is a drop in blood pressure, use tamsulosin with caution if you have low blood pressure or positional blood pressure changes, like orthostatic hypotension. Tamsulosin could potentially worsen already low pressures, especially after starting or increasing your dose.
People who have cataracts or glaucoma
Tamsulosin may affect your iris, leading to intraoperative floppy iris syndrome (IFIS) that may be noted during cataract surgery or glaucoma surgery. Avoid starting tamsulosin if you're planning to have cataract or glaucoma surgery. Tell your healthcare provider if you've taken tamsulosin in the months preceding any scheduled surgery; IFIS has occurred even when tamsulosin was discontinued months before those eye procedures.
People with heart failure
Tamsulosin may worsen existing heart failure.
People with sulfa allergies
Some people who are allergic to drugs in the sulfonamide (sulfa) class may also have an allergic reaction to tamsulosin (e.g., skin rash, swelling, trouble breathing, etc.). If you are allergic to sulfa drugs, make sure your healthcare provider knows about it, and use tamsulosin with caution.
This list does not include all tamsulosin warnings. Seek medical advice from your healthcare provider or pharmacist for more drug information.
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
American Urology Association (AUA). (2020). Urology Care Foundation: What is benign prostatic hyperplasia? Retrieved from https://www.urologyhealth.org/urologic-conditions/benign-prostatic-hyperplasia-(bph)
DailyMed. (n.d.). TAMSULOSIN HYDROCHLORIDE capsule. Retrieved Sep. 25, 2020 from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8cb27f78-2d5d-4640-b7b5-ed06973c8133
GoodRx.com. (n.d.). Tamsulosin. Retrieved from https://www.goodrx.com/tamsulosin
Narayan, P. & Tunuguntla, H. S. (2005). Long-term efficacy and safety of tamsulosin for benign prostatic hyperplasia. Reviews in Urology , 7 Suppl 4 (Suppl 4), S42–S48. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1477608/#B13
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2019). Urinary Retention. Retrieved on Sep. 25, 2020 from https://www.niddk.nih.gov/health-information/urologic-diseases/urinary-retention