Tamsulosin#Use in combination therapy

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Tamsulosin is used for benign prostatic hyperplasia and to help with the passage of kidney stones.{{cite press release | url = http://www.prnewswire.com/news-releases/study-shows-use-of-tamsulosin-or-nifedipine-helps-patients-to-clear-ureteral-stone-fragments-faster-and-reduces-rate-of-recurrence-54518887.html | title = Study Shows Use of Tamsulosin or Nifedipine Helps Patients to Clear Ureteral Stone Fragments Faster and Reduces Rate of Recurrence }} Tamsulosin, however, appears to be effective only for stones over 4 mm and less than 10 mm in size.

Tamsulosin is also used as an add-on treatment for acute urinary retention. Men may void more successfully after catheter removal if they are taking tamsulosin, and are less likely to need repeat catheterization.{{cite journal | vauthors = Lucas MG, Stephenson TP, Nargund V | title = Tamsulosin in the management of patients in acute urinary retention from benign prostatic hyperplasia | journal = BJU International | volume = 95 | issue = 3 | pages = 354–357 | date = February 2005 | pmid = 15679793 | doi = 10.1111/j.1464-410X.2005.05299.x | s2cid = 30254915 | doi-access = }}

Tamsulosin does not decrease the overall size of the prostate in men with benign prostatic hyperplasia and is not recommended for the prevention of prostate cancer.{{Cite book|title=Medical-surgical nursing: assessment and management of clinical problems| vauthors = Lewis SM, Dirksen SR, Heitkemper MM, Bucher LH |year= 2013|isbn=978-0-323-10089-2|edition=9th|publisher=Mosby|location=St. Louis, Missouri|oclc=228373703}}

The results of the CombAT (combination of dutasteride (Avodart) and tamsulosin (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.{{cite journal | vauthors = Roehrborn CG, Siami P, Barkin J, Damião R, Major-Walker K, Morrill B, Montorsi F | title = The effects of dutasteride, tamsulosin and combination therapy on lower urinary tract symptoms in men with benign prostatic hyperplasia and prostatic enlargement: 2-year results from the CombAT study | journal = The Journal of Urology | volume = 179 | issue = 2 | pages = 616–621; discussion 621 | date = February 2008 | pmid = 18082216 | doi = 10.1016/j.juro.2007.09.084 }} The combination medication dutasteride/tamsulosin (Jalyn) was approved by the US Food and Drug Administration (FDA) in June 2010.{{cite web | title=Drug Approval Package: Jalyn (dutasteride and tamsulosin) NDA #022460 | website=U.S. Food and Drug Administration (FDA) | date=3 February 2011 | url=https://www.accessdata.fda.gov/drugsatfda_docs/nda/2010/022460s000_jalyn_toc.cfm | access-date=30 March 2025}}

• 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 person's history with this drug, and thus having the option of alternative techniques.{{cite web | last=Taylor | first=Jill | title=Good Cataract Surgery Outcomes Possible in IFIS Due to Tamsulosin | website=Medscape | date=16 November 2006 | url=https://www.medscape.com/viewarticle/547937 | access-date=30 March 2025}}
• Severe hypotension.{{cite journal | vauthors = Bird ST, Delaney JA, Brophy JM, Etminan M, Skeldon SC, Hartzema AG | title = Tamsulosin treatment for benign prostatic hyperplasia and risk of severe hypotension in men aged 40-85 years in the United States: risk window analyses using between and within patient methodology | journal = BMJ | volume = 347 | pages = f6320 | date = November 2013 | pmid = 24192967 | pmc = 3817852 | doi = 10.1136/bmj.f6320 }}{{cite journal | vauthors = Ramirez J | title = Severe hypotension associated with α blocker tamsulosin | journal = BMJ | volume = 347 | pages = f6492 | date = November 2013 | pmid = 24192968 | doi = 10.1136/bmj.f6492 | hdl-access = free | s2cid = 24324483 | hdl = 10906/78488 }}
• Alpha-blockers, including prazosin, terazosin, doxazosin, or tamsulosin, do not appear to affect all-cause mortality in heart failure rehospitalization in those also receiving β-blockers.{{cite journal | vauthors = Page RL, O'Bryant CL, Cheng D, Dow TJ, Ky B, Stein CM, Spencer AP, Trupp RJ, Lindenfeld J | title = Drugs That May Cause or Exacerbate Heart Failure: A Scientific Statement From the American Heart Association | journal = Circulation | volume = 134 | issue = 6 | pages = e32–e69 | date = August 2016 | pmid = 27400984 | doi = 10.1161/CIR.0000000000000426 | doi-access = free | title-link = doi }}
• 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.{{Cite web|url=https://www.drugs.com/sfx/tamsulosin-side-effects.html|title=Tamsulosin Side Effects|website=Drugs.com|access-date=27 April 2011}}

{{Main|Alpha blocker}}

Tamsulosin is a selective α₁ receptor antagonist that has preferential selectivity for the α_1A receptor in the prostate versus the α_1B receptor in the blood vessels.{{Cite book | vauthors = Shen H | title=Illustrated Pharmacology Memory Cards: PharMnemonics | year=2008 | publisher=Minireview | isbn=978-1-59541-101-3 | page=13}}

When alpha 1 receptors in the bladder neck, prostate, ureter, and urethra are blocked, a relaxation in smooth muscle tissue results. This mechanism decreases resistance to urinary flow, reduces discomfort associated with benign prostatic hyperplasia, and facilitates passage of kidney stones.

Tamsulosin was first sold in 1997 under the brand name Flomax. The US patent expired in October 2009.{{cite web|title=Flomax – Big Patent Expirations of 2010|url=http://www.fiercepharma.com/special-reports/flomax-big-patent-expirations-2010|date=10 February 2010|access-date=14 January 2012|archive-date=22 April 2012|archive-url=https://web.archive.org/web/20120422163615/http://www.fiercepharma.com/special-reports/flomax-big-patent-expirations-2010|url-status=dead}} The US Food and Drug Administration (FDA) approved generic versions in March 2010.{{cite web | title=FDA Approves First Generic Tamsulosin to Treat Enlarged Prostate Gland | publisher=U.S. Food and Drug Administration (FDA) | via=PR Newswire | date=2 March 2010 | url=https://www.prnewswire.com/news-releases/fda-approves-first-generic-tamsulosin-to-treat-enlarged-prostate-gland-85995072.html | access-date=30 March 2025}}

It is sold by various companies, including Boehringer Ingelheim and CSL.{{cn|date=March 2025}} Tamsulosin hydrochloride extended-release capsules are sold under the brand names Urimax 0.4 (India),Tamlocept 0.4 (India), Flomax, Flomaxtra, Contiflo XL, bestflo, Mecir LP (France), Urimax, Pamsvax, and Pradif, although generic, unmodified-release capsules are still approved and sold in many countries (such as Canada). Generic extended-release tablets are sold in most countries of the European Economic Area (EEA). In Mexico, it is sold as Secotex, as Harnal D in Japan and Indonesia, and as Harnal OCAS (oral controlled absorption system) in Thailand.{{cite web | title = Drugs.com Database | url= https://www.drugs.com/international/harnal-d.html}} In Egypt,{{cite news |title= Novartis hits Astellas with transplant drug generic|url=https://www.reuters.com/article/americasRegulatoryNews/idUST34424920090811 |publisher= Reuters|date= 11 August 2009|access-date=11 August 2009}} Italy, Russia and Iceland, it is sold under the brand name Omnic by Astellas Pharma Europe. Tamsulosin hydrochloride is sold in Bangladesh under the brand names Uromax, Prostanil MR, Tamisol MR, and Tamsin.{{citation needed|date=August 2017}} It is available to patients in the UK on National Health Service prescription (prescribed without brand name, at nominal or no cost to patients),{{cite web |title=About tamsulosin |publisher=NHS|date=2 February 2023|url=https://www.nhs.uk/medicines/tamsulosin/about-tamsulosin/ |access-date=16 May 2025}} and in 2010 became available for over-the-counter purchase without prescription.{{cite journal | vauthors = | title = OTC tamsulosin for benign prostatic hyperplasia | journal = Drug and Therapeutics Bulletin | volume = 48 | issue = 10 | pages = 113–116 | date = October 2010 | pmid = 20926447 | doi = 10.1136/dtb.2010.10.0052 | s2cid = 32141889 }}

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{{Drugs used in benign prostatic hypertrophy}}

{{Adrenergic receptor modulators}}

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