Tamsulosin (Flomax) 💊

💊 Used for prostatic outflow obstruction symptoms in men (e.g. benign prostatic hyperplasia).

📖 About

Always check the BNF link here.

• 🎯 Selective action at α1A-adrenergic receptors in the prostate and bladder neck.
• 🚽 Improves urinary flow and relieves lower urinary tract symptoms (LUTS).

⚙️ Action

• α1A receptor blockade → relaxes smooth muscle at bladder neck & prostate → ↓ outflow resistance.
• α1B receptor blockade → systemic vasodilation (less selective, but explains hypotension side effects).

💉 Indications / Dose

• ✅ First-line for moderate to severe LUTS/BPH → symptom improvement in ~70% of men.
• 👴 Benign prostatic hyperplasia: Tamsulosin 400 micrograms PO OD (usually after food).

🔄 Interactions

• ⬆️ CYP450 inhibitors (e.g. erythromycin, ketoconazole) increase plasma levels of tamsulosin → risk of hypotension.
• ⚠️ Additive hypotension with other α-blockers or antihypertensives.

⚠️ Cautions

• 💫 Risk of falls and syncope due to orthostatic hypotension (especially on initiation).
• 👁️ Floppy iris syndrome – inform ophthalmologist before cataract surgery.
• ⚠️ Use with caution in elderly and those on antihypertensives.

⛔ Contraindications

• 🚫 History of postural hypotension.
• 🚫 Recurrent falls related to hypotension.

💥 Side Effects

• 💫 Dizziness, orthostatic hypotension.
• 🤧 Hypersensitivity reactions (rare).
• ⚠️ Retrograde ejaculation.
• 🧠 Headache, asthenia, rhinitis (less common).

📚 References

• Tamsulosin in BNF