Facts about flomax (tamsulosin)

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Flomax (tamsulosin hydrochloride) is a drug used to treat an enlarged prostate and chronic inflammation of the prostate. According to the Pharmacy Technician Certification Board, it is one of the most commonly prescribed medications for older men and one of the 200 most prescribed medications overall.

Flomax received FDA approval in 1997. In 2009, drug maker Boehringer Ingelheim lost a patent on a drug molecule, and as a result, many low-cost generics are now available.

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Indications

Flomax belongs to a class of medications known as alpha blockers, which work by relaxing both the bladder neck muscles and the prostate muscles. Thus , men with prostate problems can urinate more freely, reducing the need to urinate at night (nocturia) and improving the urgency and frequency of urination.

Flomax is indicated for the treatment of a number of common medical conditions in men, including:

Although Flomax can lower blood pressure, it is not approved for the treatment of hypertension (high blood pressure) .

Dose

Flomax is available in 0.4 milligram (mg) capsules. It is taken daily about 30 minutes after a meal, ideally at the same time each day.

The effect of the drug is usually felt within the first 48 hours. It may take two to six weeks to completely get rid of urination. If the 0.4 mg dose does not provide relief, your doctor may recommend that you double your dose to 0.8 mg once a day. Never increase your dose unless directed to do so by your healthcare professional.

If you miss an appointment, take it as soon as you remember. However, if it is time for your next dose, skip the missed dose and proceed as usual. Never take a double dose of Flomax, as this can cause a sharp drop in blood pressure (hypotension).

Today, many urologists prescribe Flomax as part of a dual therapy. A 2019 meta-analysis showed that the combination of tamsulosin and avodart (dutasteride) provides a greater therapeutic benefit for BPH. The combination has a higher incidence of sexual side effects, but can markedly reduce the risk of progression of BPH-related symptoms and acute urinary retention compared to tamsulosin alone.

In 2010, a combination drug called Jalin (dutasteride 0.5 mg / tamsulosin 0.4 mg) received FDA approval.

Common side effects

While Flomax is considered safe for long-term use, there are a number of side effects to be aware of. The most common are (in terms of frequency of occurrence) :

  • Headache
  • Dizziness
  • Rhinitis (hay fever)
  • Ejaculation problems (including retrograde ejaculation)
  • Abnormal weakness
  • Chest pain
  • Cough
  • Drowsiness
  • Nausea
  • Decreased libido
  • Blurry vision
  • Rash
  • Priapism (painful erection that lasts four hours or more)

Other more troublesome side effects include dizziness, dizziness, postural hypotension (low blood pressure when standing up), and fainting. These symptoms, known as orthostasis, usually occur within the first eight weeks of treatment. Due to its potential effect on blood pressure, people with low blood pressure, mechanical heart problems, or congestive heart failure should be closely monitored while taking Flomax.

Flomax may take 2 to 6 weeks to work. Call your doctor if your urination does not improve within two weeks, or if you experience serious, persistent, or worsening side effects, such as a rash, priapism, or fainting.

Interaction and contraindications.

Flomax is contraindicated in people with a known allergy to Flomax or any of its ingredients.

Flomax should not be used with certain CYP3A4 inhibitors. These are medicines that block the CYP3A4 enzyme, a substance produced by the liver that can affect the bioavailability (concentration) of flomax in the blood. Taking a strong CYP3A4 inhibitor may increase the bioavailability of Flomax and the severity of side effects (usually low blood pressure).

In some cases, it may be necessary to monitor blood pressure during treatment. In other cases, one of the two medications may need to be changed.

Talk to your doctor if you are taking any of the following:

  • Alpha blockers used to treat high blood pressure, such as doxazosin (Cardura), dibenziline (phenoxybenzamine), and Minipress (prazosin).
  • Antiarrhythmic drugs such as Multaq (dronedarone) and Nexterone (amiodarone)
  • Antibiotics such as Amoxil (amoxicillin), (Biaxin), clarithromycin, and Ketek (telithromycin).
  • Antifungal medications such as itraconazole, ketoconazole, omeprazole, lansoprazole, and voriconazole.
  • Anti-TB drugs such as isoniazid and rifampin.
  • Darvon (propoxyphene), an opioid pain reliever
  • Erectile dysfunction medications such as Viagra (sildenafil), Cialis (tadalafil), and Levitra (vardenafil)
  • HIV protease inhibitors such as Reyataz (atazanavir), Prezista (darunavir), and Kaletra (lopinavir / ritonavir)
  • Qualaquin (quinine), used to treat malaria
  • Ranexa (ranolazine), used to treat angina pectoris
  • Serzon (nefazodone), an antidepressant
  • Varubi (rolapitant), used to treat nausea associated with chemotherapy.
  • Viekira Pak (ombitasvir / paritaprevir / ritonavir / telaprevir), used to treat hepatitis C.

Flomax should not be used in people with end-stage kidney disease. People with kidney failure should also be monitored regularly due to the increased risk of hypertensive reaction.

If you are scheduled to have surgery to remove cataracts or glaucoma , tell your doctor if you are using or have recently used Flomax. A serious eye condition called intraoperative flexible iris syndrome is known to occur in about 2% of people who have undergone cataract surgery while taking Flomax.

Therefore, the use of Flomax is not recommended before cataract surgery due to studies showing an increased risk of retinal detachment or loss of the lens.

Considerations

Flomax is not indicated for women. Due to its possible effect on blood pressure, it is important to inform your doctor if you experience dizziness while taking Flomax. When you wake up from bed in the morning, be careful not to fall or pass out. The same applies if you plan to drive due to the risk of visual impairment and dizziness. In some cases, you may need to stop treatment if the medicine interferes with your ability to work properly.

Because BPH is very similar to prostate cancer , men with prostate problems should have tests to rule out cancer before starting treatment and at regular intervals thereafter .

Generic and payment assistance

Following the termination of the Boehringer Ingelheim patent in 2009, the FDA approved the first generic Flomax in March 2010. There are 11 generic 0.4 mg tamsulosin available in the United States today, priced between $ 10 and $ 30 for a 30-day period. supply.

For its part, Boehringer Ingelheim offers the Flomax brand online for $ 35 for 30 capsules or $ 90 for 90 capsules with free home delivery.

In the meantime, qualifying Jalyn users can enroll in the GSKForU GlaxoSmithKline Patient Assistance Program to receive the drug at little or no cost. If you live in the United States, do not have drug coverage, and meet certain income guidelines, you may be eligible. Jalin's current monthly retail price is between $ 120 and $ 250.

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