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Flomax (tamsulosin hydrochloride) belongs to a class of medications known as alpha-blockers. It relaxes the muscles in the prostate and bladder neck to improve urine flow and reduce symptoms of benign prostatic hyperplasia (BPH), a condition in which the prostate enlarges as men age. Flomax was developed by Boehringer Ingelheim and originally approved by the FDA in 1997. Since then, it has become one of the most commonly prescribed BPH treatments.
Flomax Pharmacological Activity
The prostate gland surrounds the urethra, the tube that carries urine from the bladder out of the body. As the prostate enlarges due to BPH, it constricts the urethra, causing urinary retention and other lower urinary tract symptoms like frequent/urgent urination, weak stream, and incomplete emptying of the bladder.
By blocking alpha-1a adrenergic receptors, Flomax relaxes smooth muscle in the prostate and bladder neck. This opens the urethra and improves urine flow to alleviate BPH symptoms rapidly. Peak drug concentrations are reached in 2-4 hours and effects last up to 24 hours from a single dose.
Indications for Use
Flomax is prescribed to improve urination in men with mild to moderate BPH symptoms. It provides fast relief of:
- Weak, interrupted urine stream
- Urgency and frequency of urination
- Feeling unable to fully empty the bladder
Flomax should not be used in women or pediatric patients. It is not approved for use in high risk symptomatic BPH patients, including those with urinary retention, urinary tract infections, or bladder stones.
Treatment Regimens and Dosages
The recommended dosage is 0.4 mg capsule taken orally once daily, approximately 30 minutes after eating. Flomax is well absorbed without regard to food intake. No dosage adjustment is needed for elderly patients or those with renal impairment.
Flomax reaches maximum effect within 2-4 weeks. A therapeutic trial of 4-6 weeks is needed to accurately determine efficacy. Many patients notice significant improvement within days that increases over weeks. Flomax may be taken long-term or discontinued after symptoms improve.
Recommendations for Use
To optimize effectiveness and minimize side effects:
- Take one 0.4 mg capsule daily with food and water
- Take at the same time each day (morning or evening)
- Do not crush, split, or chew the capsule
- If switching from another BPH drug, start Flomax once prior med finishes
- Use regularly for best results, even during symptom-free periods
- Continue taking Flomax for 2-4 weeks after surgery to facilitate urine flow
- Seek medical advice before combining Flomax with other alpha blockers
If a dose is missed, take it as soon as remembered unless it is close to the next scheduled dose. Do not take two capsules at once. Return to the normal schedule the following day, without doubling up doses.
- If developing a serious infection or having surgery, tell doctors Flomax is being taken, as its effects on lowering blood pressure may require adjustment of anesthesia medications.
- Use caution when driving or operating machinery as dizziness can occur, especially early in treatment.
- Avoid becoming dehydrated and practice good hygiene to reduce the risk of urinary tract infections.
- Inform all healthcare providers that Flomax is being taken.
Possible Side Effects
The most common side effects include:
- Runny nose
- Blurred vision
These effects are often mild and usually clear up within a week or two of starting treatment. Drinking adequate fluids can minimize dizziness and lightheadedness. Using nasal decongestant sprays can reduce runny nose symptoms.
Rarely, more severe side effects may occur such as:
- Severe hypotension
- Irregular heartbeat
Seek immediate medical care if experiencing serious side effects. Flomax may need to be discontinued.
Interactions with Other Drugs
Flomax can potentially interact with other medications. Its alpha-blocker effects are increased when combined with certain antibiotics like erythromycin. Blood pressure medications, antifungals, and blood thinners may also interact with Flomax.
Always discuss any new medications with a doctor and pharmacist to check for interactions. Also avoid combining Flomax with other alpha blockers for BPH like terazosin or doxazosin, unless directed by a physician. Combining alpha blockers increases side effects risk.
Store at controlled room temperature between 59-86°F (15-30°C). Keep this and all medications out of reach and sight of children. Do not store in bathrooms as moisture may damage the medication.
Flomax has provided effective, convenient relief of BPH symptoms for over 20 years. Discuss any questions or concerns about using Flomax with a healthcare provider. They can determine if it is the right treatment option for managing bothersome urinary issues associated with an enlarged prostate.