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Tamsulosin: What is the Dosage and How Much Does it Cost?

Over 70 percent of men over the age of 70 will experience benign prostatic hyperplasia, an extremely common medical condition that increasingly affects men as they age. Benign prostatic hyperplasia, or an enlarged prostate, is a frustrating condition that can cause embarrassment, but it is not inherently dangerous and is not indicative of the future likelihood of prostate cancer. Tamsulosin is a popular medication used for the treatment of benign prostatic hyperplasia, but what is the dosage and how much does it cost? 

What is Tamsulosin?

Tamsulosin, which is also sold under the brand name Flomax, belongs to a class of drugs called alpha-blockers, which also includes alfuzosin, doxazosin, and silodosin. These medications tamsulosin cause the muscles of the body to relax by blocking the action of norepinephrine, a hormone that causes the muscles in the walls of the arteries and veins to constrict. Alpha-blockers can be used to treat symptoms of high blood pressure when used with other medications, but they are most commonly used to treat symptoms of an enlarged prostate gland or benign prostatic hyperplasia, and can help with urinary retention issues and the urinary tract. Tamsulosin is only intended for the treatment of symptoms associated with an enlarged prostate. Tamsulosin can also be combined with non-alpha-blocker urinary retention medications as well, including dutasteride and finasteride. 

What is Tamsulosin Used to Treat?

Tamsulosin is primarily used for the treatment of benign prostatic hyperplasia (BPH), also known as prostate enlargement or an enlarged prostate. It is common for men to experience BPH as they age, but others experience the condition as a result of other health issues such as diabetes and heart disease, and lifestyle factors can also play a role. Although BPH is common, it is still an inconvenient, frustrating, and sometimes embarrassing condition. 

BPH occurs when the prostate, which surrounds a portion of the urethra (a thin tube that carries urine and semen out of the penis) becomes enlarged, squeezing the urethra and diminishing its flow. BPH commonly affect urine flow, which can be experienced as difficulty starting to urinate, a weak urine stream, or dribbling urine as you finish. Men with BPH also experience bladder issues because the bladder works harder to eliminate urine in men with the condition. Over time, the bladder muscles begin to weaken, which causes increased difficulty in emptying your bladder. 

Men with weak bladders may suffer from any or all of the following symptoms:

  • Waking up during the night to urinate
  • Frequent trips to the bathroom (eight or more times per day)
  • Incomplete emptying (feeling like you have to urinate even after you just went)
  • Incontinence (lack of control over urination)
  • A sudden, urgent need to pee

It is common for men with BPH to feel ashamed, inconvenienced, or embarrassed by their condition, but there are many different treatments for the condition. BPH can be effectively treated using tamsulosin and similar medications.

How Much Does Tamsulosin Cost?

Tamsulosin is considered a moderately priced drug and is available both in its generic form and under the brand name Flomax. A one-month supply of 30 capsules (0.4 mg) of tamsulosin costs between $7.17 and $9.50, while a one-supply of Flomax at the same dosage costs approximately $250. Unless there is a medical reason that a patient needs to take Flomax, most doctors prescribe the generic version of the medication because it is widely available and much more affordable.

 While some people are unsure about the quality or safety of generic drugs, these concerns are unfounded. Generic medications are subjected to the same stringent testing by the FDA as brand name medications, so they are guaranteed to be safe. Generic medications are also equally effective, as they use the same active ingredient and same quantity as the brand name drug but may use different inactive ingredients that affect the color, size, shape, or taste of the medication, but that do not affect its effectiveness. 

What Are the Benefits of Tamsulosin?

Tamsulosin is a popular and highly effective drug for the treatment of BPH with several benefits. Benefits of tamsulosin include:

  • The medication is well tolerated by men with kidney or liver disease, who generally do not need to adjust their dosage of the medication. However, men with end-stage kidney or liver disease should discuss the use of tamsulosin with their doctors.
  • Tamsulosin is effective at improving urine flow rates and other symptoms of BPH, including incomplete emptying, hesitancy, intermittency, and weak urine streams.
  • Most patients (approximately 80 percent) who finished six years of treatment with tamsulosin responded positively to the medication and reported a low incidence of orthostasis.

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What Risks Are Associated With Tamsulosin?

Risks associated with taking tamsulosin include:

  • When moving from a sitting to a standing position, tamsulosin can sometimes cause an unsafe drop in blood pressure. Patients are most likely to experience this issue when they first start taking tamsulosin or increase their dosage of the medication. Vertigo and syncope, a temporary loss of consciousness, can also occur. Due to these risks, tamsulosin can cause an increased likelihood of falls, which can be dangerous for older men.
  • Priapism, a painful erection lasting longer than four hours, can occur in some men. Priapism is a serious condition that requires medical attention.
  • People with a sulfa allergy can experience an adverse reaction to tamsulosin.
  • Tamsulosin can react with several different types of drugs, including CYP2D6 inhibitors like paroxetine, CYP3A4 inhibitors like ketoconazole, PDE5 inhibitors like Viagra (sildenafil) or tadalafil, blood thinners like warfarin.
  • Tamsulosin can cause some patients to feel dizzy when they first wake up in the morning or from a nap. It’s important to be careful when moving from a lying position to a sitting or standing position while taking tamsulosin, as orthostatic hypotension may be a factor.
  • Tamsulosin can cause your blood pressure to become too low if other factors, such as heart disease, dialysis, dehydration, vomiting, diarrhea, heavy sweating, or a low-salt diet are present.

What Dose of Tamsulosin Should I Take?

Both the generic and brand name forms of tamsulosin are sold in 0.4 mg capsules, with most patients starting on an initial dose of 0.4 mg taken once per day by mouth. The maximum recommended daily dose is 0.8 mg taken in the form of two capsules once per day. Your healthcare provider will determine the correct dosage of tamsulosin for you based on your age, other health conditions, the severity of your symptoms, and other medications you may be taking. Tamsulosin is generally taken about 30 minutes after a meal and should be taken at the same time each day. 

What Are the Side Effects of Tamsulosin?

Side effects associated with tamsulosin are categorized as either common or rare. Tamsulosin is generally well tolerated by most men. When common side effects are experienced, they are usually mild and are experienced for only a few days or weeks until the patient’s body adjusts to the medication. If side effects persist or an allergic reaction develops, seek medical help from a healthcare professional. Common side effects associated with tamsulosin that usually do not need medical attention include:

  • Abnormal ejaculation
  • Decreased amount of semen
  • Blurred vision
  • Chest pain
  • Back pain
  • Tooth problems
  • Drowsiness
  • Weakness
  • Headache
  • Fever, chills, body aches, flu symptoms
  • Sleep problems (insomnia)
  • Dizziness
  • Runny or stuffy nose, sinus pain, sore throat, cough
  • Decreased interest in sex
  • Low blood pressure
  • Nausea
  • Diarrhea

Certain side effects of tamsulosin can be serious and require medical attention. Seek medical attention from your healthcare provider immediately if you experience any of the following rare but serious side effects while taking tamsulosin:

  • Painful or difficult urination
  • Chest pain
  • Cough, hoarseness, or runny nose
  • Lower back or side pain
  • Feelings of lightheadedness
  • Priapism/painful erection lasting more than four hours
  • Severe skin reaction characterized by the following:
    • Burning in the eyes
    • Painful skin
    • Fever 
    • Sore throat
    • Swelling in the face or tongue
    • Blistering or peeling associated with the skin rash
    • Rash on the face or upper body
    • Red or purple skin rash that spreads

Who Should Not Take Tamsulosin?

Tamsulosin can make some medical conditions worse. People with a history of any of the following medical conditions should speak to their doctor before taking tamsulosin:

  • Allergy to sulfa drugs
  • Severe liver disease
  • Hypotension (low blood pressure)
  • Severe kidney disease

Tamsulosin may cause adverse effects and drug interactions with the following prescription drug or over the counter medications, so be sure to give your doctor a complete list of medications you are currently taking to ensure proper medical advice and direction.

  • Antibiotics such as clarithromycin, erythromycin, or doxycycline
  • Antifungals, such as itraconazole and ketoconazole
  • Antidepressants, such as fluoxetine, paroxetine, St John’s Wort, monoamine oxidase inhibitors, and tricyclic antidepressants (such as amitriptyline, imipramine, and nortriptyline)
  • Antihistamines, such as diphenhydramine
  • CYP3A4 or CYP2D inducers or inhibitors
  • HIV medications such as ritonavir
  • Beta-blockers such as atenolol or metoprolol
  • Cyclosporine
  • Some heart medications, such as amiodarone, clonidine, digoxin, diltiazem, propafenone, quinidine, and verapamil
  • Imatinib
  • Other alpha-blockers such as prazosin or terazosin
  • Some medications used to treat mental illness, such as clozapine or thioridazine
  • NSAIDs, such as diclofenac, ibuprofen, and indomethacin, may decrease the blood pressure-lowering capabilities of tamsulosin.

References:

https://www.drugs.com/tips/tamsulosin-patient-tips 

https://www.drugs.com/tamsulosin.html 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1477608/ 

https://www.webmd.com/men/prostate-enlargement-bph/what-is-bph#1 

https://www.einj.org/journal/view.php?number=798&viewtype=pubreader

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Published August 31st, 2020 by Chris Riley
Fact Checked by Chris Riley

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