tamsulosin hydrochloride


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tamsulosin hydrochloride

Bazetham, Contiflo XL, Flomax, Flomax CR, Flomaxtra, Novo-Tamsulosin, Omnic MR, Ran-TamsulosinW, Ratio-Tamsulosin, Sandoz Tamsulosin, Stronazon, Tabphyn

Pharmacologic class: Alpha-adrenergic blocker

Therapeutic class: Anti-adrenergic

Pregnancy risk category B

Action

Decreases smooth muscle contractions of prostate by binding to alpha1-adrenergic receptors. This action increases urine flow and reduces symptoms of benign prostatic hyperplasia (BPH).

Availability

Capsules: 0.4 mg

Indications and dosages

BPH

Adults: 0.4 mg/day P.O. after a meal. After 2 to 4 weeks, may increase to 0.8 mg/day.

Contraindications

• Hypersensitivity to drug or its components

Precautions

Use cautiously in:

• concurrent use of other alpha-adrenergic blockers or strong CYP3A4 inhibitors (avoid use)

• concurrent use of moderate CYP3A4 inhibitors, strong or moderate CYP2D6 inhibitors, other cytochrome P450 inhibitors, warfarin, and in patients who are poor CYP2D6 metabolizers

• patients at increased risk for prostate cancer.

Administration

• Give 30 minutes after same meal each day.

Adverse reactions

CNS: dizziness, headache, asthenia, insomnia, drowsiness, syncope, vertigo

CV: orthostatic hypotension, chest pain

EENT: rhinitis, amblyopia, pharyngitis, sinusitis

GU: retrograde or diminished ejaculation, decreased libido

Musculoskeletal: back pain

Respiratory: increased cough

Other: tooth disorder, infection

Interactions

Drug-drug. Cimetidine: increased tamsulosin blood level, greater risk of toxicity

Doxazosin, prazosin, terazosin: increased risk of hypotension

Ketoconazole (strong CYP3A4 inhibitor), paroxetine (strong CYP2D6 inhibitor): increased tamsulosin Cmax and area under the curve

Drug-behaviors. Alcohol use: increased risk of hypotension

Patient monitoring

• Monitor blood pressure. Stay alert for orthostatic hypotension.

Patient teaching

• Tell patient to take 30 minutes after same meal each day.

• Instruct patient not to chew or open capsule. Advise him to swallow it whole.

• Tell patient to move slowly when sitting up or standing, to avoid dizziness or light-headedness from sudden blood pressure decrease.

• Caution patient to avoid hazardous activities on first day of therapy.

• Inform patient that drug may cause abnormal ejaculation. Advise him to discuss this issue with prescriber.

• As appropriate, review all other significant adverse reactions and interactions, especially those related to the drugs and behaviors mentioned above.

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References in periodicals archive ?
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