Tamsulosin is a medicine prescribed to treat lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). In the US, the drug is known as Flomax, but it is also known as Flomaxtra, Omnic Ocas, Omnic ERV, or Tamsulin in other countries.
What are the main features of benign prostatic hyperplasia?
BPH is common among older men, with symptoms that include difficulty at the start of urination, a weak urine stream, and the need to urinate often or urgently, including disturbing normal sleep. The incidence of this condition rises with age. Around 8% of men in their 40s are reported as showing some or all of these symptoms, and this rises to 50% in their 60s and reaches 80% by the ninth decade, meaning the majority of cases develop after the age of 50.Â
What are the causes of BPH?
BPH is the diagnosis given when there is an enlarged prostate that cannot be attributed to any form of malignancy. The exact cause of benign prostatic hyperplasia is unknown, but there’s strong evidence that it is related to aging and the hormonal changes that come with it.Â
As men age, their hormone levels change, which may cause the prostate gland to grow. The hormone dihydrotestosterone stimulates the growth of certain cells in the prostate. Changes in testosterone levels may also play a role in the growth of the gland.Â
- An unhealthy diet high in red or processed meat, saturated fats, and dairy products
- Hyperinsulinemia (elevated levels of insulin in the bloodstream sometimes due to insulin resistance)
- Dyslipidemia (abnormal levels of fats in the blood – either high total cholesterol or high triglycerides)
- Genetics – people with a family history of BPH are more likely to develop an enlarged prostate
- Obesity
- Heart and circulatory disease
- Type 2 diabetes
- Inactivity
- Erectile dysfunction
- Antihistamines
- Decongestants like pseudoephedrine
- Tricyclic antidepressants
- Muscle relaxers like cyclobenzaprine and orphenadrine
What are the most frequent treatments for Benign Prostatic Hyperplasia?
The most common treatments for BPH are:
- Alpha blockers such as Flomax. These medications generally work quickly in men with relatively small prostates.Â
- 5-alpha reductase inhibitors like Proscar and Propecia, that shrink prevent prostate growth by inhibiting hormonal changes. These medications might take up to six months to be effective.Â
- Combination drug therapy, where it might be recommended to take both an alpha blocker like Flomax along with a 5-alpha reductase inhibitor like Proscar and Propecia at the same time if either medication alone isn’t effective.
- In cases where the drug therapies may not be advised, surgical intervention offers the following options:
-
- TURP – transurethral resection of the prostate with removal of all but the outer part of the prostate. TURP generally relieves symptoms quickly, and most men have a stronger urine flow soon after the procedure.Â
- TUIP – transurethral incision of the prostate with one or two small cuts in the prostate gland. It might be used if there are health problems that make other surgical options too risky.
- TUMT – transurethral microwave thermotherapy using microwave energy from an electrode to destroy the inner portion of the enlarged prostate gland.
- TUNA – transurethral needle ablation using radio waves passing through needles to heat and destroy excess prostate tissue.
- Ablative laser procedures such as PVP (photoselective vaporization of the prostate) and HoLAP (holmium laser ablation of the prostate) vaporize obstructive prostate tissue.Â
- PUL – prostatic urethral lift to compress the sides of the prostate. The procedure might be recommended in cases of concern about the treatment’s impact on erectile dysfunction and ejaculatory problems.
- Open prostatectomy is generally done when there is a very large prostate, bladder damage or other complicating factors. The surgery may require a short hospital stay.
- HoLEP – holmium laser enucleation of the prostate to remove the tissue blocking urine flow and preventing regrowth. The removed tissue can be examined for prostate cancer and other conditions.
Why is Flomax the drug of choice for BPH?
While Flomax doesn’t directly work to shrink the prostate, it relaxes the muscles around the prostate and bladder. This helps to relieve symptoms caused by an enlarged prostate, which interferes with the outflow of urine from the bladder.
Tamsulosin belongs to a class of drugs known as alpha blockers. These drugs relax smooth muscles at the neck of the bladder and in the prostate so that urine can flow out more easily.
Are there any other conditions treated with Flomax?
Flomax may sometimes be prescribed to treat patients with chronic prostatitis and to help with the passage of kidney stones. The benefit with a kidney stone is greater for larger stones.
What is the history of Flomax?
Flomax was first marketed in 1996 and after the U.S. patent expired in October 2009 the FDA approved generics containing tamsulosin. It is marketed by various companies under license, including under the trade name Omnic.
How much can I save when buying Flomax or its generics from IsraelPharm?
The following is a sample of the prices charged for Flomax and generic Omnic medications.
| Name | Dose | Average price++ | IsraelPharm |
| Generic Tamsulin | 0.4mg / 30 tablets | $79 | $35 |
| Flomax | 0.4mg / 30 tablets | $352 | $32 |
Note: Prices quoted here are correct at the time of posting based on a survey of online sources and may be subject to change at any time.
Frequently Asked Questions
What are the most common side effects of Flomax?
Research to date has found the medication to be safe and effective for most people. Mild side effects, such as dizziness, lightheadedness, weakness, drowsiness, headache, nausea, diarrhea, back pain, and blurred vision are sometimes experienced in the early stages of treatment. If these do not clear up within a few days, talk to your pharmacist or the prescribing physician.
If you experience severe or persistent side effects such as an erection that is painful or lasts more than four hours, severe dizziness, or fainting, you should contact your doctor right away.
What foods should I avoid while taking Flomax?
Grapefruit juice and citrus fruits may intensify adverse side effects of the drug. You should try to limit grapefruit in particular and discuss the best practices with your pharmacist.
Do I need to take care when standing up?
Tamsulosin has been reported as causing dizziness when rising too quickly. It’s best to move slowly from lying down into a sitting position, and only then stand up. This will allow the body to adjust to any changes in blood pressure.
Do I need to choose between Flomax brand and a tamsulosin generic?
Normally, the dispensing pharmacist can suggest switching from brand to generic, or vice versa, unless the prescribing doctor has specified “brand only” or “no switching” on the script, in which case the specified format must be supplied. We have a great article here that explains more about the options.
