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Are There Alternatives to Unpleasant Tamsulosin Side Effects?

Tamsulosin is often a go-to drug for symptoms of an enlarged prostate gland, but tamsulosin side effects can be daunting. Are there other drug options?

Many physicians think that the best approach to benign prostate enlargement and problems peeing, especially at night, is a prescription for tamsulosin (Flomax). But for some, like this reader, tamsulosin side effects can be disruptive to quality of life.

Q. I’ve been on tamsulosin for a year to reduce urinary symptoms from an enlarged prostate. I am experiencing sinus swelling, eye discomfort, no interest in sex and poor ejaculation. I am still getting up three times a night to pee.

I will soon be seeing my urologist. Are there other drugs for benign prostate enlargement?

A. The tamsulosin side effects you describe are not that uncommon. The FDA warns about dizziness, especially upon standing, as well as vertigo. Other complications may include stuffy nose (rhinitis), sinusitis, sore throat, cough, weakness, back pain, sleepiness, insomnia, reduced libido, abnormal ejaculation and blurred vision.

Floppy Iris Syndrome:

One serious tamsulosin side effect affects cataract surgery. The FDA warns that:

“Intraoperative Floppy Iris Syndrome (IFIS) has been observed during cataract and glaucoma surgery in some patients on or previously treated with alpha1 blockers, including FLOMAX capsules.

“Most reports were in patients taking the alpha1 blocker when IFIS occurred, but in some cases, the alpha1 blocker had been stopped prior to surgery. In most of these cases, the alpha1 blocker had been stopped recently prior to surgery (2 to 14 days), but in a few cases, IFIS was reported after the patient had been off the alpha1 blocker for a longer period (5 weeks to 9 months). IFIS is a variant of small pupil syndrome and is characterized by the combination of a flaccid iris that billows in response to intraoperative irrigation currents, progressive intraoperative miosis despite preoperative dilation with standard mydriatic drugs and potential prolapse of the iris toward the phacoemulsification incisions. The patient’s ophthalmologist should be prepared for possible modifications to their surgical technique, such as the utilization of iris hooks, iris dilator rings, or viscoelastic substances.

“IFIS may increase the risk of eye complications during and after the operation. The benefit of stopping alpha1 blocker therapy prior to cataract or glaucoma surgery has not been established. The initiation of therapy with tamsulosin in patients for whom cataract or glaucoma surgery is scheduled is not recommended.”

One ophthalmologist told us that this tamsulosin side effect can last for years after the drug has been stopped. Since many men suffering an enlarged prostate gland may also be experiencing cataracts, this is not a trivial issue. If the eye surgeon is not well trained in how to deal with this adverse drug reaction the surgery may not turn out as well as anticipated.

Other Options Besides Tamsulosin:

Cialis (tadalafil) For Prostate Enlargement:

You may want to ask your doctor about tadalafil (Cialis). Most men think of this as an alternative to Viagra for treating ED, but the FDA has approved it to ease symptoms of prostate enlargement. It should not have negative sexual side effects.

Here is a link to more information on this “double duty drug.”

Avodart (dutasteride) for Prostate Enlargement:

Another prescription option is either dutasteride (Avodart) or finasteride (Proscar), though these drugs may also have sexual side effects.

The People’s Pharmacy Bottom Line on Tamsulosin Side Effects:

Tamsulosin may be appropriate for men with no likelihood of developing cataracts and who do not experience side effects like dizziness, sinusitis or sexual difficulties. If those tamsulosin side effects occur, however, there are other options worth consideration.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.”.
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