Tamsulosin

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Tamsulosin

Tamsulosin, sold under the brand name Flomax among others, is a medication used to treat symptomatic benign prostatic hyperplasia and chronic prostatitis.[6][7] It is also used to help with the passage of kidney stones.[8] The evidence for benefit with a kidney stone is better when the stone is larger.[8] Tamsulosin is taken by mouth.[6]

Quick Facts Clinical data, Pronunciation ...
Tamsulosin
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Clinical data
Pronunciation/tæmˈsləsɪn/[1]
tam-SOO-lə-sin
Trade namesFlomax, others
AHFS/Drugs.comMonograph
MedlinePlusa698012
License data
Pregnancy
category
  • AU: B2
Routes of
administration
By mouth
Drug classα1 blocker
ATC code
Legal status
Legal status
Pharmacokinetic data
Bioavailability100% (by mouth)
MetabolismLiver
Elimination half-life9–13 hours
Excretion76% Kidney
Identifiers
  • (R)-5-(2-{[2-(2-Ethoxyphenoxy)ethyl]amino}propyl)-2-methoxybenzene-1-sulfonamide
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.109.780
Chemical and physical data
FormulaC20H28N2O5S
Molar mass408.51 g·mol−1
3D model (JSmol)
  • CCOc1ccccc1OCCN[C@@H](C)Cc1ccc(OC)c(c1)S(=O)(=O)N
  • InChI=1S/C20H28N2O5S/c1-4-26-17-7-5-6-8-18(17)27-12-11-22-15(2)13-16-9-10-19(25-3)20(14-16)28(21,23)24/h5-10,14-15,22H,4,11-13H2,1-3H3,(H2,21,23,24)/t15-/m1/s1 Y
  • Key:DRHKJLXJIQTDTD-OAHLLOKOSA-N Y
  (verify)
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Tamsulosin – ARISTO Pharma – 0.4 mg prolonged-release tablets – Urologikum

Common side effects include dizziness, headache, insomnia, nausea, blurry vision, and sexual problems.[9][6] Other side effects may include feeling lightheaded with standing due to changes in blood pressure, and angioedema.[9] Tamsulosin is an alpha blocker and works by relaxing muscles in the prostate.[10] Specifically it is an α1-adrenergic receptor blocker.[6]

Tamsulosin was approved for medical use in the United States in 1997.[6] It is available as a generic medication.[11][9] In 2022, it was the twentieth most commonly prescribed medication in the United States, with more than 25 million prescriptions.[12][13]

Medical uses

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Flomax 0.4 mg oral capsule

Tamsulosin is used for benign prostatic hyperplasia and to help with the passage of kidney stones.[8][14] Tamsulosin, however, appears to be effective only for stones over 4 mm and less than 10 mm in size.[8]

Tamsulosin is also used as an add-on treatment for acute urinary retention. People may void more successfully after catheter removal if they are taking tamsulosin. People taking tamsulosin also are less likely to need repeat catheterization.[15]

Tamsulosin does not decrease the overall size of the prostate in men with benign prostatic hyperplasia and is not recommended for the prevention of prostate cancer.[16]

Combination therapy

The results of the CombAT (combination of dutasteride (Avodart) and tamsulosin (Duodart)) trial in 2008, demonstrated that treatment with the combination of dutasteride and tamsulosin provides greater symptom benefits compared to monotherapy with either agent alone for treatment of benign prostatic hyperplasia.[17] The combination medication dutasteride/tamsulosin (Jalyn) was approved by the US Food and Drug Administration (FDA) in June 2010.[18]

Adverse effects

Mechanism

Tamsulosin is a selective α1 receptor antagonist that has preferential selectivity for the α1A receptor in the prostate versus the α1B receptor in the blood vessels.[24]

When alpha 1 receptors in the bladder neck, prostate, ureter, and urethra are blocked, a relaxation in smooth muscle tissue results.[16] This mechanism decreases resistance to urinary flow, reduces discomfort associated with benign prostatic hyperplasia, and facilitates passage of kidney stones.[16]

Brand names

Tamsulosin was first sold in 1997 under the brand name Flomax. The US patent expired in October 2009.[25] The US Food and Drug Administration (FDA) approved generic versions in March 2010.[11] In 2010, tamsulosin was available as OTC medication in UK.[26]

It is sold by various companies, including Boehringer Ingelheim and CSL.[citation needed] Tamsulosin hydrochloride extended-release capsules are sold under the brand names Urimax 0.4 (India),Tamlocept 0.4 (India), Flomax, Flomaxtra, Contiflo XL, bestflo, Mecir LP (France), Urimax, Pamsvax, and Pradif, although generic, unmodified-release capsules are still approved and sold in many countries (such as Canada). Generic extended-release tablets are sold in most countries of the European Economic Area (EEA). In Mexico, it is sold as Secotex, as Harnal D in Japan and Indonesia, and as Harnal OCAS (oral controlled absorption system) in Thailand.[27] In Egypt,[28] Italy, Russia and Iceland, it is sold under the brand name Omnic by Astellas Pharma Europe. Tamsulosin hydrochloride is sold in Bangladesh under the brand names Uromax, Prostanil MR, Tamisol MR, and Tamsin.[citation needed]

References

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