What are the contraindications of Tamsulosin (Flomax)?

From the Guidelines

Flomax (tamsulosin) is contraindicated in patients with a known hypersensitivity to tamsulosin or any components of the product, as well as those with a history of syncope, severe renal impairment, or severe hepatic impairment, and it should be used cautiously in patients with orthostatic hypotension. The contraindications for Flomax are based on its mechanism of action, which involves relaxing smooth muscles in the prostate and bladder neck, and can cause unwanted effects in certain populations 1. Some key points to consider when prescribing Flomax include:

• Patients with a history of syncope (fainting) with the medication should avoid it
• Those with severe renal impairment (creatinine clearance less than 10 mL/min) should use Flomax cautiously
• It's also contraindicated in combination with strong CYP3A4 inhibitors like ketoconazole
• Patients with severe hepatic impairment should avoid Flomax
• Men planning cataract or glaucoma surgery should inform their ophthalmologist about Flomax use, as it can cause Intraoperative Floppy Iris Syndrome
• Flomax should not be used in women or children The medication can interact with other alpha-blockers, phosphodiesterase-5 inhibitors, and antihypertensive medications, potentially causing dangerous drops in blood pressure, as noted in the 2023 European Association of Urology guidelines on the management of non-neurogenic male lower urinary tract symptoms 1. In general, the use of alpha-blockers like Flomax should be based on a thorough evaluation of the patient's medical history and current medications, and patients should be closely monitored for potential adverse effects, as recommended by the American Urological Association guideline on management of benign prostatic hyperplasia 1.

From the FDA Drug Label

Tamsulosin Hydrochloride Capsules are contraindicated in patients known to be hypersensitive to tamsulosin hydrochloride or any component of Tamsulosin Hydrochloride Capsules. Reactions have included skin rash, urticaria, pruritus,angioedema, and respiratory symptoms [ see Adverse Reactions (6.2)]. The main contraindication for Flomax (tamsulosin) is:

• Hypersensitivity to tamsulosin hydrochloride or any component of the capsules 2

From the Research

Flomax Contraindications

• Flomax, also known as tamsulosin, is a medication used to treat benign prostatic hyperplasia (BPH) 3, 4, 5, 6, 7
• The following are potential contraindications for Flomax:
  • Hypersensitivity to tamsulosin or any other ingredient in the medication 4
  • Patients with a history of orthostatic hypotension 5
  • Patients taking other medications that may interact with tamsulosin, such as phosphodiesterase-5 inhibitors 6
• It is essential to note that Flomax may cause abnormal ejaculation, which is a common adverse effect 3, 4, 5, 7
• Additionally, Flomax may increase the risk of neurodegenerative diseases, such as Parkinson's disease and Alzheimer's disease, in elderly patients 6
• Patients with certain medical conditions, such as prostate cancer, should use Flomax with caution and under the guidance of a healthcare professional 4, 6