From the Guidelines
Flomax (tamsulosin) is an effective treatment option for urinary frequency due to benign prostatic hyperplasia (BPH). According to the American Urological Association (AUA) guideline on management of BPH 1, alpha-adrenergic blocker therapy, including tamsulosin, is a recommended treatment option for patients with lower urinary tract symptoms (LUTS) secondary to BPH. The guideline states that tamsulosin, along with other alpha-blockers such as alfuzosin, doxazosin, and terazosin, has equal clinical effectiveness in relieving symptoms of BPH, including urinary frequency.
The standard dosage of tamsulosin is 0.4 mg taken once daily, approximately 30 minutes after the same meal each day, with some patients requiring dose adjustment up to 0.8 mg daily if needed 1. Improvement in symptoms typically begins within 1-2 weeks, though full benefits may take up to a month. Tamsulosin should be taken consistently for ongoing symptom relief. Patients should be aware of possible side effects including dizziness, headache, retrograde ejaculation, and orthostatic hypotension (especially when first starting the medication).
Key benefits of tamsulosin include:
- Relief of urinary frequency and other LUTS symptoms
- Improvement in urine flow
- Reduction in bladder outlet obstruction
- Potential for fewer cardiovascular side effects compared to non-selective alpha blockers
It's essential to note that tamsulosin works specifically on the urinary symptoms of BPH by targeting the alpha-1A receptors that predominate in the prostate tissue, making it a selective treatment option for urinary symptoms. As with any medication, patients should be monitored for potential side effects and adjustments made as needed to ensure optimal treatment outcomes.
From the FDA Drug Label
The primary efficacy assessments included: 1) total American Urological Association (AUA) Symptom Score questionnaire, which evaluated irritative (frequency, urgency, and nocturia), and obstructive (hesitancy, incomplete emptying, intermittency, and weak stream) symptoms, where a decrease in score is consistent with improvement in symptoms; Mean changes from baseline to Week 13 in total AUA Symptom Score were significantly greater for groups treated with Tamsulosin Hydrochloride Capsules 0.4 mg and 0.8 mg once daily compared to placebo in both U. S. studies
Tamsulosin (Flomax) is effective for treating urinary frequency due to benign prostatic hyperplasia (BPH), as evidenced by a significant decrease in total AUA Symptom Score, which includes irritative symptoms such as frequency. 2
From the Research
Efficacy of Flomax (Tamsulosin) for Urinary Frequency
- Flomax (tamsulosin) is effective in treating urinary frequency due to benign prostatic hyperplasia (BPH) 3, 4, 5, 6, 7.
- Tamsulosin improves symptoms and peak urine flow relative to placebo, with a small to moderate improvement in urinary symptoms and flow 5, 7.
- The weighted mean differences for mean change from baseline for the Boyarsky symptom score for 0.4 mg and 0.8 mg doses of tamsulosin relative to placebo were -1.1 points and -1.6 points, respectively 5, 7.
Dosage and Administration
- The usual dosage of tamsulosin is 0.4 or 0.8 mg orally once a day 3, 4.
- The beneficial effects of tamsulosin on voiding symptoms, peak urinary flow rate, and bladder emptying appear to be dose-related, up to a ceiling dose of 0.4 mg 4.
- Increasing the dose of tamsulosin from 0.4 to 0.8 mg seems to have no substantial additional benefit 6.
Safety and Tolerability
- Tamsulosin is generally well tolerated, with the most common adverse events being dizziness, asthenia, and abnormal ejaculation 3, 4, 5, 6, 7.
- Adverse effects increase markedly as tamsulosin dosing increases, and are reported in 75% of men receiving the 0.8 mg dose 5, 7.
- Long-term treatment with tamsulosin is safe and well tolerated in patients with lower urinary tract symptoms/BPH, with no clinically significant changes in blood pressure or pulse rate 6.