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Drug overview for TAMSULOSIN HCL (tamsulosin hcl):
Generic name: tamsulosin HCl (tam-SOO-loe-sin)
Drug class: Alpha-Blockers
Therapeutic class: Genitourinary Therapy
Tamsulosin hydrochloride is an alpha1-adrenergic blocking agent with selectivity for alpha1A-adrenergic receptors, which are mainly located in nonvascular smooth muscle (e.g., prostate).
No enhanced Uses information available for this drug.
Generic name: tamsulosin HCl (tam-SOO-loe-sin)
Drug class: Alpha-Blockers
Therapeutic class: Genitourinary Therapy
Tamsulosin hydrochloride is an alpha1-adrenergic blocking agent with selectivity for alpha1A-adrenergic receptors, which are mainly located in nonvascular smooth muscle (e.g., prostate).
No enhanced Uses information available for this drug.
DRUG IMAGES
TAMSULOSIN HCL 0.4 MG CAPSULE
The following indications for TAMSULOSIN HCL (tamsulosin hcl) have been approved by the FDA:
Indications:
Benign prostatic hyperplasia with lower urinary tract symptom
Professional Synonyms:
Symptomatic benign prostatic hyperplasia
Symptomatic benign prostatic hypertrophy
Symptomatic BPH
Symptomatic prostatic hypertrophy
Indications:
Benign prostatic hyperplasia with lower urinary tract symptom
Professional Synonyms:
Symptomatic benign prostatic hyperplasia
Symptomatic benign prostatic hypertrophy
Symptomatic BPH
Symptomatic prostatic hypertrophy
The following dosing information is available for TAMSULOSIN HCL (tamsulosin hcl):
The manufacturer states that safety and efficacy of tamsulosin in children younger than 18 years of age have not been established, and clinical experience in these patients is not available.
Although protein binding of tamsulosin may be altered in patients with mild to moderate (i.e., creatinine clearance of 30-70 mL/minute per 1.73 m2) or severe (i.e., creatinine clearance of 10 to less than 30 mL/minute per 1.73 m2) renal impairment and in patients with moderate hepatic impairment resulting in changes of overall plasma concentrations of the drug, alterations in intrinsic clearance and concentrations of unbound tamsulosin do not appear to be substantial. Therefore, the manufacturer states that dosage adjustment in such patients is not necessary. However, tamsulosin has not been studied in patients with end-stage (i.e., creatinine clearance of less than 10 mL/minute per 1.73 m2) renal disease.
Although protein binding of tamsulosin may be altered in patients with mild to moderate (i.e., creatinine clearance of 30-70 mL/minute per 1.73 m2) or severe (i.e., creatinine clearance of 10 to less than 30 mL/minute per 1.73 m2) renal impairment and in patients with moderate hepatic impairment resulting in changes of overall plasma concentrations of the drug, alterations in intrinsic clearance and concentrations of unbound tamsulosin do not appear to be substantial. Therefore, the manufacturer states that dosage adjustment in such patients is not necessary. However, tamsulosin has not been studied in patients with end-stage (i.e., creatinine clearance of less than 10 mL/minute per 1.73 m2) renal disease.
Tamsulosin is administered orally. Because food may decrease peak plasma concentrations of tamsulosin and lengthen the time to achievement of peak plasma concentrations and decrease oral bioavailability of the drug, the manufacturer recommends that tamsulosin be taken 30 minutes after a meal; it is recommended that the drug be taken after the same meal each day. Patients should be advised that the capsules must be swallowed intact and not be opened, chewed, or crushed.
| DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
|---|---|---|
| TAMSULOSIN HCL 0.4 MG CAPSULE | Maintenance | Adults take 1 capsule (0.4 mg) by oral route once daily 1/2 hour following the same meal each day |
| DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
|---|---|---|
| TAMSULOSIN HCL 0.4 MG CAPSULE | Maintenance | Adults take 1 capsule (0.4 mg) by oral route once daily 1/2 hour following the same meal each day |
The following drug interaction information is available for TAMSULOSIN HCL (tamsulosin hcl):
There are 2 contraindications.
These drug combinations generally should not be dispensed or administered to the same patient. A manufacturer label warning that indicates the contraindication warrants inclusion of a drug combination in this category, regardless of clinical evidence or lack of clinical evidence to support the contraindication.
| Drug Interaction | Drug Names |
|---|---|
| Silodosin; Tamsulosin/Strong CYP3A4 Inhibitors SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient. MECHANISM OF ACTION: Strong CYP3A4 inhibitors may inhibit the metabolism of silodosin and tamsulosin.(1,2) CLINICAL EFFECTS: Coadministration of a strong CYP3A4 inhibitor may cause an increase in silodosin and tamsulosin levels and effects, including severe hypotension.(1,2) PREDISPOSING FACTORS: In patients receiving tamsulosin, the interaction may be worse in patients who are CYP2D6 poor metabolizers because tamsulosin also undergoes metabolism by this pathway.(2) PATIENT MANAGEMENT: The US manufacturer of silodosin states that concurrent use of strong CYP3A4 inhibitors is contraindicated.(1) The US manufacturer of tamsulosin states that tamsulosin should not be used with strong CYP3A4 inhibitors.(2) The US manufacturer of itraconazole states that silodosin or tamsulosin should not be administered until at least 2 weeks after itraconazole treatment.(3) DISCUSSION: Administration of ketoconazole (200 mg daily for 4 days) increased the Cmax and AUC of a single dose of silodosin (4 mg) by 3.7-fold and 2.9-fold, respectively.(1) Administration of ketoconazole (400 mg daily for 4 days) increased the Cmax and AUC of a single dose of silodosin (8 mg) by 3.8-fold and 3.2-fold, respectively.(1) In a study in 24 healthy male subjects, administration of ketoconazole (400 mg daily for 5 days) increased the Cmax and AUC of a single dose of tamsulosin (0.4 mg) by 2.2-fold (90% CI 1.96, 2.45) and 2.8-fold (90% CI 2.56, 3.07), respectively. No serous adverse events were reported when subjects took tamsulosin with ketoconazole.(2,4) Strong inhibitors of CYP3A4 include: adagrasib, boceprevir, ceritinib, clarithromycin, cobicistat, idelalisib, itraconazole, josamycin, ketoconazole, lonafarnib, mibefradil, mifepristone, nefazodone, posaconazole, ribociclib, telaprevir, telithromycin, troleandomycin, tucatinib and voriconazole.(5,6) |
CLARITHROMYCIN, CLARITHROMYCIN ER, GENVOYA, ITRACONAZOLE, ITRACONAZOLE MICRONIZED, KETOCONAZOLE, KISQALI, KORLYM, KRAZATI, LANSOPRAZOL-AMOXICIL-CLARITHRO, MIFEPREX, MIFEPRISTONE, NEFAZODONE HCL, NOXAFIL, OMECLAMOX-PAK, POSACONAZOLE, PREZCOBIX, RECORLEV, SPORANOX, STRIBILD, SYMTUZA, TOLSURA, TUKYSA, TYBOST, VFEND, VFEND IV, VOQUEZNA TRIPLE PAK, VORICONAZOLE, ZOKINVY, ZYDELIG, ZYKADIA |
| Alfuzosin;Silodosin;Tamsulosin/Protease Inhibitors SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient. MECHANISM OF ACTION: The protease inhibitors may inhibit the metabolism of alfuzosin,(1) silodosin,(2) and tamsulosin(3) by CYP3A4. CLINICAL EFFECTS: Co-administration of a protease inhibitor may result in increased alfuzosin,(1) silodosin,(2) and tamsulosin(3) levels and serious effects such as hypotension. PREDISPOSING FACTORS: In patients receiving tamsulosin, the interaction may be worse in patients who are CYP2D6 poor metabolizers because tamsulosin also undergoes metabolism by this pathway.(3) PATIENT MANAGEMENT: The US manufacturers of alfuzosin(1) and silodosin(2) state that concurrent use of strong CYP3A4 inhibitors is contraindicated. The US manufacturer of tamsulosin states that tamsulosin should not be used with strong CYP3A4 inhibitors.(3) The US manufacturers of atazanavir,(4) darunavir,(5) fosamprenavir,(6) indinavir,(7) lopinavir/ritonavir,(8) nelfinavir,(9), nirmatrelvir/ritonavir,(10 paritaprevir, (11) saquinavir,(12) and tipranavir(13) state that concurrent use of alfuzosin is contraindicated. DISCUSSION: Administration of ketoconazole (400 mg daily), another inhibitor of CYP3A4, increased the maximum concentration (Cmax) and area-under-curve (AUC) of a single dose of alfuzosin (10 mg) by 2.3-fold and 3.2-fold, respectively.(1) Administration of ketoconazole (200 mg daily) increased the Cmax and AUC of a single dose of alfuzosin (10 mg) by 2.1-fold and 2.5-fold, respectively.(1) Administration of ketoconazole (200 mg daily for 4 days), increased the Cmax and AUC of a single dose of silodosin (4 mg) by 3.7-fold and 2.9-fold, respectively.(2) Administration of ketoconazole (400 mg daily for 4 days) increased the Cmax and AUC of a single dose of silodosin (8 mg) by 3.8-fold and 3.2-fold, respectively.(2) In a study in 24 healthy subjects, administration of ketoconazole (400 mg daily for 5 days) increased the Cmax and AUC of a single dose of tamsulosin (0.4 mg) by 2.2-fold and 2.8-fold, respectively.(3) |
APTIVUS, ATAZANAVIR SULFATE, DARUNAVIR, EVOTAZ, FOSAMPRENAVIR CALCIUM, KALETRA, LOPINAVIR-RITONAVIR, PAXLOVID, PREZISTA, REYATAZ, VIRACEPT |
There are 0 severe interactions.
There are 2 moderate interactions.
The clinician should assess the patient’s characteristics and take action as needed. Actions required for moderate interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration.
| Drug Interaction | Drug Names |
|---|---|
| CGMP Specific PDE Type-5 Inhibitors/Alpha-Blockers SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Concurrent use of avanafil,(1) sildenafil,(2-5) tadalafil,(6-9) or vardenafil(10-14) and an alpha-blocker may result in additive or synergistic effects on blood pressure. CLINICAL EFFECTS: Concurrent use of avanafil,(1) sildenafil,(2-5) tadalafil,(6-9) or vardenafil(10-14)) and an alpha-blocker may result in symptomatic hypotension. PREDISPOSING FACTORS: Patients who have a history of hemodynamic instability on alpha-blocker therapy prior to initiating avanafil, sildenafil, tadalafil, or vardenafil may be at an increased risk of symptomatic hypotension during concurrent therapy. PATIENT MANAGEMENT: The US manufacturer of avanafil states that patients taking alpha-blockers should be stabilized on their alpha-blocker prior to beginning avanafil therapy. Avanafil should be initiated at the 50 mg dosage. In patients stabilized on avanafil therapy, alpha-blocker therapy should be initiated at the lowest possible dosage.(1) The US, Australian, Canadian, and UK manufacturers of sildenafil state that patients taking alpha-blockers should be stabilized on their alpha-blocker prior to beginning sildenafil therapy. Sildenafil should be initiated at the lowest possible dosage. In patients stabilized on sildenafil therapy, alpha-blocker therapy should be initiated at the lowest possible dosage.(2-5) The US manufacturer of tadalafil states that patients taking tadalafil for erectile dysfunction (ED) and alpha-blockers should be stabilized on their alpha-blocker prior to beginning tadalafil therapy. Tadalafil should be initiated at the lowest possible dosage. In patients stabilized on tadalafil therapy, alpha-blocker therapy should be initiated at the lowest possible dose. The combination of tadalafil and an alpha-blocker for treatment of benign prostatic hyperplasia (BPH) is not recommended. Patients on alpha-blocker therapy for BPH should discontinue their alpha-blocker at least one day prior to starting tadalafil for once daily use for the treatment of BPH.(6) The Australian manufacturer of tadalafil states that tadalafil should be used with caution in patients taking alpha-blockers.(7) The Canadian manufacturer of tadalafil states that it may be used with tamsulosin and should be used with caution with other alpha-blockers.(8) The UK manufacturer of tadalafil states that concurrent use with alpha-blockers is not recommended.(9) The US, Canadian, and UK manufacturers of vardenafil state that patients taking alpha-blockers should be stabilized on their alpha-blocker prior to beginning vardenafil therapy. Vardenafil should be initiated at the lowest possible dosage. In patients stabilized on vardenafil therapy, alpha-blocker therapy should be initiated at the lowest possible dosage.(10-12) The UK manufacturer of vardenafil states that vardenafil may be give at any time in relation to tamsulosin; however, a dose separation period of 6 hour should be considered for other alpha-blockers.(12) The Australian manufacturer of vardenafil states that concurrent use with alpha-blockers is not recommended.(13) The US manufacturers of doxazosin,(14) prazosin(15) and terazosin(16) state that PDE-5 inhibitor therapy should be initiated at the lowest dose. DISCUSSION: In a study in 24 subjects, concurrent use of avanafil (200 mg) with doxazosin (1 mg on Day 1, titrated to 8 mg for Days 8-18) resulted in 7 subjects experiencing potentially clinically significant changes in blood pressure.(1) In a study in 24 subjects, concurrent use of avanafil (200 mg) with tamsulosin (0.4 mg Days 1-11) resulted in 5 subjects experiencing potentially clinically significant changes in blood pressure.(1) Simultaneous administration of sildenafil (25 mg) and doxazosin (4 mg) resulted in mean additional reductions of supine blood pressure of 7 mmHg systolic and 7 mmHg diastolic. When doxazosin (4 mg) was simultaneously administered with higher doses of sildenafil, there were reports of symptomatic postural hypotension within one to four hours.(2) In a study, concurrent administration of a single dose of tadalafil (20 mg) to healthy subjects receiving alfuzosin (10 mg daily) resulted in mean maximum decreases in standing and supine systolic blood pressure by 2.2 mmHg and 4.4 mmHg, respectively. There were no subjects with a decrease from baseline standing systolic blood pressure greater than 30 mmHg.(6) In a study, concurrent administration of a single dose of tadalafil (20 mg) to 18 healthy subjects receiving doxazosin (8 mg daily) resulted in significant augmentation of the blood-pressure lowering effects of doxazosin (by 9.8 mmHg). The number of subjects with a standing blood pressure of less than 85 mmHg was greater after concurrent doxazosin and tadalafil than when compared to doxazosin with placebo (28% versus 6%). One subject reported vertigo and another reported dizziness. No syncope was reported.(5,14) In a second study, concurrent administration of a single dose of tadalafil (20 mg) to healthy subjects receiving doxazosin (4-8 mg daily) also resulted in augmentation of the blood-pressure lowering affects of doxazosin. One subject reported symptomatic hypotension and another reported dizziness with concurrent therapy.(6) In a study, concurrent administration of a single dose of tadalafil (20 mg) to healthy subjects receiving tamsulosin (0.4 mg daily) resulted in no significant decreases in blood pressure.(6,17) Hypotension has been reported with concurrent use of terazosin and phosphodiesterase-5 inhibitors.(16) With simultaneous administration of vardenafil (10 mg) and terazosin (10 mg), 6 of 8 healthy subjects experienced a standing systolic blood pressure of less than 85 mmHg. With simultaneous vardenafil (20 mg) and terazosin (10 mg), 2 of 9 subjects experienced a standing systolic blood pressure of less than 85 mmHg. When vardenafil (20 mg) was administered 6 hours apart from terazosin (10 mg), 7 of 28 subjects experienced a standing systolic blood pressure of less than 85 mmHg.(10) With simultaneous administration of vardenafil (10 mg) and tamsulosin (0.4 mg), two of 16 subjects experienced a standing systolic blood pressure of less than 85 mmHg. When vardenafil (20 mg) was administered six hours apart from tamsulosin (0.4 mg), one of 24 subjects experienced a standing systolic blood pressure of less than 85 mmHg.(10) In a study in subjects with benign prostatic hyperplasia (BPH) on stable tamsulosin or terazosin therapy, simultaneous vardenafil (5 mg) and tamsulosin resulted in no effects on blood pressure. Simultaneous vardenafil (5 mg) with terazosin resulted in hypotension in some subjects. This effect did not occur when vardenafil and terazosin were separated by 6 hours.(12) In a placebo controlled, crossover study in 22 subjects with benign prostatic hyperplasia receiving tamsulosin, subjects received single doses of vardenafil (10 mg and 20 mg). No patients exhibited symptomatic hypotension. Three patients receiving 20 mg of vardenafil reported dizziness, but none had a systolic blood pressure of less than 95 mmHg.(18) In a placebo-controlled study in 24 health male subjects, administration of sildenafil (100 mg) or tadalafil (20 mg) with silodosin resulted in an increase in positive orthostatic tests in the 12 hours after concurrent administration when compared with the administration of silodosin alone. There were no reports of symptomatic orthostasis or dizziness.(19) |
ADCIRCA, ALYQ, AVANAFIL, CIALIS, ENTADFI, OPSYNVI, REVATIO, SILDENAFIL CITRATE, STENDRA, TADALAFIL, TADLIQ, VARDENAFIL HCL, VIAGRA |
| Tamsulosin/Diltiazem;Dronedarone;Verapamil SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Tamsulosin is primarily metabolized by CYP3A4 and CYP2D6. Diltiazem, dronedarone, and verapamil are both moderate inhibitors of CYP3A4 and weak inhibitors of CYP2D6(1,2) and so may delay tamsulosin metabolism via both major pathways. The pharmacodynamic effects of diltiazem and verapamil on blood pressure may further increase the risk for hypotension from tamsulosin. CLINICAL EFFECTS: Co-administration of diltiazem, dronedarone, or verapamil may cause an increase in tamsulosin levels and effects, including symptomatic hypotension. PREDISPOSING FACTORS: The interaction may be more severe in poor metabolizers of CYP2D6 or in patients receiving additional agents which inhibit CYP3A4 or CYP2D6. PATIENT MANAGEMENT: The manufacturer of tamsulosin states there is a potential for a significant increase in exposure when tamsulosin is co-administered with both CYP3A4 and CYP2D6 inhibitors.(3) The risk for hypotension from tamsulosin is more likely after starting or increasing the dose of either drug.(3) Monitor for orthostatic hypotension prior to a dose increase and delay dose adjustment if needed. Monitor patients after a dose increase, particularly those with a history of hypotension, orthostasis or falls. Instruct patient to report episodes of dizziness, lightheadedness or feeling faint.(3) DISCUSSION: An open label, multicenter, prospective trial evaluated the safety of tamsulosin 0.4 mg daily over 24 weeks in 1784 patients. The most commonly reported adverse effects were dizziness, headache, abnormal ejaculation and hypotension. Patients receiving verapamil had an approximately 3-fold (odds ratio 3.166, 95% confidence interval 1.513, 6.58) increase in the risk for adverse events.(4) |
CARDIZEM, CARDIZEM CD, CARDIZEM LA, CARTIA XT, DILT-XR, DILTIAZEM 12HR ER, DILTIAZEM 24HR ER, DILTIAZEM 24HR ER (CD), DILTIAZEM 24HR ER (LA), DILTIAZEM 24HR ER (XR), DILTIAZEM HCL, DILTIAZEM HCL-0.7% NACL, DILTIAZEM HCL-0.9% NACL, DILTIAZEM HCL-NACL, DILTIAZEM-D5W, MATZIM LA, MULTAQ, TIADYLT ER, TIAZAC, TRANDOLAPRIL-VERAPAMIL ER, VERAPAMIL ER, VERAPAMIL ER PM, VERAPAMIL HCL, VERAPAMIL SR |
The following contraindication information is available for TAMSULOSIN HCL (tamsulosin hcl):
Drug contraindication overview.
Known hypersensitivity to tamsulosin or any ingredient in the formulation.
Known hypersensitivity to tamsulosin or any ingredient in the formulation.
There are 0 contraindications.
There are 5 severe contraindications.
Adequate patient monitoring is recommended for safer drug use.
| Severe List |
|---|
| CYp2d6 poor metabolizer |
| CYp3a4 poor metabolizer |
| Intraoperative floppy iris syndrome |
| Orthostatic hypotension |
| Priapism |
There are 1 moderate contraindications.
Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.
| Moderate List |
|---|
| Cataract surgery |
The following adverse reaction information is available for TAMSULOSIN HCL (tamsulosin hcl):
Adverse reaction overview.
Headache, infection, asthenia, back pain, chest pain, dizziness, somnolence, insomnia, decreased libido, rhinitis, pharyngitis, increased cough, sinusitis, diarrhea, nausea, tooth disorder, abnormal ejaculation, blurred vision.
Headache, infection, asthenia, back pain, chest pain, dizziness, somnolence, insomnia, decreased libido, rhinitis, pharyngitis, increased cough, sinusitis, diarrhea, nausea, tooth disorder, abnormal ejaculation, blurred vision.
There are 12 severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
| None. | None. |
| Rare/Very Rare |
|---|
|
Angioedema Atrial fibrillation Cardiac arrhythmia Erythema multiforme Exfoliative dermatitis Hypersensitivity drug reaction Intraoperative floppy iris syndrome Priapism Skin rash Stevens-johnson syndrome Syncope Urticaria |
There are 30 less severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
|
Back pain Diarrhea Disorder of ejaculation Dizziness General weakness Headache disorder Rhinitis |
Blurred vision Chest pain Cough Drowsy Infection Insomnia Libido changes Nausea Pharyngitis Sinusitis Tooth disorder Vertigo |
| Rare/Very Rare |
|---|
|
Accidental fall Constipation Dyspnea Epistaxis Hypotension Orthostatic hypotension Palpitations Pruritus of skin Visual changes Vomiting Xerostomia |
The following precautions are available for TAMSULOSIN HCL (tamsulosin hcl):
Not indicated for use in children.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
Contraindicated
| None |
Severe Precaution
| None |
Management or Monitoring Precaution
| None |
Category B. Not indicated for use in women.
Not indicated for use in women.
No substantial differences in safety and efficacy relative to younger adults, but increased sensitivity cannot be ruled out.
The following prioritized warning is available for TAMSULOSIN HCL (tamsulosin hcl):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for TAMSULOSIN HCL (tamsulosin hcl)'s list of indications:
| Benign prostatic hyperplasia with lower urinary tract sx | |
| N40.1 | Benign prostatic hyperplasia with lower urinary tract symptoms |
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