tamsulosin hydrochloride

(tam soo low' sin)

Flomax

Pregnancy Category B

Drug class
Alpha-adrenergic blocker (peripherally acting)

Therapeutic actions
Blocks the smooth muscle alpha1-adrenergic receptors in the prostate, prostatic capsule,
prostatic urethra, and bladder neck, leading to relaxation of the bladder and prostate and
improving the flow of urine in cases of benign prostatic hypertrophy.

Indications
• Treatment of the signs and symptoms of benign prostatic hyperplasia (BPH)

Contraindications and cautions

• Contraindicated with hypersensitivity to tamsulosin, prostate cancer, pregnancy,
lactation.
• Use cautiously with hypotension.

Available forms
Capsules—0.4 mg

Dosages
ADULTS
0.4 mg PO daily 30 min after the same meal each day; if response is not satisfactory in 2–
4 wk, dosage may be increased to 0.8 mg PO daily 30 min after the same meal each day.
PEDIATRIC PATIENTS
Safety and efficacy not established.

Pharmacokinetics
Route Onset Peak
Oral Varies 4–6 hr
Metabolism: Hepatic; T1/2: 9–15 hr
Distribution: May cross placenta; enters breast milk
Excretion: Urine and feces

Adverse effects
• CNS: Somnolence, insomnia
• CV: Orthostatic hypotension, syncope
• GI: Nausea, dyspepsia
• GU: Abnormal ejaculation, decreased libido, increased urinary frequency
• Other: Cough, sinusitis, rhinitis

Interactions
Drug-drug
• Increased hypotensive effects with other alpha-adrenergic antagonists
• Risk of increased toxic effects of cimetidine

Nursing considerations
CLINICAL ALERT!
Name confusion has occurred between Fosamax (alendronate) and Flomax
(tamsulosin); use caution.

Assessment
• History: Allergy to tamsulosin; pregnancy, lactation; prostatic cancer,
hypotension
• Physical: Body weight; skin color, lesions; orientation, affect, reflexes;
ophthalmologic exam; P, BP, orthostatic BP; R, adventitious sounds, status of
nasal mucous membranes; voiding pattern, normal output, urinalysis

Interventions
• Ensure that patient does not have prostatic cancer before beginning treatment.
• Administer once a day, 30 min after the same meal each day.
• Resume therapy at 0.4 mg daily if therapy is interrupted for any reason.
• Ensure that patient does not crush, chew, or open capsule. Capsule should be
swallowed whole.
• Monitor patient carefully for orthostatic hypotension; chance of orthostatic
hypotension, dizziness, and syncope is high with the first dose. Establish safety
precautions as appropriate.

Teaching points
• Take this drug exactly as prescribed, once a day. Do not chew, crush, or open
capsules; capsules must be swallowed whole. Use care when beginning therapy;
the chance of dizziness or syncope is greatest at that time. Change position slowly
to avoid increased dizziness. Take the drug 30 min after the same meal each day.
• These side effects may occur: Dizziness, weakness (more likely when you change
position, in the early morning, after exercise, in hot weather, and when you have
consumed alcohol; some tolerance may occur after you have taken the drug for a
while; avoid driving or engaging in tasks that require alertness; change position
slowly, use caution in climbing stairs, lie down if dizziness persists); GI upset (eat
frequent small meals); impotence (discuss this with your health care provider);
stuffy nose. Most of these effects will disappear gradually with continued therapy.
• Report frequent dizziness or fainting, worsening of symptoms.

Adverse effects in Italic are most common; those in Bold are life-threatening.