Flomax: Why This is America’s #1 Treatment for BPH

BPH stands for benign prostatic hyperplasia — it’s a condition affecting roughly 50% of men between the age of 50 and 60 and 90% of men over 80. 

The main treatment for this condition is a drug called Flomax (tamsulosin) — which is among the top 50 most prescribed medications in the United States. 

BPH is not typically life-threatening but can dramatically alter the quality of life for those affected. 

The main issue of the condition is a blockage of the urinary tract as the prostate gland grows in size. This can make it difficult, if not impossible, to empty the bladder. Men affected by this condition need to make frequent trips to the bathroom throughout the day and night. 

In this article, we’ll cover everything you need to know about Flomax. We cover how it works, how to use it safely, and where to buy cheap Flomax tablets online. 

What is Flomax? 

Flomax is prescribed to men suffering from the effects of an enlarged prostate or men with large kidney stones.

The drug works by relaxing the muscles in the prostate and bladder — helping to reduce the size of the prostate and improve the flow of urine. 

When the prostate enlarges as a result of conditions like benign prostatic hyperplasia (BPH), it can press against the urethra and make it very difficult to empty the bladder. 

Currently, Flomax is not approved by the FDA for women or children. 

What’s the Dose of Flomax? 

Flomax is sold in capsules containing 0.4 mg of the active ingredient — tamsulosin. 

If you don’t experience any benefit after using the drug for 2 to 4 weeks, your doctor may increase the dose to 0.8 mg daily. This is the maximum dose of Flomax per day. 

It’s important to maintain a schedule when using this medication. It’s recommended you take the capsule at the same time every day, preferably after a meal (about 30 minutes after you’re finished eating). 

If you miss your dose, take another capsule as soon as possible. If you’re already close to the next scheduled dose, skip the missed dose and return to the normal routine. 

How Long Does it Take for Flomax to Work?

The effects of Flomax usually begin around 48 hours after the first dose. Users note a much more steady flow of urine and a more complete emptying of the bladder after using it for a short time. 

Flomax doesn’t directly fix the underlying cause of BPH — it merely relieves the condition’s symptoms. For this reason, Flomax is often combined with another class of medications known as 5-alpha-reductase inhibitors — which does a better job of treating the underlying problem. 

The issue with 5-alpha-reductase (5-AR) inhibitors is that they can take several months of consistent use before producing any results.

Combination therapy with Flomax and 5-AR inhibitors like dutasteride is expected to produce immediate benefits within the first week of use, which will gradually improve as the prostate shrinks in size. 

How Long Does Flomax Last?

The effects of Flomax improve the more frequently you use it. The first dose of the drug will last approximately 12 hours. After several daily doses, blood plasma levels of the drug start to increase, and the length of time the drug works becomes longer. 

After about a week of consistent use, a single Flomax pill will provide relief for a full 24 hours. 

How Much Does Flomax Cost?

Tamsulosin is no longer protected by patent law, so there are dozens of generic versions available. This increase in competition drives down the cost of the drug. 

The average cost of tamsulosin pills today is about 10 cents USD. In other parts of the world, such as the UK, the drug is even cheaper. 

Why Take Flomax at Bedtime?

Many doctors will recommend taking the first couple of doses at bedtime before transitioning to using the drug after the same meal each day (usually after breakfast or dinner). 

The reason for taking the first dose before bed is to minimize the impact of side effects like dizziness and fainting. The first time you use the drug will likely make you feel dizzy. As you take the medication more frequently, these side effects become less common. 

After the first couple of doses, you can switch to using the drug with the same meal each day, about 30 minutes after eating. 

The History of Flomax

Tamsulosin was first approved by the FDA in 1997. It was sold under the brand name Flomax, which was owned by the German pharmaceutical giant Boehringer Ingelheim. The company listed the new medication at around $1 per pill until the patents expired in 2009. 

As soon as the patent protecting the company from competitors expired, Boehringer Ingelheim dropped the price to around 10 cents per pill to compete with the new generic market. 

A year prior, in 2008, a clinical trial demonstrated that a combination of tamsulosin and dutasteride provided greater improvement in symptoms of BPH. This study (called the CombAT trial) lead to the creation of the mixed medication — Jalyn — which was later approved in June 2010.

Today, there are dozens of manufacturers producing generic versions of Flomax. These products contain the same active ingredients as the original formula, along with a few modified “extended-release” versions of the drug. 

Who Should Take Flomax?

You should only use Flomax if your doctor specifically prescribes it. Flomax is a prescription medication with the potential to cause harm if misused. Improper use can lead to serious side effects.

Despite having the ability to reduce blood pressure, Flomax is not approved as a treatment for with high blood pressure. 

The main reason for using Flomax is to improve the flow of urine in patients with an enlarged prostate. 

If you’re experiencing poor urine flow, visit a doctor before using Flomax. Prostate cancer and BPH have overlapping symptoms but require very different treatments — so it’s important to rule out more serious health conditions before seeking treatment.

Is Flomax Dangerous?

Flomax is not considered a dangerous drug. A large, 6-month study following 1784 patients that were using tamsulosin concluded that the drug had an excellent safety profile and there were no major adverse effects expected from using the medicine [1]. 

With that said, there are some warnings to be aware of when using Flomax. 

These concerns are the reason this medication is available by prescription only. A doctor will need to weigh the level of risk to benefit from using the drug before you can get a prescription. 

Your doctor will likely ask for blood tests to check your liver and kidney function, check your blood pressure and cross-check any potential interactions with Flomax and your current medications. 

Side Effects of Flomax Include:

  • Back pain
  • Blurred vision
  • Diarrhea
  • Headache or chest pain
  • Impotence
  • Inability to ejaculate
  • Indigestion
  • Insomnia
  • Low blood pressure
  • Low sperm count
  • Nausea/Vomiting
  • Priapism (painful erection lasting more than 6 hours)
  • Reduced libido
  • Runny nose
  • Skin rashes
  • Sudden dizziness

Flomax & Negative Drug Interactions

Different medications can have overlapping effects on the body. There are three main ways a drug can interact with another medication: 

  1. Agonistic effect — makes the effects of the medications too strong
  2. Antagonistic effect — makes the effects of the medications too weak
  3. Metabolic interference — either speeds up or slows down the metabolism (breakdown) of the medication

There are a few different medications that may interact with Flomax and other forms of tamsulosin, including: 

A) Other Alpha-Blocker Medications 

Alpha-blockers are used for a variety of applications — including blood pressure regulation. Flomax itself is an alpha-blocker used for BPH. When combined with other alpha-blockers, such as prazosin or terazosin, the effects of both medications may compound and result in excessively low blood pressure. This can make those affected feel dizzy and may even lead to fainting spells. 

B) Erectile Dysfunction Medications

Erectile dysfunction medications like Viagra, Cialis, and Levitra all cause the blood vessels to dilate — leading to a reduction in blood pressure. When combined with Flomax, the effects of both drugs can cause blood pressure to drop too low.

C) Drugs Metabolized by CYP3A4 Enzymes

Flomax is metabolized in the liver by a specific set of enzymes called CYP3A4 isoenzymes. If other medications are used at the same time that also require these enzymes for metabolism, it can cause both medications to build up in the bloodstream. 

Eventually, these medications can build up to dangerous levels — potentially leading to an overdose.

The most problematic CYP3A4 competitors include the azole class of antifungals (itraconazole, ketoconazole), antivirals (boceprevir, cobicistat), antibacterials (clarithromycin), and HIV protease inhibitors (lopinavir and ritonavir).

Who Should Avoid Using Flomax?

Flomax isn’t suitable for everybody. Your doctor may choose to prescribe a different medication to help manage your condition if you meet any of the following criteria:

  • Allergy to sulfa drugs or alpha-blockers
  • Chronic or untreated low blood pressure
  • History of liver failure
  • History of prostate cancer
  • Women and children

How Does Flomax Work?

Flomax works by relaxing the muscles of the prostate and bladder. As the muscles relax, the pressure placed on the urethra is reduced. This allows urine to flow more freely.

More specifically, Flomax blocks two receptors found in the prostate and bladder called alpha-1A and alpha-1D adrenergic receptors [2]. 

In particular, the alpha-1A receptors are abundant in the prostate gland, prostatic capsule, prostatic urethra, and bladder.   

The adrenergic receptors (think adrenaline) are involved with the fight or flight stress response. When this system is activated, compounds like norepinephrine target the alpha-1A and 1D receptors located in the arteries, heart, lungs, and other organs. 

Activating the adrenergic receptors causes an increase in blood pressure, heart rate, airway diameter, and mental alertness — all of which are designed to help us navigate stressful conditions. 

Unfortunately, the prostate gland gets caught in the crossfire. Adrenergic receptors in this organ, as well as the bladder, can become activated. Once activated, the muscles contract and eventually hypertrophy over time — causing the organs to enlarge.

An enlarged prostate is problematic because the organ presses directly on the urethra. When the prostate becomes too big, it compresses the urethra and prevents urine from flowing freely. 

Flomax stops this effect by inhibiting the adrenergic receptors in the prostate [3]. The muscles in the prostate relax, and the organ shrinks in size — eventually unblocking the urethra to allow urine to pass more freely once again. 

Flomax Alternatives

Flomax isn’t the only alpha-blocker used to treat BPH, and there are other classes of drugs used to treat the condition as well. The most common alternatives are 5-alpha-reductase inhibitor medications (5ARIs). 

A) Generic Tamsulosin Medications

The patents awarded to the creator of Flomax have been expired for nearly a decade. Today, there are dozens of generic versions of the drug available. The available options can vary depending on the country you live in. 

Generic Versions of Tamsulosin Include:

  • Bestflo
  • Contiflo XL
  • Flomaxtra
  • Harnal D 
  • Mecir LP
  • Omnic
  • Prostanil MR
  • Secotex
  • Tamisol MR
  • Tamsin
  • Urimax

B) Other Alpha-Blockers

Flomax is the most commonly prescribed alpha-blocker for BPH, but there are other alpha-blocker medications available as well. 

List of Other Common Alpha-Blocker Medications:

  • Alfuzosin (Uroxatral)
  • Doxazosin (Cardura)
  • Terazosin (Hytrin)

C) 5 Alpha-Reductase Inhibitors

5 ARIs are a completely different class of medications commonly used to treat BPH. These drugs work by preventing the conversion of testosterone to dihydrotestosterone (DHT) — which is many times more potent. 

It’s believed that excess conversion of testosterone to DHT is the primary cause of an enlarged prostate gland. 

5ARI drugs block the enzyme responsible for manufacturing DHT. 

This drug class is considered the primary treatment for BP, but it can take several months to produce any benefit. For this reason, doctors may prescribe a combination of 5ARIs with fast-acting drugs like Flomax. 

List of Common 5ARI Medications for BPH:

  • Dutasteride (Avodart)
  • Finasteride (Proscar and Propecia)

Where to Buy Flomax in 2023

Flomax and other forms of tamsulosin are prescription-only drugs in the United States, Europe, Canada, Australia, and most other parts of the world. 

The only way to get ahold of this medication is to get a prescription from a medical doctor. Next, you’ll need to visit your local pharmacy or shop around one of the many online pharmacies. 

Most pharmacies will give you the option to choose the brand name version — Flomax — or cheaper generic forms of the drug. 


References

  1. Michel, M. C., Bressel, H. U., Goepel, M., & Rübben, H. (2001). A 6‐month large‐scale study into the safety of tamsulosin. British journal of clinical pharmacology, 51(6), 609-614.
  2. Dunn, C. J., Matheson, A., & Faulds, D. M. (2002). Tamsulosin. Drugs & aging, 19(2), 135-161.
  3. Lepor, H. (2007). Alpha blockers for the treatment of benign prostatic hyperplasia. Reviews in urology, 9(4), 181.

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