How common are tamsulosin side effects?

In this article:

• Common side effects
• Serious side effects
• Tamsulosin and ejaculation problems
• Chest pain and tamsulosin
• Tamsulosin side effects in older adults
• How soon do side effects start?
• Duration of side effects
• Long-term use
• Contraindications
• Warnings
• Interactions
• How to avoid side effects
• Side effect treatment

In this article

• Common side effects
• Serious side effects
• Tamsulosin and ejaculation problems
• Chest pain and tamsulosin
• Tamsulosin side effects in older adults
• How soon do side effects start?
• Duration of side effects
• Long-term use
• Contraindications
• Warnings
• Interactions
• How to avoid side effects
• Side effect treatment

Tamsulosin is a generic prescription drug that relieves urination problems caused by an enlarged prostate gland, a condition called benign prostatic hyperplasia (BPH). An enlarged prostate interferes with urine flow by narrowing the urethra. 

Tamsulosin belongs to a class of drugs called alpha blockers that work by relaxing the smooth muscles in the urethra, allowing urine to flow more freely. Also sold as brand-name Flomax, tamsulosin is often prescribed with other drugs that reduce the size of the prostate gland, such as Avodart (dutasteride) or Propecia (finasteride). Because the side effects of these medications sometimes overlap, it’s not always easy to determine their source when more than one drug is used.

Common side effects of tamsulosin

In clinical trials, about 18% of people had ejaculation problems when taking tamsulosin at the highest dose. Dizziness, nasal congestion, and headache were also common, especially at higher doses. For people taking tamsulosin, commonly reported side effects include:

• Ejaculation problems
• Headache
• Dizziness
• Stuffy and runny nose
• Infection
• Weakness
• Back pain
• Diarrhea
• Sore throat
• Cough
• Drowsiness
• Stuffy sinuses
• Sleepiness
• Lowered sex drive

Serious side effects of tamsulosin

The most serious side effects of tamsulosin are:

• Low blood pressure with position changes (orthostatic hypotension)
• Fainting
• Irregular heartbeats
• Painful or persistent erections (priapism)
• Severe allergic reactions
• Severe skin reactions

Tamsulosin can also interfere with glaucoma or cataract surgery.

Tamsulosin and ejaculation problems

Ejaculation failure, delayed ejaculation, ejaculation into the bladder, or decreased semen volume are common side effects of tamsulosin. In clinical trials, 8% of those taking a low dose experienced ejaculation abnormalities, and that rate increased to 18% at a higher dose. For people who received a placebo as part of the study, only 0.2% experienced ejaculation problems. When BPH is treated with both tamsulosin and a drug like finasteride or dutasteride, the risk of ejaculation problems increases. On the positive side, tamsulosin may help with premature ejaculation and improve erectile dysfunction.

Chest pain and tamsulosin

In clinical trials, 4% of people taking tamsulosin experienced unspecified chest pain compared to 3.7% of those given a placebo. These statistics are very close, so it’s uncertain what role tamsulosin plays in chest pain. However, tamsulosin, like other alpha blockers, does widen blood vessels, which reduces blood pressure and causes the heart to beat faster. As with any drug, if chest tightness or pain is experienced while taking tamsulosin, tell the prescribing healthcare provider about the problem.

Tamsulosin side effects in older adults

In clinical trials, no differences were observed in safety or effectiveness based on age. However, older people are at greater risk for falls and accidents, so healthcare providers will monitor side effects such as low blood pressure, orthostatic hypotension, dizziness, and fainting when using tamsulosin. 

How soon do tamsulosin side effects start?

Some side effects can start soon after beginning tamsulosin, such as headache, dizziness, rash, drowsiness, stuffy nose, and chest pain. People with heart rate abnormalities may experience a worsening of their condition soon after starting tamsulosin. Allergic reactions, low blood pressure, and racing heartbeats can also occur rapidly. Other side effects, such as ejaculation problems, lowered sex drive, and weakness, may take days, weeks, or months after starting tamsulosin to manifest.

How long do tamsulosin side effects last?

Many side effects get better after the drug is stopped. It takes the body approximately 14 hours—give or take a few hours—to eliminate half of a dose of tamsulosin. So people can expect to be free of tamsulosin in a couple of days after taking the last dose. Many adverse effects, such as headache, dizziness, drowsiness, and low blood pressure, should improve by then.

Does tamsulosin affect sexual function permanently?

For most people who use tamsulosin, the drug’s effects on sexual function aren’t severe enough to stop taking the medication. And when tamsulosin is stopped, side effects like problems with ejaculation resolve. 

Is tamsulosin safe for long-term use?

Most of tamsulosin’s side effects are temporary. They either get better as the body adapts to the drug or go away when the medication is stopped. A few may cause long-term problems, such as severe skin reactions, falls that occur because of low blood pressure, or damage to the penis from priapism.

Who should not take tamsulosin?

Tamsulosin is never prescribed to people who are allergic to the drug or its inactive ingredients. 

Tamsulosin is indicated to treat BPH. However, it is sometimes also used in children and adults to help expel small kidney stones. It is unknown if tamsulosin is safe in pregnancy or breastfeeding.

Because tamsulosin may cause dizziness or faintness when standing up, older patients are monitored more closely to prevent falls. 

Tamsulosin warnings

All prescription drugs have risks. Fortunately, tamsulosin is a relatively mild drug in terms of side effects. Although it can cause problems, the most severe problems are rare. 

Cautions

Most of tamsulosin’s risks are related to pre-existing health conditions. Sometimes these conditions are made worse by the drug. In other cases, side effects are more likely to be severe or intolerable. Healthcare providers are cautious when prescribing tamsulosin to people who:

• Are allergic to sulfa drugs
• Have a specific liver enzyme that is not good at breaking down tamsulosin (poor CYP2D6 metabolizers)
• Feel faint or dizzy when standing up (orthostatic hypotension)
• Are about to have glaucoma or cataract surgery

For eye surgery, tamsulosin can cause a condition called intraoperative floppy iris syndrome, which makes it difficult to dilate the pupil before the operation. This problem isn’t life-threatening, but it does make it difficult for the surgeon to work on the eye. Most cases of floppy iris syndrome are due to tamsulosin treatment. The solution is to temporarily discontinue tamsulosin before surgery. 

Abuse and dependence

The FDA does not classify tamsulosin as a drug that might be abused or that results in physical dependence.

Overdose

In the event of an overdose, get emergency medical help. Low blood pressure and racing heartbeats are the most serious problems, so medical assistance will be needed to bring these back to normal. 

Tamsulosin interactions

Most drug interactions with tamsulosin occur with drugs that block the body’s ability to break down tamsulosin or medicines that aren’t broken down well when combined with tamsulosin. Both cases increase the likelihood of side effects. Some of these drugs include:

• SSRIs
• Tricyclic antidepressants
• Calcium channel blockers
• HIV/AIDS medications
• Macrolide antibiotics (particularly clarithromycin and erythromycin)
• Benzodiazepines
• Opioids
• Antifungal medications such as ketoconazole or itraconazole
• Monoamine oxidase inhibitors (MAOIs)
• Histamine blockers (allergy and stomach acid drugs such as cimetidine)
• Some heart rhythm drugs
• Dietary supplements such as niacin or St. John’s wort
• Cannabis and cannabinoids
• Grapefruit or grapefruit juice

This is a long list of drugs, too long to memorize. Remember that none of these are strictly prohibited, and not all are dangerous when combined with tamsulosin. However, you and your healthcare provider will need to watch for side effects. Doses may need to be reduced if side effects become a problem.

Additionally, it is not advisable to combine tamsulosin with other alpha blockers, such as Cardura (doxazosin), Minipress (prazosin), Uroxatral (alfuzosin), or terazosin. Some of these alpha blockers are used to treat high blood pressure. The combination will increase the alpha-blocking effects of both drugs, making serious side effects more likely and common side effects worse.

How to avoid tamsulosin side effects

Here are a few common-sense tips to keep side effects at bay.

1. Tell the prescriber about all medical conditions and medications

To stay safe, give a complete medical history to the prescribing healthcare provider. That means everything you’ve had in the past and present, especially:

• Low blood pressure
• Prostate cancer
• Liver problems
• Kidney problems
• Upcoming eye surgery
• Allergies to medications
• A complete list of all prescription drugs, over-the-counter medications, and dietary supplements being taken

2. Take tamsulosin as directed

It’s easy to make mistakes when taking drugs. Read and follow all the directions on the prescription label or given by the prescriber. Use an alarm or app to help make sure that doses are taken on time. A checklist or scheduler can also help monitor doses. If a dose is missed, take it as soon as it’s remembered. However, if it’s almost time for the next dose, skip the missed dose and take the next dose at the scheduled time. Never double up on doses for any reason.

RELATED: Flomax (tamsulosin) dosage guide

3. Stand up slowly and move carefully

Some people taking tamsulosin may experience dizziness, lightheadedness, or faintness when standing up. Even bending over can cause problems. This can be helped by standing up slowly. Be cautious when bending over, and move slowly when changing positions. It’s also a good idea to remove objects in a room that can cause injury if somebody falls on them.

4. Avoid driving for a little bit 

To help prevent accidents, avoid driving or engaging in other high-risk activities for the first few days of tamsulosin treatment. The drug can cause lightheadedness and dizziness, so it’s a good idea to experience the effects of the medication before getting behind the wheel.

5. Avoid some supplements

The risk of tamsulosin side effects increases slightly when taking dietary supplements, such as vitamin B3 (niacin), turmeric, green tea, CBD, ginger, and echinacea. 

How to treat the side effects of tamsulosin

If side effects do happen, here’s what you can do:

• Ejaculation problems: Consult with your healthcare provider about alternative options.
• Dizziness or fainting: Sit or lie down right away and stay hydrated.
• Painful erections: Go to the ER if an erection lasts more than four hours.
• Chest pain: Contact your healthcare provider to discuss this symptom. Get emergency medical attention if the pain is severe or is accompanied by nausea, sweating, shortness of breath, or feeling faint.
• Allergic reactions: Seek emergency care for swelling, hives, trouble breathing, or severe skin symptoms.

If you’re experiencing uncomfortable side effects, speak with your healthcare provider. They may adjust your dose or suggest a different medication.

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