Alternative to Tamsulosin for Nocturia?

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I'm a 53 year old male in good health except for the fairly recent onset of Nocturia. My need to urinate pretty much every hour during the night began suddenly around 3 months ago. At the time of writing this, the resulting fatigue/frustration due to sleep deprivation is having a massive impact on every aspect of my life and I'm at the point of giving up any hope of a restful nights sleep in spite of being totally exhausted.

After several visits to see my GP for  blood and urine tests plus a DRE (after which the Dr told me my prostate felt okay) I was referred to a urologist 2 weeks ago. After a second DRE (again told my prostate felt okay) and a urine flow test, the urologist explained my PSA level was slightly high for my age at 4.5. He offered me two options, either have an immediate prostate biopsy or wait 3 months and retest my PSA level... I elected to wait. Unbeknown to me, the urologist also instructed my GP to prescribe Tamsulosin 400micrograms (Diffundox). I only discovered this 10 days later having made yet another appointment to beg for help with getting some sleep.

My annoyance with the GP was eclipsed by the immense relief at finally being prescribed something that might help, but any relief was very short lived... After taking the Tamsulosin for the past 3 days, I can't face taking them again today due to the side effects!... I know it may sound trivial to some, but the side effects are compounded by the fact the medication is having zero effect on the nocturia and my being exhausted. I was still waking almost every hour by the urge to urinate, but thanks to the Tamsulosin my throat and mouth were so dry I didn't even have any saliva to swallow, a persistent dry cough, pounding headaches and disturbing nightmares impaired what little sleep I had been getting, chronic diarrhoea began the morning after taking the first capsule, while the headache and hoarse voice persisted throughout each of the 3 torturous days... On the only positive note, I did notice a slight increase in my urine flow rate, but as I'd never considered the pre-tamsulosin flow a problem it was nothing to be excited about.

My dilemma is... I feel as though I'm back at square one. Where do I go from here? Do I make yet another appointment with a GP and ask for referral back to the urologist?... Will the urologist simply offer me option number 1 again and point at a biopsy needle?... Or is there an alternative medication to Tamsulosin?... Hopefully one that works for frequent night time urination and without the side effects, but with that said, I'd suffer the side effects and hopefully medicate to lessen them if it meant getting even a few hours quality sleep.

Any input or advice will be gratefully received and thank you for reading.

1 like, 7 replies

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7 Replies

  • Posted

    I have been taking tamsulosin 400 mg for several years.

    it was worse at the beginning but my body gradually got used to it.

    the side effects were better than not being able to pee well.

    i had a red face, difficulty swallowing, long erections for no reason, and I think it made me dizzy sometimes. But the side effects get less as time goes on, I don't know why that is the case. The pills mess around with our blood pressure especially in certain tissues like prostate gland and unfortunately a few other organs as well. like nose and throat and maybe elsewhere too.

    after several years I noticed that its side effects got less and less and in the end I noticed I was able to pee without using the pill at all. I believe but am not sure that all its side effects reverse when you stop taking them.

    Tamsulosin in got me through a very difficult patch, I am very grateful to the developers of it.

    all best with your problem....

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    • Posted

      Thank you for taking the time to reply Steve. It was encouraging to hear from someone who found Tamulosin helpful for a change.

      I guess the difference between your experience and mine is that I have NO difficulty urinating. Sure, the flow isn't what it used to be when I was a teenager, and I did notice a slight increase while the tamulosin was in my system, but I've always figured a decrease in flow comes naturally with ageing.

      My problem is having the urge to pee several times every night and the fact I get very little sleep due to that.

      My state of health has severely declined over the past 3 months due to sleep deprivation which I also believe is responsible for my finding the side effects of tamulosin unbearable.

       

      Us both being prescribed the same drug for issues that are at totally opposite ends of the spectrum strikes me as bizarre, but kinda reinforces my opinion of tamulosin not being the appropriate medication for me personally even without the side effects.

      I hope your health continues to improve

      Regards

      BC

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  • Posted

    I was on Tamsulosin 400mg at start of 2014 but got palpitations from it.  My NHS consultant suggested I try saw palmetto tablets which I have been on for about 15 months now - I take Vogel Prostasan brand.  They seem to work pretty well and are a homeopathic alternative to the alpha-blocker drugs.   My local health food shop suggested taking pumpkin seeds combined with saw palmetto slow down the inevitable prostate growth.   
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    • Posted

      Hi Twiglet

      Cheers for the heads up on the natural alternatives to tamulosin.

      I'm keeping a list of everything homoeopathic and prescribed drugs that folks recommend, so your mention of pumpkin seeds combined with saw palmetto is truly appreciated!

      Kind Regards

      BC

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  • Posted

    Sorry to hear about your problems, BaldyCat.

    4 years ago when I first went to the urologist I was given Tamsulosin but it made no difference and , in consultation with my GP, I stopped taking it.

    Last year I blocked up and was sent to the urologist again as a blood test revealed a PSA of over 13. I had a catheter and was then put on Tamsulosin and this stopped the block. I then had a biopsy which was fine but I do have a very very enlarged prostate and my PSA is reducing - now 11.9.

    The first lot of Tamsulosin after the episode last year was Diffundox and I had no problems with it. The second lot was another brand and this made me feel like I had a permanent cold but I didn't realise what was happening until I went back onto Diffundox. My prescription was for Tamsulosin and the pharmacist was giving me whateve generic brand they had in stock. I went to the GP and my prescription is for the Diffundox branded Tamsulosin and all is fine.

    It maybe that a change of brand will sort you out as I have seen on other forums that people can have a different reaction to brands.

    Getting up in the night does vary with me. Last night I didn't have to get up for 8 hours and this seems to be quite a usual pattern. However, about once a week i am up and down 4 or 5 times for no apparent reason that my wife or I can discern.

    I would go back to your GP and ask for a different brand and if that does not work a referal to the urologist migjht be needed and a camera examination etc needed. Someting is blocking your flow and they need to find out what.

    Good luck.

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    • Posted

      Thanks for empathy and wishes of good luck Peter... I spoke with a GP earlier today and I'm pleased to say they completely endorsed my decision to stop taking tamulosin (I was taking the Diffundox brand BTW)

      It's very interesting to hear that folks have had varying experiences with different brands. In my ignorance I'd have thought manufacturers were bound by strict guidelines as to the components used in anything prescribed as 'tamulosin', but I guess I've got a lot to learn about pharmaceuticals in the coming months.

      I offer my sympathy on reading you still have the odd night of disturbed sleep, but it's also very encouraging to hear your PSA level is heading in the right direction as well as learning nocturia can be a random problem too... I'm crossing my fingers and hoping for one of those 8 hour restful nights sometime soon.

      As I mentioned in my reply above to Steve, I don't have a blockage or restriction lessening or preventing me from peeing... In fact some form of urine retention would be a relief from the constant trips to the bathroom... (It's not long enough to tie a knot in it) wink

      The GP was more than happy to offer me an alternative drug or refer me back to the urologist for further investigation. I opted for the referral in the hope the actual cause of my nocturia will be diagnosed, as opposed to continuing to throw various medications at the symptoms and hoping one works.

      Regarding "a camera examination etc" I can't say I'm looking forward to the invasive procedures, but from what I've read of other sufferers experiences on the patient.info forums, the worrying about it beforehand is worse than the actual procedure.

      Regards & The Best of Luck to you too

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  • Posted

    Tricky! I put up with this for years then bit the bullet and had a TURP done. Never regretted it even though I now get retrograde ejaculation. You can train yourself not to fully wake up. The trick is not to let your mind wander and stand up to pee and lean forward so gravity helps. However you must NEVER dream about going yo the toilet or you will be in strife!
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