Tamsulosin and Floppy Eye

Posted , 10 users are following.

Hello everyone, I was hoping to take a bit of a shortcut to find out more about this floppy eye from tamsulosin.

I have been taking it for over 15 years, and have not noticed a problem until recently. The strange thing is I was on a generic brand (ratio) and found it to be excellent. I'm in Canada and they no longer seem to be able to get it at our pharmacies. I tried the other generic brand (Sandoz) and have to admit I did not find it as effective.

So about 2 months ago I went on the Flomax brand and I am noticing driving at night to be really odd. Lights from other cars are way too bright. I think that everyone has their brights on. Seeing at night is more difficult too. Takes a few more seconds for eyes to focus in dark room.

I am 56 years old in good health other than the prostate and I am on prescribed TRT.

Can someone let me know what I am likely experiencing:

  1. Is this the onset of cateracts?
  2. Can it be caused by floppy eye, or is floppy eye something that just makes carteract surgery more difficult?
  3. Would floppy eye correct itself if I stopped tamsulosin?
  4. Any links to detailed floppy eye posts or websites would be excellent

Thanks so much for any insite,

Kevin

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  • Posted

    Suggest you consult an opthalmologist. Has nothing to do with BPH.

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  • Posted

    There have been a couple (brief) discussions here about tamulosin and floppy iris syndrome. You can try the search function. Better yet, consult a medical professional who will have more knowledge than anonymous strangers on the internet.

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    • Posted

      Doctors tend to play down patients questions on drug side effects and many have not heard of Floppy Iris Syndrome and tend to deny other Tamsulosin side effects as being very rare. In the UK at least NHS urologists prefer to ply you with drugs for years as they come out of the GP's budget rather than the Health Authority pay for surgery.

      I live in a holiday resort that is also a retirement town and meet a lot of old Guys with prostate problems. The most common answer to the how are you question is 'Miserable'.

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  • Posted

    I had been told that I had cataracts forming but from the way they had been observed it would be about six years before they became a problem. I was later prescribed Amiodarone for atrial fibrillation and Tamsulosin for my prostate. The Amiodarone caused deposits to form in my eyes and floopy iris syndrome on one eye from the Tamsulosin.

    I made an appointment with an opthalmologist who noted my worsening cataracts and asked if I wanted surgery now or later. I said now. I had a different surgeon each time and the one who got the floppy iris one complained 'Why do they always give me the difficult ones'

    Amiodarone is a terrible drug for side effects as is Bisoprolol that I was also taking. I once asked the practice nurse if they were the most complained about by patients. She said 'No Tamsulosin is' I said 'Yes by men' she said 'No by their wives'

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  • Posted

    A number of articles that I scanned seemed to indicate that IFIS was observed even after years of stopping tamsulosin. Here's a quote from an article titled "How to Avoid Intraoperative Floppy Iris Syndrome ":

    ' At least for tamsulosin, IFIS has still been observed in patients who discontinued therapy as long as nine months or even three years before cataract surgery.

    The persistence of IFIS several months after stopping tamsulosin implies that the atrophic iris changes resulting in an atonic pupil are probably permanent. In some studies, IFIS developed as soon as three months after the patient started taking tamsulosin— I had one patient who developed all the intraoperative changes after taking only two doses of tamsulosin.'

    It appears that alfuzosin has less risk at producing Intraoperative Floppy Iris Syndrome. Google "Alfuzosin for BPH Linked to Fewer Snags in Cataract Surgery".

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  • Posted

    From what I've read alfuzosin patients do not floppy eye syndrome.

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    • Posted

      Derek: That's not true. The risk is less, but in the study I mentioned above, there were men who developed IFIS from taking alfuzosin.

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    • Posted

      At least the odds are not so much against you in that case.

      What % in the study ? I've only read of floppy iris syndrome in relation to Tamsulosin but it must presumably happen under other circumstances.

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    • Posted

      From the article:

      IFIS occurred in 34.3% (24/70) of the tamsulosin group, 16.3% (7/43) of the alfuzosin group, and 4.4% (5/113) of the control group. Neither posterior capsular rupture nor significant surgical complications occurred in the case or control groups.

      The findings indicate that severe IFIS was statistically more likely with tamsulosin than alfuzosin (P = .036). Together with the control group, the substudy showed that moderate to severe IFIS can occur even in low-risk eyes, with no history of alpha blocker, in the absence of epinephrine use for irrigation.

      "Benign prostatic hyperplasia and cataracts are 2 of the most common conditions that normally occur with aging in men. So as the population ages, the prospect of IFIS will only increase," Dr. Chang told Medscape Medical News. Dr. Chang and coauthor John R. Campbell, MD, who is in private practice in Marin, California, were the first to report the symptoms, and name the syndrome, in 2005. "From the outset, we were impressed that [IFIS] seemed more often associated with tamsulosin than with nonselective alpha blockers, such as terazosin or doxazosin."

      Tamsulosin, alfuzosin, terazosin, and doxazosin are all alpha1-adrenergic antagonists, but tamsulosin is the only one that is selective for the alpha-1A receptor subtype that predominates in the prostate and iris smooth muscle. Tamsulosin and alfuzosin are clinically uroselective, with less incidence of postural hypotension.

      "Our study showed that tamsulosin was more likely to cause severe IFIS," Dr. Chang told Medscape Medical News. "Therefore, a patient needing to start a uroselective alpha-1 antagonist might want to try alfuzosin first if they had any sign of a cataract."

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    • Posted

      Interesting article. Thank you for putting it up. There are so many side effects that doctors either do not know about, ignore or take a chance on.

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    • Posted

      With regards to tamsulosin, it is worse here in the states. When I first started alpha blockers, I asked my GP if there was anything else besides tamsulosin. He said there was not. After a couple of week on it, I decided I didn't like it (made my tinnitus worse and started having sexual side effects). So, I did some research and found alfuzosin, which is prescribed much more in Europe. My urologist knew of it but had never prescribed it. I sent my urologist that article on IFIS that I mentioned above. A couple of weeks later, I got a message from him saying that he and his department head were considering prescribing alfuzosin more. I sent the article to my GP, who also suffers from BPH and told him that I was now on alfuzosin. He responded saying that he was considering switching to alfuzosin.

      Most of these doctors are too busy or not interested in keeping up with what is current; preferring instead to have someone in their department tell them what to prescribe. My philosophy is to keep on top of things and question everything. I've lost two uros because of that, but at least the guy I have now is willing to listen.

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    • Posted

      Physicians are well rewarded by drug makers reps who leave samples for patients. The more prescriptions they write the more they are rewarded.

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    • Posted

      I'm not sure of the cost difference between them but in the UK GP's prescribe the cheaper option or a generic drug. My GP does not prescribe Avodart as there are cheaper generic alternatives. Pharmacists search out the cheapest version and we all complain that nearly every prescription is from a different maker and often from a different country usually East European.

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