Tamsulosin/Flomax

Hi Rogcal,

Nope. One of the reasons I self-track is the paucity of doctors help with anything even a bit outside their speciality. 

I specifically ask my nephrologist what may have caused me both loosing a kidney in the first place, and now getting the remaining on seemingly failing. "No diea; it can be many things"

The urologists know both my kidney problems and my use of tamsulosin - they are the ones who put me on it. Nothing from them either.

Hi ianC,

Richp21 may be right and the data collection may be questionable/flawed and not ideal for clinical trials.  However, I would not set it aside just because the FDA did not compile it.  Moreover, I would rather rely on actual patients experiences than on limited data collected by the FDA.  Many adverse reactions are not collected or reported to the FDA for a variety of reasons.

For example, on one occasion, my dermatologist prescribed me a medication.  When I asked about side effects, he said nothing to worry.  He said that only 1 to 3% of patients reported problems.  I told him that I would probably fall in that narrow group.  He laughed and told me not to worry.  Interestingly, the medication had a requirement: a weekly blood test to check liver enzymes.  I took my doctor at his word and did not worry.  Then, I received an emergency phone call from my doctor telling me to stop taking the medication immediately.  The lab had called alerting him that my liver enzymes were out of control and could damage my liver.  I later checked and could not find any scientific or medical references regarding potential liver problems connected to that medication.

Here is some interesting information regarding tamsulosin and possible renal failure.  By the way, this is from the FDA website. Please note that I highlighted some information for reference only.

Renal Dysfunction

The pharmacokinetics of tamsulosin HCl have been compared in 6 subjects with mild-moderate (30=CLcr 70mL/min/1.73m2) or moderate-severe (10=CLcr<30 mL/min/1.73m2) renal impairment and 6 normal subjects (CLcr<90 mL/min/1.73m2). While a change in the overall plasma concentration of tamsulosin HCl was observed as the result of altered binding to AAG, the unbound (active) concentration of tamsulosin HCl, as well as the intrinsic clearance, remained “relatively” constant.  Therefore, patients with renal impairment do not require an adjustment in FLOMAX capsules dosing. However, patients with endstage renal disease (CLcr<10 mL/min/1.73m2) have not been studied.

Talk about questionable data.  I think it is alarming that the FDA based their findings on such limited number of patients and from such study reach the conclusion that that the medication does not have the potential to cause harm. 

There may be additional data but I could not find it.

Hi James

I agree. As I said, such data is at least better than nothing; and your point that it may be preferable to any seemingly 'proper' research is well made on the basis of greater numbers. For myself, regardless of what research says, and experts, in the end the only thing that matters to me is my experience - I've found, over 40+ years of self-tracking, that my own results are occasionally different from advice based on averages.and now can have life-saving guidance. 

Thanks James for that illuminationg info (and creative way around the restrictions on this site).

Your idea is great for playing with the dosages.

However, I've decided not to use tamsulosin at all and live with getting up in the night an extra time. After my prostatectomy, which was mainly successful, it is not too bad. Better than risking my kidney; from the other data (Review: could Flomax cause Kidney Failure? - just putting that in Google brings up the link OK for me), being male and over 60 (I'm 80) makes me high risk (I suspect the others who have used tamsulosin for years were younger guys).

Thakns again.

Looks like the moderator deleted James post about smaller doses of Tamsulosin. It's still elsewhere, and here's my reply:

Hi James,

      Thanks so much for your post. I've located the study and will look it over in the next few days. I had looked into using a lower dose of Tamsulosin. I had spoken to my urologist, and he said that splitting the capsules in smaller portions would not work as there was some kind of time release mechanism incorporated in it, and spliiting it would result in random strengths, sometimes very small, sometimes very large. The study at first glance seems to indicate otherwise, unless they were using a version that didn't have the time release. At any rate, this is very interesting to me and needs further investigation. Thanks again. (I will also post this reply at the other thread where you posted yours.)

James/all,

Please stop saying you cannot post links here as you can.

As long as the link is to a reputable site it will get approved. If you don't want to wait for approval then use the Private Message service to pass on. If users post in the manner as happened here ie "creative way around the restrictions on this site" then they are more likely to get deleted and account deactivated.

I have deleted the repeat post above as all you need to say is "see my post to Tom above". I have inserted the actual link in question into the original post and removed the split text. 

If anyone has any issues with this then send me a Private Message rather than taking this off topic by replying here.

Regards,

Alan

    Just wanted to say thanks for the clarification and the work that you are doing. Much appreciated.

Rich

I was only trying to provide useful information to BPH patients.  I only try to post reputable information from reputable sources (links).  Thanks for your clarification.

Thanks again,

James

The time release version is coated to delay action and will not work to control the dosage.  You need to use the uncoated (cheap) generic version. The generic version should work just fine.

Good luck and good health.

Hi James,

   I am using a generic version, not Flomax. Just going by what my uro said. Maybe he's wrong. I'll check with my pharmacist. 

So the plot thickens. The pharmacist said that the tam I am taking is not time release. I asked him why I couldn't split the capsule in two, he said it would be very difficult to get equal or near equal doses. He suggested talking to the doc about switching to another med in the same family with lower doses available and that comes in tablet form so easier to split accurately. He mentioned teroqosin (sp?) and doxizosin. I need to do some reading on these to see if they are worth considering. Do you know bout either of them? I seem to remember that they lower blood pressure, which would not be good for me as I have borderline low bp.

Sorry I am not familiar with either medication.  You could weight the capsule contents (you need an accurate pharmaceutical type scale (Amazon sells them) and calculate the dosage you want to use.  Otherwise, you could convert the dry powder to milliliters (ml).  Then use distilled or sterile water to water-based tam. Ask your pharmacist how to make an accurate conversion.   Also, use a calibrated glass eye dropper to calculate the dosage and make the adjustments that work for you.  If you go the water route (the easiest), make sure to use a brown bottle to avoid light degradation.  For best results, make small amounts and keep the medication in your refrigerator. 

Good luck and good health!

James