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Alpha-1 Antagonist·Urology
Lower urinary tract symptoms (LUTS) associated with BPH
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Max Dose
400 mcg/day
Half-life
10-15 h
Caution: Hypotension
RISK
High risk: Floppy Iris
CRITICAL
Avoid / Cautions
History of orthostatic hypotension syncope.
Overview
Highly selective Alpha-1A receptor antagonist. Relaxes smooth muscle in the prostate and bladder neck, rapidly improving urinary flow in BPH.
Clinical Focus
Must be flagged to ophthalmologists prior to cataract surgery due to Intraoperative Floppy Iris Syndrome (IFIS).
Bottom Line
Tamsulosin is the first-line alpha-blocker for BPH symptom relief with prostate selectivity, but causes significant first-dose hypotension and must be flagged before cataract surgery (IFIS risk).
Brand Names
Flomaxtra, Duodart (combo with Dutasteride)
Oral Routes
Modified-release tablets/capsules (400 mcg). Do not crush.
Prescribing & PBS
Authority Required (PBS).
Primary
Lower urinary tract symptoms (LUTS) associated with BPH.
Off-Label
Medical expulsive therapy for ureteric stones.
Clinical Place
First-line agent for rapid relief of BPH symptoms. Works within days, unlike 5-ARIs which take months.
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