Skip to main content

Tamsulosin (Monograph)

Brand name: Flomax
Drug class: Selective alpha-1-Adrenergic Blocking Agents
ATC class: G04CA02
VA class: CV150
Chemical name: (R)-5-[2-[[2-(2-ethoxyphenoxy)ethyl]amino]propyl] -2-methoxybenzenesulfonamide monohydrochloride
Molecular formula: C20H28N2O5S•HCl
CAS number: 106463-17-6

Medically reviewed by on May 30, 2023. Written by ASHP.


α1-Adrenergic blocking agent with selectivity for α1A-adrenergic receptors; sulfamoylphenethylamine derivative.

Uses for Tamsulosin

Benign Prostatic Hyperplasia (BPH)

Reduction of urinary obstruction and relief of associated manifestations (e.g., hesitancy, terminal dribbling of urine, interrupted or weak stream, impaired size and force of stream, sensation of incomplete bladder emptying or straining) in hypertensive or normotensive patients with symptomatic BPH.

Although drug therapy usually is not as effective as surgical therapy, it may provide adequate symptomatic relief with fewer and less serious adverse effects compared with surgery.

May consider combined therapy with an α1-adrenergic blocker and 5α-reductase inhibitor for men with bothersome moderate to severe BPH and demonstrable prostatic enlargement. Has been more effective than therapy with either drug alone in preventing long-term BPH symptom progression. Men at risk for BPH progression are most likely to benefit from combination therapy.

Other Uses

Manufacturer states that tamsulosin should not be used for the treatment of hypertension.

Tamsulosin Dosage and Administration


Oral Administration

Administer orally once daily, 30 minutes after the same meal each day.

Swallow capsules intact; do not open, crush, or chew capsules.


Available as tamsulosin hydrochloride; dosage expressed in terms of the salt.



Initially, 0.4 mg once daily. Allow 2–4 weeks to assess response at initial dosage. May increase dosage to 0.8 mg once daily, if necessary, to improve urinary flow rates and reduce symptoms.

If administration is interrupted for several days at either dosage (i.e., 0.4 or 0.8 mg daily), reinitiate therapy at dosage of 0.4 mg once daily.

Special Populations

Hepatic Impairment

Dosage adjustment not necessary in patients with moderate hepatic impairment.

Renal Impairment

Dosage adjustment not necessary in patients with mild to severe renal impairment (Clcr 10–70 mL/minute per 1.73 m2).

Not studied in patients with end-stage renal disease (Clcr <10 mL/minute per 1.73 m2).

Cautions for Tamsulosin




Postural Hypotension

Potential for postural hypotension, dizziness, or vertigo; syncope may occur.


Priapism reported rarely; treat promptly.

Sensitivity Reactions

Allergic Reactions

Rash, pruritus, urticaria, and angioedema of the tongue, lips, and face reported; positive rechallenge in some patients.

Sulfonamide Sensitivity

Allergic reaction to tamsulosin reported rarely in patients with sulfonamide sensitivity. Use with caution in patients with serious or life-threatening sulfonamide sensitivity.

General Precautions

Prostate Cancer

Exclude possibility of prostate cancer prior to initiation of therapy.

Intraoperative Floppy Iris Syndrome (IFIS)

IFIS observed during phacoemulsification cataract surgery in some patients receiving α1-blockers, including tamsulosin. Most cases were in patients who continued tamsulosin therapy at the time of cataract surgery.

Specifically question male patients being considered for cataract surgery to ascertain whether they have received tamsulosin or other α1-blockers. If patient has received tamsulosin, ophthalmologist should be prepared for possible modifications to his/her surgical technique (e.g., use of iris hooks, iris dilator rings, viscoelastic substances) to minimize complications of IFIS.

Benefit of discontinuing α1-blockers, including tamsulosin, prior to cataract surgery not established.

Specific Populations


Category B. Not indicated for use in women.


Not indicated for use in women.

Pediatric Use

Not indicated for use in children.

Geriatric Use

No substantial differences in safety and efficacy relative to younger adults, but increased sensitivity cannot be ruled out.

Common Adverse Effects

Headache, infection, asthenia, back pain, chest pain, dizziness, somnolence, insomnia, decreased libido, rhinitis, pharyngitis, increased cough, sinusitis, diarrhea, nausea, tooth disorder, abnormal ejaculation, blurred vision.

Drug Interactions

Specific Drugs




α-Adrenergic blocking agents

Additive effects

Concomitant use not recommended


No change in BP or pulse rate

Dosage adjustment not necessary


Increased plasma tamsulosin concentrations

Use with caution, particularly with doses >0.4 mg


Pharmacokinetic interaction unlikely


No change in BP or pulse rate

Dosage adjustment not necessary


Decreased plasma tamsulosin concentrations

Not clinically important


No change in BP or pulse rate

Dosage adjustment not necessary


Pharmacokinetic interaction unlikely


Possible pharmacokinetic interaction

Available data inconclusive; use with caution

Tamsulosin Pharmacokinetics



Essentially completely absorbed following oral administration under fasting conditions; peak plasma concentrations attained within 4–5 hours.


Food delays time to peak plasma concentration by about 2 hours. When administered under fasting conditions, bioavailability and peak plasma concentration are increased by 30 and 40–70%, respectively, compared with fed state.



Appears to distribute into extracellular fluids in humans. In animals, distributed into kidney, prostate, liver, gallbladder, heart, aorta, and brown fat, with minimal distribution into brain, spinal cord, and testes.

Plasma Protein Binding

94–99% (mainly to α1-acid glycoprotein).

Special Populations

In patients with moderate hepatic impairment, protein binding is altered, resulting in changes in overall plasma concentrations; however, no substantial alterations in intrinsic clearance and concentrations of unbound drug.

In patients with renal impairment, protein binding is altered, resulting in changes in overall plasma concentrations; however, no substantial alterations in intrinsic clearance and concentrations of unbound drug.



Extensively metabolized by CYP enzymes (specific isoenzyme[s] not identified) in the liver. Metabolites undergo further conjugation prior to excretion.

Elimination Route

Excreted in urine (76%) and feces (21%).


Because of absorption rate-controlled pharmacokinetics of tamsulosin capsules, apparent half-life is about 9–13 hours in healthy individuals and 14–15 hours in patients with BPH.

Special Populations

In males 55–75 years of age, intrinsic clearance is decreased and elimination half-life is prolonged, resulting in a 40% increase in AUC compared with males 20–32 years of age.





25°C (may be exposed to 15–30°C).


Advice to Patients


Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.

Tamsulosin Hydrochloride


Dosage Forms


Brand Names




0.4 mg


Boehringer Ingelheim

AHFS DI Essentials™. © Copyright 2024, Selected Revisions June 9, 2011. American Society of Health-System Pharmacists, Inc., 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.

Reload page with references included