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Flomax Review Article

 

Flomax belongs to a group of alpha adrenergic blockers and is used for the treatment of symptoms of benign prostatic hyperplasia. The recommended dosage is 0.4 mg per day. Flomax works by relaxing the muscles of prostate and bladder neck there by making it easier to urinate, because in men urethra, the tube which carries urine from the bladder to the penis travels through the prostate gland. When men get older, the prostate gland enlarges and the muscle cells within the prostate gland and the neck of the bladder, which control the flow of urine, tighten. It is recommended not to use this medication if allergic to tamsulosin.

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What is FLOMAX?

FLOMAX (Generic name: tamsulosin) is a drug that belongs to the alpha-adrenergic blockers. It is not designated for the treatment of hypertension but it is used to treat prostate gland enlargement in men or what we called benign prostatic hyperplasia (BPH). It is also used to improve the urination and it reduces the symptoms of BPH.

Flomax makes the muscles of the bladder neck and the prostate relax thus helping the person with an enlarged prostate urinate easily.

What is BENIGN PROSTATIC HYPERPLASIA or BPH?

The benign prostatic hyperplasia is a condition where the prostate becomes enlarged; it is more common in elderly than in early adulthood. It is non-malignant prostate gland enlargement, meaning it’s not cancerous and doesn’t extend to other parts of the body. It is distinguished by the formation of huge, separate lesions in the periurethral area of the prostate rather than in the peripheral region, which commonly are affected by the prostate cancer. The exact source of BPH is unknown but study shows that both androgens and estrogens appear to contribute to the development of BPH.

TextProstate gland is walnut-shaped, located just beneath the urinary bladder of the men, and is normally about 3cm thick and 4cm wide. It is a gland that secretes a thin, milky, alkaline fluid that mixes together with sperm and other secretions that make the semen. The prostate gland also functions in the elimination of the urine. The urethra is the tube that holds the urine which passes through the center of the prostate. As the prostate gets larger, the harder it is for the urine to pass, and this makes for an important symptom of the BPH.

These are the symptoms that one can experience: difficulty in starting urine flow, weak stream, urgency of urination, increase in urinary frequency even at night, which disrupts the sleep pattern of the person, and difficulty in fully emptying the urinary bladder.

How many people have BPH?

It is one of the most widespread diseases of aging men. Information says that 25% of men older than 55 years of age and 50% of men older than 75 year of age experience symptoms of BPH. (Porth, 2002)

The rate of BPH in American men is elevated that almost half of men aging 50 will have prostate enlargement, and men aging at 80 can expect an 80-90% possibility of developing such. BPH is the most common illness among men beyond aging 55 with about 2 million men were treated for it yearly in the United States. While symptoms of BPH and prostate cancer are alike, BPH has never been shown to be a root cause for developing prostate cancer.

The prostate gets bigger in most men when they go older, and, 45% of men aging 46 years old can expect to experience from the symptoms of BPH if they survive 30 years. Occurrence of rates grows from 3 cases per 1000 man- at the age 45–49 years old, to 38 cases per 1000 man- by the age of 75–79 years old. While the prevalence rate is 2.7% for men who are aging 45–49 years old, it raises to 24% by the age of 80 years old.
For some men, the symptoms may be worst enough to require treatment. (Wikipedia, 2011)

What are the effects of FLOMAX in the body?

The benign prostatic hyperplasia symptoms are actually due to the bladder obstruction that is consisting of two (2) original components: one static and one dynamic. The static component is related to the increase in prostate size, in part, by a creation of smooth muscle cells found in the prostate. However, the severity of symptoms and the amount of obstruction in the urethra do not relate well with the prostate size. The other one is the dynamic component, its purpose is to increase the in the bladder neck and in the prostate gland’s smooth muscle tone leading to pressing of the bladder outlet. The sympathetic nervous stimulation of alpha1 adrenoceptor intercede the smooth muscle tone, in which are abundantly located in the prostatic capsule, prostatic urethra, prostate and bladder neck. And when these adrenoceptors are blocked, they result in the smooth muscles in the prostate gland and the bladder neck will relax, ensuing in a development in urine flow and a decrease in symptoms.

Tamsulosin or the Flomax, is an alpha1 adrenoceptor blocking driving force, it has the selectivity for alpha1 receptors in the prostate. There are three separate alpha1 adrenoceptor subtypes and they are classified into: alpha1A, alpha1B, and alpha1D; their division differs amid human organs and tissue. It is about a 70 percent of the alpha1 receptors have been known as alpha1A subtype in the prostate.


How does the body react to FLOMAX intake?

FLOMAX capsules should be taken 0.4 mg once each day because it is the recommended as the dose. It must be taken for about 30 minutes succeeding the same mealtime daily.

For some people who failed to respond to Flomax at the dosage of 0.4 mg dose for the past two (2) to four (4) weeks, the dosage will be greater than before and it will be twice of the usual dose and that is 0.8 mg once a day. If the medication was not religiously taken and it was stopped or interrupted for many days at whichever dose the 0.4 mg or 0.8 mg dose, the treatment is started back again to 0.4mg once a day.

Tamsulosin is broadly metabolized by a certain enzyme that is in the liver and the dose that goes out in the body in urine unchanged is only less than 10%. However, the action of the drug in has not been fully established. In addition, the enzymes that mainly initiate the first phase of metabolism of Flomax have not been determinedly recognized. As a result, probable interactions with other enzymes cannot be distinguished with current information. Flomax undertakes widespread conjugation to sulfate proceeding to renal secretion. Incubations with liver cells showed no proof of clinically importance of metabolic interactions amid tamsulosin and amitriptyline, glyburide (glibenclamide), albuterol (beta agonist), and finasteride. Still, the end product of the in vitro testing of the tamsulosin interaction with warfarin and diclofenac were vague.

The excretion of Flomax is through urine and feces. And a percentage of 97 of the administered radioactivity was found, with urine (76%) which represents the primary way of excretion when match up to feces (21%) more than 168 hours.


What are the do’s and don’ts during FLOMAX intake?

Before taking this drug you have to tell your doctor the allergies you have to certain drugs. This is because the drug may have inactive ingredients that may cause allergic reactions. Take Flomax as prescribed by the doctor. Do not take it in smaller and larger amounts or longer than recommended. Do not mash, chew up or open the capsule but swallow it as a whole. Take the medication at bedtime on your first dosage to minimize dizziness and fainting. On the following days take it 30 minutes before meal and take it the same time daily.

This drug may cause you to be dizzy and drowsy, limit your activity that requires being attentive or focusing such as driving and handling machineries. Avoid alcoholic beverages. Symptoms like dizziness, drowsiness, lightheadedness, ejaculation problems or runny/stuffy nose may take place. If any of these persist or get worse, tell your doctor right away.
Do not mixed with other medications as it may cause some drug interaction with each other. It may decrease the desired effect or increase its effect. It is also safe if you inform your doctor the drugs you are currently taking any to aware him of drug interaction it may cause.


What are the recent breakthroughs and recommended studies on FLOMAX?

There are current ongoing studies on therapeutic effect of Flomax (Tamsulosin) after Extracorporeal Shock Wave Lithotripsy (ESWL) to treat Urolithiasis. (Georgiev, 2011) There are also ongoing studies on therapeutic effect of Flomax (Tamsulosin) in Patients with Symptomatic Benign Prostatic Hyperplasia (SBPH). (Chung,2011)



References:

Andriole Jr., Gerald L. MD and Tyler L. Christensen, MD. “Benign Prostatic Hyperplasia: Current Treatment Strategies.” Consultant Live. Consultant. Vol. 49 No. 2. February 1, 2009.

“Benign prostatic hyperplasia.” Wikipedia the Free Encyclopedia. 2011. Wikimedia Foundation, Inc., 21 September 2011

Chung JW, et al. Efficacy and Tolerability of Tamsulosin 0.4 mg in Patients with Symptomatic Benign Prostatic Hyperplasia. Korean J Urol. 2011 Jul 24. Flomax. RxList. 2011.

Georgiev MI, et. al.Efficacy of Tamsulosin Oral Controlled Absorption System After Extracorporeal Shock Wave Lithotripsy(ESWL) to Treat Urolithiasis. Urology. 2011 Sep 12

Glenn Gerber, MD. Benign Prostatic Hyperplasia (BPH, Enlarged Prostate). MedicineNet. 1996-2011.

Porth, Carol Mattson. Pathophysiology, Concepts of Altered Health States. Milwaukee: Wisconsin, 2002

Samadi, David, MD. About BPH. Robotic Oncology. 2005-2011.


 

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