Talk:Tamsulosin

Proposed change to 'adverse effects' section

I invite other editors to help me clarify the 'adverse effects' section in this article, as several of the bullet points seem misleading.

Specifically, the reference to the American Heart Association article "Drugs That May Cause or Exacerbate Heart Failure" is not related to tamsulosin as it relates to prostatic disease, but describes problems encountered by a separate alpha blocker used in the context of patients participating in a clinical trial designed to prevent heart disease. Increased risks of cardiac failure in these patients was described as being due to inappropriate lowering of blood pressure (presumably in hypertensive patients who would have otherwise benefited from other drugs used for hypertension); misdiagnosis; or masking of otherwise diagnosable HF, etc. The point being, this section and the issues raised don't appear directly relevant to men being treated specifically for prostate disease. I propose removing, or at the very least, qualifying this excerpt - if it must be kept in.

Another misleading bullet is "Congestive Heart Failure" (also in the Adverse Effects section). This bullet, in the subsection 'Adverse Events' makes it appear as though Tamsulosin and CHF are directly correlated. But the abstract linked to this bullet point is simply listing alpha blockers as contraindications in people already suffering from heart failure, among other cardiac diseases. Thanks for your assistance.Ronsword (talk) 23:40, 23 January 2018 (UTC)

UPDATE on above proposed edit: In the American Heart Association article discussed in my previous post, there is, in fact, reference to tamsulosin - among other drugs - and a possible increased incidence of CHF. I've thus clarified these points in "Adverse Effects" subsection, and included possible explanations of how alpha blockers with/or without concurrent use of b-blockers, might mitigate or alter CHF incidence in susceptible populations, as per the American Heart Association article.Ronsword (talk) 17:49, 25 January 2018 (UTC)

Regarding effects on the heart, I know first hand from trying this medication, that it can cause irregular heartbeat. This was my personal experience --- heart palpitations. I understand that because it was my personal experience, this does not qualify for the article. Nevertheless, this factor should be considered in the context of the above remarks with respect to any prospective change to the article. ---Dagme (talk) 17:46, 1 October 2018 (UTC)

: Should we include mention of risk re: dementia?

I am aware of the guidelines for source material for medical pages, and that review articles or meta-analyses are preferred. However, I wonder if we should consider adding information to the Tamsulosin page based on a recent well-done analysis that shows the risk of tamsulosin over other agents in its class, in terms of incidence of dementia. I know that Wikipedia referencing rules serve a purpose but also that there is flexibility when it is for the greater good. In this case I would argue the latter applies as a prospective trial for this will never be done. No Institutional Review Board would ever approve a prospective trial when the harm was this great.

Given this circumstance I would ask if it would be acceptable to this information to the Tamsulosin page:

Preliminary evidence suggests that tamsulosin has a significantly higher incidence of dementia than all other agents used to treat benign prostatic hypertrophy. According to a large database analysis of Medicare published in 2018, the incidence of dementia was 31.3/1000 person‐years in the tamsulosin cohort, in comparison to 25.9/1000 person‐years in the no‐benign prostastic hyperplasia‐medication cohort. The risk of dementia was significantly higher in the tamsulosin cohort, when compared with the no‐BPH‐medication cohort (HR [95% CI]: 1.17 [1.14, 1.21]) and each of the alternative‐BPH‐medication cohorts: doxazosin (1.20 [1.12, 1.28]), terazosin (1.11 [1.04, 1.19]), alfuzosin (1.12 [1.03, 1.22]), dutasteride (1.26 [1.19, 1.34]), and finasteride (1.13 [1.07, 1.19]).

Is adding something like this a possibility? How do other participants view this situation? Dr. Bob in Arizona (talk) 02:10, 12 April 2018 (UTC)

Should be updated to show that Tamsulosin is now available over-the-counter (OTC) and is no longer ℞-only.2601:4C4:C203:21FC:C83A:3D08:9044:5938 (talk) 12:17, 29 September 2019 (UTC)

References

Incorrect reference?

What does the Reuters article about market speculation over the immune-suppresant drug Prograf having a generic introduced in the US and the attempts of the Japanese manufacturer to delay it have to do with the name under which tamsulosin is marketed in Egypt? Am I missing something in this link? A search for "egypt" didn't find anything. A Shortfall Of Gravitas (talk) 09:26, 1 November 2019 (UTC)

Ironically for the section title, the reference showing up in this section of the page belongs with the above section about dementia. The link in my above question is different... :P A Shortfall Of Gravitas (talk) 09:27, 1 November 2019 (UTC)

Not GSL

In the UK Tamsulosin is only available from pharmacies (see https://www.nhs.uk/medicines/tamsulosin/), it is not on the general sales list. 81.140.244.69 (talk) 15:36, 30 August 2020 (UTC)

Contrainidcations

Who should not take Tamsulosin HCL? The following conditions are contraindicated with this drug. Check with your physician if you have any of the following:

Conditions: orthostatic hypotension a form of low blood pressure priapism a prolonged erection of the penis cataract surgery floppy iris during eye surgery CYP2D6 poor metabolizer reduced activity of cytochrome p450 CYP3A4 Allergies: Tamsulosin

Mechanism section

The final paragraph of the Mechanism section reads "Selective action of tamsulosin in alpha 1A/D receptors is controversial and over three quarters of tamsulosin registered human studies are unpublished.[18]"

Two things: 1) This is the only place in the article that mentions alpha-1D. Needs clarification. 2) I don't see anywhere in the referenced article (18) That says that 3/4 of the studies are unpublished. Perhaps I'm blind. Can this be elucidated by someone with knowledge in the area? ThreeRocks (talk) 21:31, 25 September 2021 (UTC)

You're not blind. I couldn't find anything in the reference to support anything that last paragraph states.

Regarding the "1A/D problem" I'd say they meant to say "1A/B", but that's beside the point...

The reference given does not mention any controversy over the selectivity of the drug for alpha-1a over alpha-1b receptors or, for that matter, 1a and 1d receptors, instead mentioning the selectivity mentioned in the rest of the article, and noting that symptoms associated with alpha-1a blockade are reduced in comparison to non-selective blockers.

It does not comment on the fraction of human studies of tamsulosin that are unpublished.

As an aside, the paragraph has the tone of a conspiracy theory. A "controversy", and hidden, adverse findings in unpublished studies. While such things do occur, no evidence is provided. It is, of course, irrelevant that it reads like a conspiracy theory. What matters is that it appears to be fabricated, based on the reference given. I mention it only as a possible explanation for the presence of the paragraph.

I think it should be removed. At least I try (talk) 00:44, 13 September 2023 (UTC)