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Medical Forum / Diseases and Disorders / Prostate BPH / April 2007effects of stopping or reducing dosage of Tamsulosin
I have been reducing my dosage of Tamsulosin, which causes fatigue and mental fog, while starting on Saw palmetto. As this medication lowers blood pressure, does stopping it increase blood pressure? What side effects should I expect, and for how long? What reduction schedule would work? I have been on it, off and on, for about six or seven months, but mostly on, with short breaks of reduced dosages. Tamsulosin also affects sexual performance in my case. Anybody else with the same experience? >I have been reducing my dosage of Tamsulosin, which causes fatigue and >mental fog, while starting on Saw palmetto. As this medication lowers >blood pressure, does stopping it increase blood pressure? What side >effects should I expect, and for how long? What reduction schedule >would work? I have been on it, off and on, for about six or seven >months, but mostly on, with short breaks of reduced dosages. >Tamsulosin also affects sexual performance in my case. Anybody else >with the same experience? Yikes! Don't you read the available articles on line about drugs you take. Tamsulosin (Flomax) is well known for causing anejaculation. The drug co propaganda admits to libido changes, pretends to retrograde ejaculation, and mentions nothing about anejaculation. For a different view see the ABEJAC study analyzed in the report on the 20th (2005) Congress of the European Association of Urology. Together with the SSRI's Flomax should bear a black box warning something like, "This product is injurious to your sexual functioning. Only persons who see no value in sex should take it". (Yeah, there's a chance that the FDA would take sex seriously, NOT.) You should try alfusozin (Uroxatral) instead. For me it actually has a pro-sexual effect. On Apr 3, 8:02 am, Unkn...@InvalidISP.gov wrote: > >I have been reducing my dosage of Tamsulosin, which causes fatigue and > >mental fog, while starting on Saw palmetto. As this medication lowers [quoted text clipped - 18 lines] > You should try alfusozin (Uroxatral) instead. For me it actually has a > pro-sexual effect. Can you tell me what other side effects Alfusozin has? I took it only for about a day or two, found I was feeling lightheaded, dizzy, and stopped. I know that was too short a trial, and am willing to try again, but perhaps you can tell me your experience of switching? >On Apr 3, 8:02 am, Unkn...@InvalidISP.gov wrote: >> You should try alfusozin (Uroxatral) instead. For me it actually has a >> pro-sexual effect. >Can you tell me what other side effects Alfusozin has? I took it only >for about a day or two, found I was feeling lightheaded, dizzy, and >stopped. I know that was too short a trial, and am willing to try >again, but perhaps you can tell me your experience of switching? I didn't actually switch. About three years ago, I took a trial (sample pack) of Flowmax and lost all sexual functioning for the week. Started Uroxatral about four months ago. Increases flow, reduces delay, and helps somewhat (not perfect) with urge. Used Enablex together with the Uroxatral for about a month. It was better at managing urge but it gave me constipation so I stopped it. As to side effects other than a pro-sexual difficult-to-describe tingling-in-the loins-during sex, I didn't have any. If the lightheadedness and dizziness is on standing or sitting up, it's probably orthostatic hypotension. Basically a drop in BP and common with all the alpha-1 blockers. It should resolve itself as you get used to the drug (or so I've heard). On Apr 3, 10:42 pm, Unkn...@InvalidISP.gov wrote: > >On Apr 3, 8:02 am, Unkn...@InvalidISP.gov wrote: > >> You should try alfusozin (Uroxatral) instead. For me it actually has a [quoted text clipped - 19 lines] > common with all the alpha-1 blockers. It should resolve itself as you > get used to the drug (or so I've heard). Can anyone suggest a withdrawal schedule? I stopped Tamsulosin last night, after halving my dose for 2 days, but today, feel a scary tightness in the bladder area, and am going in frequently for very short pees. >On Apr 3, 10:42 pm, Unkn...@InvalidISP.gov wrote: >> >On Apr 3, 8:02 am, Unkn...@InvalidISP.gov wrote: [quoted text clipped - 25 lines] >tightness in the bladder area, and am going in frequently for very >short pees. If your dose is 0.8 mg, then when STARTING the med, I believe you are supposed to go on 0.4 mg for a few days before going to the full dose. So for STOPPING, I would just do it in reverse. Symptoms vary quite a bit (at least for me) even when on a steady diet of meds. So I would give it some time, if possible, to see what the longer term response is to stopping the Tamsulosin. If you can't stand being ON Tamsulosin and can't stand NOT being on Tamsulosin, then you have to find another solution! That's a job for your uro. Ed > >On Apr 3, 10:42 pm, Unkn...@InvalidISP.gov wrote: > >> >On Apr 3, 8:02 am, Unkn...@InvalidISP.gov wrote: [quoted text clipped - 39 lines] > > Ed Are the alpha blockers close enough to each other that one can switch from one to the other and get an immediate result? I had an Alfuzosin today, and wonder if, theoretically, I could switch to a Terazosin tomorrow, and then back to Tamsulosin one day later. I also don't know what kind of discomfort to bear (mine was a kind of tightness and congestion in the area above the base of the penis) and what kind of discomfort I should consider as an alarm bell. I don't really understand what the definition of "acute urinary retention" is, and whether allowing oneself to get into such a situation would result in permanent damage to the system. If it's just a few extra trips to the bathroom, I would be willing to take it. >Are the alpha blockers close enough to each other that one can switch >from one to the other and get an immediate result? I had an Alfuzosin >today, and wonder if, theoretically, I could switch to a Terazosin >tomorrow, and then back to Tamsulosin one day later. I'm no pharmacist and no doctor, but I think it is very unwise to switch meds like that unless it is under doctor's orders. >I also don't know what kind of discomfort to bear (mine was a kind of >tightness and congestion in the area above the base of the penis) and [quoted text clipped - 3 lines] >in permanent damage to the system. If it's just a few extra trips to >the bathroom, I would be willing to take it. Acute urinary retention means you can't pee. And if you can't pee, the outcome is death. Fortunately death does not come as quickly from a blocked urethra as it does from a blocked coronary artery. But in both cases, you need resolution by going to emergency. There they will get the urine flowing again by catheterization. I guess I shouldn't overdramatize the part about death. You probably have days, maybe many days for all I know, before that happens. But there is the possibility of permanent damage to the bladder if it gets too full. Just because the bladder is full does not stop the kidneys from working. They are cleansing your blood; they keep adding urine and the bladder gets fuller, and will eventually stretch badly. If that goes on for long enough, the bladder may lose its flexibility and strength, and that may be permanent. You generally have a couple-few hours to get your system unplugged before damage occurs... obviously depending on many other things. If you think you are at risk of going into retention, talk to your uro about Intermittent Self-Catheterization. Ed >>Are the alpha blockers close enough to each other that one can switch >>from one to the other and get an immediate result? I had an Alfuzosin >>today, and wonder if, theoretically, I could switch to a Terazosin >>tomorrow, and then back to Tamsulosin one day later. Terazosin requires titration (customization of the dose to your ability to handle it) so unless you know your dosage for certain it's not a good idea to just change to it like you're proposing. OTOH both Alfuzosin and Tamsulosin have fixed recommended quantities so you could probably alternate. >I'm no pharmacist and no doctor, but I think it is very unwise to >switch meds like that unless it is under doctor's orders. Well, I play one on the internet <g>. You're right in theory but a little naive, I think. Most MD's I've been to just guess at these sort of suggestions as they do most of the time with the choice of antibiotic. >>I also don't know what kind of discomfort to bear (mine was a kind of >>tightness and congestion in the area above the base of the penis) and [quoted text clipped - 3 lines] >>in permanent damage to the system. If it's just a few extra trips to >>the bathroom, I would be willing to take it. >Acute urinary retention means you can't pee. And if you can't pee, the >outcome is death. Fortunately death does not come as quickly from a >blocked urethra as it does from a blocked coronary artery. But in both >cases, you need resolution by going to emergency. There they will get >the urine flowing again by catheterization. >I guess I shouldn't overdramatize the part about death. You probably >have days, maybe many days for all I know, before that happens. >But there is the possibility of permanent damage to the bladder if it >gets too full. Just because the bladder is full does not stop the >kidneys from working. They are cleansing your blood; they keep adding >urine and the bladder gets fuller, and will eventually stretch badly. >If that goes on for long enough, the bladder may lose its flexibility >and strength, and that may be permanent. Actually after a while (days at least) the urine will back up the ureters and prevent the kidneys from working. Significant and life-threatening complications will ensue. >You generally have a couple-few hours to get your system unplugged >before damage occurs... obviously depending on many other things. >If you think you are at risk of going into retention, talk to your uro >about Intermittent Self-Catheterization. You'll know it when you go into AUR. It's not just a little discomfort but real pain. (I'm relying on what I've read here--it's not my personal experience.) Retention and AUR are two different things in the context here. AUR is as Ed points out an emergency, but retention is what lots of people have all the time. They retain a small quantity of urine in the bladder. I believe it's responsible for the feeling of incomplete emptying. If it's significant the MD should be able to feel it by palpitating the bladder through the abdominal wall. There also other more complex tests usually done by the urologist. >>>Are the alpha blockers close enough to each other that one can switch >>>from one to the other and get an immediate result? I had an Alfuzosin [quoted text clipped - 14 lines] >of suggestions as they do most of the time with the choice of >antibiotic. I have been on Proscar and Flomax for a couple of years now, and although I never miss a dose and don't change my meds, my symptoms vary quite a bit. For instance, sometimes I sleep through the night, while other times (a lot more rarely, fortunately), I am up 3 or 4 times, with some of those taking 45 minutes to void. But overall, the meds have been very successful. Point is, if you keep changing meds and doses, you will never know what's doing what to you. You need to evaluate the meds over a long period of time to learn that. It is true that docs guess, and don't know beforehand what all the benefits and side effects will be, but that is a different issue. Mine put me on Proscar. He could have chosen Avodart. The Proscar is working pretty good, so now he is reluctant to switch me to Avodart, even though it is often regarded as stronger, because he doesn't know how it will do by comparison, and why fight success. Going back and forth between Proscar and Avodart would be crazy and prove nothing. Ed |
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