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Tamsulosin side effects and how to avoid them

Tamsulosin side effects include ejaculation problems and chest pain
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By | Oct. 6, 2022 Medically reviewed by Anne Jacobson, MD, MPH
Rx pill bottle and prescription pad: Tamsulosin side effects and how to avoid them

Key takeaways

  • Tamsulosin, used to treat urination problems due to an enlarged prostate, can cause side effects including ejaculation problems and chest pain.

  • Common side effects of tamsulosin include dizziness, nasal congestion, headache, and in severe cases, low blood pressure and fainting.

  • Tamsulosin’s interaction with other medications can increase the likelihood of side effects, necessitating caution with concurrent use of certain drugs, including SSRIs and calcium channel blockers.

  • To minimize tamsulosin side effects, patients should provide a complete medical history to their healthcare provider, take the medication as directed, and report any adverse reactions promptly.

Common tamsulosin side effects | Serious side effects | Ejaculation | Chest Pain | Side effects timeline | Contraindications | Warnings | Interactions | How to avoid side effects | How to treat side effects

Tamsulosin is a generic prescription drug that relieves urination problems caused by an enlarged prostate gland, a condition called benign prostatic hyperplasia (BPH). An enlarged prostate interferes with urine flow by narrowing the urethra. 

Tamsulosin belongs to a class of drugs called alpha blockers that work by relaxing the smooth muscles in the urethra, allowing urine to flow more freely. Also sold as brand-name Flomax, tamsulosin is often prescribed with other drugs that reduce the size of the prostate gland such as Avodart (dutasteride) or Propecia (finasteride). Because the side effects of these medications sometimes overlap, it’s not always easy to determine their source when more than one drug is used.

Common side effects of tamsulosin

In clinical trials, about 18% of people had ejaculation problems when taking tamsulosin at the highest dose. Dizziness, nasal congestion, and headache were also common, especially at higher doses. For people taking tamsulosin, commonly reported side effects include:

  • Ejaculation problems
  • Headache
  • Dizziness
  • Stuffy and runny nose
  • Infection
  • Weakness
  • Back pain
  • Diarrhea
  • Sore throat
  • Cough
  • Drowsiness
  • Stuffy sinuses
  • Sleepiness
  • Lowered sex drive

Serious side effects of tamsulosin

The most serious side effects of tamsulosin are:

  • Low blood pressure with position changes (orthostatic hypotension)
  • Fainting
  • Irregular heartbeats
  • Painful or persistent erections (priapism)
  • Severe allergic reactions
  • Severe skin reactions

Tamsulosin can also interfere with glaucoma or cataract surgery.

Ejaculation

Ejaculation failure, delayed ejaculation, ejaculating into the bladder, or a decrease in semen volume are common side effects of tamsulosin. In clinical trials, 8% of those taking a low dose experienced ejaculation abnormalities. That rate increased to 18% at a higher dose. For people who received a placebo as part of the study, only 0.2% experienced ejaculation problems. When BPH is treated with both tamsulosin and a drug like finasteride or dutasteride, the risk of ejaculation problems increases. On the positive side, tamsulosin may help with premature ejaculation and improve erectile dysfunction.

Chest pain

In clinical trials, 4% of people taking tamsulosin experienced unspecified chest pain compared to 3.7% of those given a placebo. These statistics are very close, so it’s uncertain what role tamsulosin plays in chest pain. However tamsulosin, like other alpha blockers, does widen blood vessels, reducing blood pressure and causing the heart to beat faster. As with any drug, if chest tightness or pain is experienced while taking tamsulosin, tell the prescribing healthcare provider about the problem.

Tamsulosin side effects in elderly people

In clinical trials, there was no difference in safety or effectiveness based on age. However, older people are at greater risk for falls and accidents, so healthcare providers will monitor side effects such as low blood pressure, orthostatic hypotension, dizziness, and fainting when using tamsulosin. 

How soon do tamsulosin side effects start?

Some side effects can start soon after beginning tamsulosin, such as headache, dizziness, rash, drowsiness, stuffy nose, and chest pain. People with heart rate abnormalities may find their condition worsening soon after starting tamsulosin. Allergic reactions, low blood pressure, and racing heartbeats could also come on rapidly. Other side effects such as ejaculation problems, lowered sex drive, and weakness may take days, weeks, or months after starting tamsulosin to manifest.

How long do tamsulosin side effects last?

Many side effects get better after the drug is stopped. It takes the body about 14 hours—give or take a few hours—to clear out half a dose of tamsulosin. So people can expect to be free of tamsulosin in a couple of days after taking the last dose. Many adverse effects, such as headache, dizziness, drowsiness, and low blood pressure should improve by then.

What are the long-term side effects of tamsulosin?

Most of tamsulosin’s side effects are temporary. They either get better as the body adapts to the drug or go away when the drug is stopped. A few may cause long-term problems, such as severe skin reactions, falls that occur because of low blood pressure, or damage to the penis from priapism.

Tamsulosin contraindications

Tamsulosin is never prescribed to people who are allergic to the drug or any of its inactive ingredients. 

Tamsulosin is indicated to treat BPH. However, it is sometimes also used in children and adults to help expel small kidney stones. It is unknown if tamsulosin is safe in pregnancy or breastfeeding.

Because tamsulosin may cause dizziness or faintness when standing up, older patients are monitored more closely in order to prevent falls. 

Tamsulosin warnings

All prescription drugs have risks. Fortunately, tamsulosin is a relatively mild drug in terms of side effects. Although it can cause problems, the most severe problems are rare. 

Cautions

In general, most of tamsulosin’s risks are related to pre-existing health conditions. Sometimes these conditions are made worse by the drug. In other cases, side effects are more likely, severe, or intolerable. Healthcare providers are cautious when prescribing tamsulosin to people who:

  • Are allergic to sulfa drugs
  • Have a specific liver enzyme that is not good at breaking down tamsulosin (poor CYP2D6 metabolizers)
  • Feel faint or dizzy when standing up (orthostatic hypotension)
  • Are about to have glaucoma or cataract surgery

For eye surgery, tamsulosin can cause a condition called intraoperative floppy iris syndrome, which makes the pupil hard to dilate before the operation. This problem isn’t life-threatening but does make it difficult for the surgeon to work on the eye. Most cases of floppy iris syndrome are due to tamsulosin treatment. The solution is to take the person off tamsulosin for a while before surgery. 

Abuse and dependence

The FDA does not classify tamsulosin as a drug that might be abused or that results in physical dependence.

Overdose

In the event of an overdose, get emergency medical help. Low blood pressure and racing heartbeats are the most serious problems, so medical help will be needed to bring these back to normal. 

Tamsulosin interactions

Most drug interactions with tamsulosin occur with drugs that block the body’s ability to break down tamsulosin, or drugs that aren’t broken down well when combined with tamsulosin. Both cases make side effects more likely. Some of these drugs include:

This is a long list of drugs, too long to memorize. Keep in mind that none of these are strictly prohibited and not all are dangerous when combined with tamsulosin. However, you and your healthcare provider will need to watch for side effects. Doses may need to be reduced if side effects become a problem.

In addition, it’s not a good idea to combine tamsulosin with other alpha blockers such as Cardura (doxazosin), Minipress (prazosin), Uroxatral (alfuzosin), or terazosin. Some of these alpha blockers are used to treat high blood pressure. The combination, of course, will increase the alpha-blocking effects of both drugs, making serious side effects more likely and common side effects worse.

How to avoid tamsulosin side effects

Here are a few common-sense tips to keep side effects at bay.

1. Tell the prescriber about all medical conditions and medications

To stay safe, give a complete medical history to the prescribing healthcare provider. That means everything you’ve had in the past and present, especially:

  • Low blood pressure
  • Prostate cancer
  • Liver problems
  • Kidney problems
  • Upcoming eye surgery
  • Allergies to medications
  • A complete list of all prescription drugs, over-the-counter medications, and dietary supplements being taken

2. Take tamsulosin as directed

It’s easy to make mistakes when taking drugs. Read and follow all the directions on the prescription label or given by the prescriber. Use an alarm or app to help make sure that doses are taken on time. A checklist or scheduler can also help monitor doses. If a dose is missed, take it as soon as it’s remembered. However, if it’s almost time for the next dose, skip the missed dose and take the next dose on time. Never double up on doses for any reason.

3. Stand up slowly and move carefully

Some people taking tamsulosin will sometimes feel dizzy, lightheaded, or faint when standing up. Even bending over can cause problems. This can be helped by standing up slowly. Be careful about bending over, and move slowly when changing position. It’s also a good idea to remove objects in a room that can cause injury if somebody falls on them.

4. Avoid driving for a little bit 

To help prevent accidents, avoid driving or other risky activities in the first few days of tamsulosin treatment. The drug can cause lightheadedness and dizziness, so it’s a good idea to experience the effects of the drug before getting behind the wheel.

5. Avoid some supplements

The risk of tamsulosin side effects goes up a little when taking dietary supplements such as vitamin B3 (niacin), turmeric, green tea, CBD, ginger, and echinacea. 

How to treat side effects of tamsulosin

Fortunately, tamsulosin has few side effects, but they do happen Here are some tips for when they do occur:

Ejaculation problems

Talk to the prescribing healthcare provider. Ejaculation problems are not life-threatening, but they do affect quality of life. If ejaculation issues are a problem, discuss your options with the prescribing healthcare provider. 

Feeling dizzy or faint

Sit down to help prevent falls and injuries. Stay seated until the dizziness passes, then get up slowly. Try to make sure you drink enough fluids. Make sure the prescriber knows about your symptoms.

Painful erections

Persistent or painful erections need medical attention right away. Go to an emergency room if an erection lasts longer than four hours, even if it’s not painful.

Chest pain

Talk to a healthcare professional if there’s any chest pain when taking tamsulosin. The prescriber may need to switch to a different drug or reduce the dose.

Allergic reactions

Allergic reactions to any drug require medical attention. They are more likely to happen early in treatment. Know the symptoms of a serious drug reaction and seek emergency help:

  • Wheezing
  • Trouble breathing
  • Swelling of the face, lips, mouth, or neck
  • Hives
  • Severe skin rash or blisters
  • Skin pain
  • Fever
  • Sore throat
  • Eye pain and burning

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