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Tamsulosin for BPH Associated with Risk for Severe Hypotension — Physician’s First Watch

Medical News |
November 8, 2013

Tamsulosin for BPH Associated with Risk for Severe Hypotension

By Joe Elia

The selective alpha blocker tamsulosin, used to treat the symptoms of benign prostatic hypertrophy, carries a doubled risk for severe hypotension, especially during early treatment, according to a BMJ study.

Using a U.S. insurance claims database, researchers found that the hospitalization rate for severe hypotension among some 380,000 users of tamsulosin or 5-alpha-reductase inhibitors (5ARI) was 29.1 per 10,000 person-years. 5ARI users had a rate of 31.3, but the rate among tamsulosin users was 42.4.

Risks were highest in weeks 1 to 4 after starting tamsulosin and remained high in weeks 5 to 8. Patients restarting tamsulosin after a 4-week hiatus showed roughly the same risk profile.

Some nonselective alpha blockers carry boxed warnings on hypotension and syncope, whereas tamsulosin does not. Clinicians should warn patients about tamsulosin's "first dose phenomenon," the authors advise.

Reader Comments (2)

valluri ramarao Physician, Family Medicine/General Practice, vijayawada

Be cautious about the first dose of tamsulosine which csn cause hypotension.

Bernardo Frider MD Physician, Internal Medicine

Its a very common AE

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