Alfuzosin vs Tamsulosin: Which Is Better?

Alfuzosin and tamsulosin are both drugs used for treating symptoms of BPH (benign prostatic hyperplasia) in men. 

These medications are very similar because they are both alpha-blockers. They have a similar safety profile, side effects, and usage. 

The main difference is in the doses and the ejaculatory abnormalities. 

Ejaculation disorders are a frequently reported side effect of tamsulosin therapy. Men can experience failure to ejaculate, abnormal ejaculation, and retrograde ejaculation.

Alfuzosin is different. Alfuzosin may even improve sexual function in men with ejaculatory dysfunction. 

This makes the drug a popular choice for sexually active men. 

Here, you can take a closer look at the differences between alfuzosin vs tamsulosin. 

What Is Alfuzosin (Uroxatral)? 

Alfuzosin (Uroxatral) is a prescription medicine for treating lower urinary tract symptoms (LUTS) or BPH. Alfuzosin is an alpha-blocker that comes as a long-acting (extended-release) tablet.

This medication is a synthetic quinazoline compound with smooth muscle relaxing activity. The alfuzosin mechanism of action is characterized by binding to and inhibiting the alpha (1)-adrenergic receptors in the lower urinary tract. 

The product helps relax the smooth muscle in the bladder, neck, and prostate, which improves urine flow and reduces urinary symptoms. Alfuzosin makes it easier to urinate and relieves the BPH symptoms. But it can’t shrink the prostate

The doses can vary. For BPH treatment, the recommended dose for adult men is often 10 mg. 

You can take it by mouth once a day. The best time to take alfuzosin is right after a meal. Avoid taking it on an empty stomach. 

What Is Tamsulosin (Flomax)? 

Tamsulosin (Flomax) is a prescription medicine for treating symptoms of an enlarged prostate, kidney stones, and bladder outlet obstruction. 

Flomax is an alpha-blocker and has a rapid onset of action for patients with moderate or severe symptoms.

The Flomax mechanism of action works by relaxing the muscles in the bladder and prostate to help with urine flow. 

The effects of the Flomax mechanism are targeted at the smooth muscle receptors of the urethra and prostate. 

Doctors often recommend Flomax when an enlarged prostate makes it harder to urinate and empty the bladder.

The most recommended dose for Flomax capsules is 0.4 mg a day. Patients should take the product about one-half hour after the same meal every day. If patients don’t respond to treatment, doctors can increase the dose to 0.8 mg a day. 

Similarities and Differences Between Alfuzosin and Flomax

Both alfuzosin and tamsulosin are selective A1 blockers. They target specific alpha receptors like the smooth muscle and urinary tract. 

They seem to cause less orthostatic hypotension than nonselective alpha-blockers, like doxazosin, prazosin, and terazosin. 

Orthostatic hypotension is a form of low blood pressure when standing after lying down or sitting. This “selectivity” is what makes both products a practical choice for managing BPH symptoms. 

They are FDA-approved medications. Tamsulosin was approved in 1997 for the treatment of enlarged prostate. While Uroxatral (alfuzosin hydrochloride) extended-release tablets were approved in 2003. 

Here is a quick look at the differences and similarities between alfuzosin vs tamsulosin. 

alfuzosin vs tamsulosin

Onset of action

Alfuzosin and tamsulosin are medications that are released slowly over time in the body rather than all at once. 

Alfuzosin is an extended-release medication designed to last longer in the body. This helps patients take the medicine less often.

Tamsulosin is also a slow-release medication. Doctors typically recommend slow-release products to patients who don’t respond effectively enough to their medicine. 

These tablets have unique coatings, which make sure that the medicine takes longer to leave the system naturally. 

The goal is to maintain a specific concentration of the administered drug during a set period of time while decreasing the odds of possible side effects. 

This medicine is released steadier and slower into the bloodstream, while having the advantage of being consumed less frequently than immediate-release (IR) formulations of the same drug, such as doxazosin.

Health effects

Both products have similar health effects. They can relieve the symptoms of BPH by relaxing the prostate and bladder muscles. 

Alfuzosin is used in men to treat urination problems, such as incomplete bladder emptying, weak stream, dribbling, and hesitation. Including urgency and urinary frequency. 

Tamsulosin can also manage BPH symptoms. But it could occasionally be taken for kidney stones.


The major difference between alfuzosin vs tamsulosin is in dosage forms. Alfuzosin comes in a 10 mg dose, while tamsulosin often starts with a 0.4 mg dose. And can be increased to a 0.8 mg dose. 


There is a slight difference in half-life. With alfuzosin, the half-life is 10 hours after oral administration, vs with tamsulosin, there is a 14 to 15 hours apparent half-life in patients.

Drug interactions

When it comes to drug interaction, alfuzosin and tamsulosin have similar profiles. Except that alfuzosin can interact with drugs that inhibit the CYP3A4 enzyme. The CYP3A4 enzyme is in charge of processing the medicine in the liver.

Drugs that block this enzyme could trigger increasing alfuzosin levels in the system. This could put you at risk of developing side effects. 

So, you shouldn’t use alfuzosin with strong inhibitors of this enzyme, such as itraconazole, ritonavir and ketoconazole. 

So far, no interactions were recorded between tamsulosin and ketoconazole/hydrocortisone topical creams. But that doesn’t mean interactions don’t exist. It is best to consult with a doctor before taking these products together. 

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Alfuzosin vs Flomax Effectiveness 

Which is better, tamsulosin vs alfuzosin? In men with lower urinary tract symptoms from BPH, both tamsulosin and alfuzosin have similar effectiveness. Both products offer an improved quality of life score and better urination. 

But, alfuzosin might be a preferred alternative for sexually active men, mainly because it has lower odds of ejaculatory abnormalities. Here is what review articles have to say.

According to retrospective studies, alfuzosin is an effective medicine for treating BPH or LUTS, with a lower rate of sexual disorders compared to other alpha-blockers.

Reports show that tamsulosin, alfuzosin, and silodosin have similar efficacy for improving LUTS secondary to BPH.  

Experts also studied the safety and efficacy of two doses (10 mg and 15 mg) of alfuzosin a day and tamsulosin (0.4 mg) once daily. They compared the drugs with a placebo in men with BPH. 

Based on the results, treatment with 10 mg of alfuzosin drastically improved urinary symptoms and was well tolerated compared to a placebo. 

There was also a significant improvement in the tamsulosin study group, with better results than the placebo. The incidence of sexual function side effects was higher with tamsulosin compared to placebo. 

While the benefit of lower sexual function side effects with the alfuzosin group was reduced with a higher 15 mg dose.

Which Has Fewer Side Effects, Alfuzosin or Flomax?

Both tamsulosin and alfuzosin have similar side effect profiles. In a prospective study of 100 patients with LUTS from BPH, these drugs had similar reports of headache (4%), dizziness (6%), and asthenia (4%). 

The only major difference was for abnormal ejaculation, which was recorded in 2 of the 50 patients (4%) using tamsulosin. 

Here is a quick look at the tamsulosin vs alfuzosin side effects.

Alfuzosin side effects

Wondering what the side effects of alfuzosin 10 mg are? Some alfuzosin side effects can include:

  • heartburn
  • stuffy or runny nose
  • headache
  • tiredness
  • constipation
  • sore throat
  • nausea
  • stomach pain
  • pain
  • other signs of infection

More serious side effects of alfuzosin can include:

  • chest pain
  • hoarseness
  • rash
  • swelling of the tongue or face
  • trouble breathing or swallowing
  • fainting

Tamsulosin side effects

Some of the tamsulosin most common side effects can include:

  • diarrhea
  • back pain
  • sleepiness
  • stuffy or runny nose
  • weakness
  • trouble sleeping
  • pressure or pain in the face
  • difficulty ejaculating
  • blurred vision
  • other signs of infection

Other serious side effects tamsulosin 0.4 mg can include:

  • painful erection lasting for hours
  • itching
  • hives
  • rash
  • swelling of the face, lips, hands, etc

Some patients experience ejaculation problems with Flomax. This includes decreased ease of ejaculation, failure to ejaculate, or the semen ending up in the bladder rather than outside the body. In fact, ejaculation disorders are a common side effect of tamsulosin.

According to a long-term study of 0.4 mg tamsulosin a day, 30% of patients developed ejaculatory dysfunction. 

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Which Medication Is Cheaper?

The alfuzosin cost is slightly higher than tamsulosin. 

For a supply of 90 tablets, 10 mg alfuzosin extended-release tablets, you can spend about $20. 

So, how much does Flomax cost? For 0.4 mg tamsulosin, for a supply of 90 tablets, the cost is about $15. The prices can vary based on the pharmacy you visit. 

Can I Take Alfuzosin and Flomax Together?

You shouldn’t be using Flomax and alfuzosin together. This type of combination treatment can make your blood pressure plummet and increase your heart rate. Especially when you are trying to stand back up after sitting for too long. 

To improve the outcome measures, talk to your doctor. If you are planning on switching from tamsulosin to alfuzosin, the doctor can suggest the best form of treatment that can accommodate your needs. They can also give you some suggestions on how to reduce the risk of side effects. 

Which is the best alpha-blocker for BPH?

Alpha-blockers are the most cost-efficient, effective, and best-tolerated of the drugs for relieving LUTS. That includes drugs such as alfuzosin, tamsulosin, doxazosin, and terazosin.

Tamsulosin has been the most commonly prescribed alpha blocker since the mid-2000s. While Alfuzosin might be suggested for sexually active men who experience ejaculatory dysfunctions from Tamsulosin.

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Natural Alternatives to Alfuzosin and Flomax

To reduce the odds of side effects, some people are opting for natural alternatives. These can include:


Alpha blockers like alfuzosin and tamsulosin can relax the bladder neck and prostate muscles. This helps men urinate. 

They are both effective in curbing the LUTS symptoms from BPH. They also have similar efficacy and side effect profiles. 

The major difference is in the doses and the ejaculatory dysfunction. Alfuzosin comes in a 10 mg dose, while tamsulosin offers a 0.4 mg or 0.8 mg dose. Tamsulosin also has a higher risk for ejaculatory abnormalities. 

That’s why it is critical to talk to a specialist to find the right treatment that works for you. If you want to try natural supplements, then you might want to consider options like Saw palmetto, Pygeum Africanum, Shatavari, or Beta-sitosterol.

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  2. Mari A, Antonelli A, Cindolo L, Fusco F, Minervini A, De Nunzio C. Alfuzosin for the medical treatment of benign prostatic hyperplasia and lower urinary tract symptoms: a systematic review of the literature and narrative synthesis. Ther Adv Urol. 2021 Apr.
  3. Manjunatha R, Pundarikaksha HP, Madhusudhana HR, Amarkumar J, Hanumantharaju BK. A randomized, comparative, open-label study of efficacy and tolerability of alfuzosin, tamsulosin and silodosin in benign prostatic hyperplasia. Indian J Pharmacol. 2016 Mar-Apr.
  4. Nordling J. Efficacy and safety of two doses (10 and 15 mg) of alfuzosin or tamsulosin (0.4 mg) once daily for treating symptomatic benign prostatic hyperplasia. BJU Int. 2005.
  5. Comparison of Alfuzosin and Tamsulosin Once Daily for Treatment of Lower Urinary Tract Symptoms due to Benign Prostatic Hyperplasia: A Randomized, Prospective Study.
  6. Song SH, Son H, Kim KT, Kim SW, Moon du G, Moon KH, Park K, Park JK, Lee SW, Hyun JS, Park NC. Effect of tamsulosin on ejaculatory function in BPH/LUTS. Asian J Androl. 2011.
  7. van Moorselaar RJ, Hartung R, Emberton M, Harving N, Matzkin H, Elhilali M, Alcaraz A, Vallancien G; ALF-ONE Study Group. Alfuzosin 10 mg once daily improves sexual function in men with lower urinary tract symptoms and concomitant sexual dysfunction. BJU Int. 2005.
  8. Moon, H.W., Yang, J.H., Choi, J.B. et al. Prescription pattern of alpha-blockers for management of lower urinary tract symptoms/benign prostatic hyperplasia. Sci Rep 8, 13223 (2018).

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