Alfuzosin vs Tamsulosin- A Guide to Prostate Medication Choices

Facing benign prostatic hyperplasia (BPH) can feel a bit like finding a complex path, trying to step out of the shadows. As we started seeking solutions to navigate through the challenges of BPH, a natural question emerged: “Alfuzosin vs Tamsulosin: Which Is Better?” Both Alfuzosin and Tamsulosin come into play when it comes to managing BPH. Here, you can take a closer look at the differences between both drugs. 

What Is Alfuzosin (Uroxatral)? 

Alfuzosin (Uroxatral) is a prescription medicine for treating lower urinary tract symptoms (LUTS) or BPH. It is an alpha-blocker that comes as a long-acting (extended-release) tablet. This medicine is a man-made quinazoline compound that helps relax smooth muscles. The way alfuzosin works involves attaching to and slowing down the alpha (1)-adrenergic receptors in the lower urinary tract.

This product aids in relaxing the smooth muscles in the bladder, neck, and prostate, leading to improved urine flow and decreased urinary symptoms. Alfuzosin facilitates easier urination and provides relief from BPH symptoms, although it doesn’t reduce the size of the prostate.

If talking about consumption, the recommended dosage for adult men undergoing BPH treatment is typically 10 mg, and it’s taken orally once a day. To maximize its effectiveness, it’s advisable to take alfuzosin right after a meal, avoiding consumption 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. 

Alfuzosin Vs Tamsulosin- Understanding The Difference 

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. 

If talking about alfuzosin vs flomax (Tamsulosin), they are FDA-approved medications. Tamsulosin was approved in 1997 for the treatment of an enlarged prostate. While Uroxatral (alfuzosin hydrochloride) extended-release tablets were approved in 2003.

The major difference between alfuzosin and 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.  Here is a quick look at the similarities and differences between alfuzosin and tamsulosin.

Action Time 

Alfuzosin and tamsulosin are medications that are released slowly over time in the body rather than all at once. It is an extended-release medication designed to last longer in the body. However, Tamsulosin is also considered a slow-release medication. Doctors typically recommend these 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 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.

Effects On Health 

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. On the other hand, tamsulosin can also manage BPH symptoms. But it could occasionally be taken for kidney stones.

Drug Interactions

When it comes to how these drugs interact with others, both alfuzosin and tamsulosin follow similar patterns. However, alfuzosin comes with a specific caution. It may interact with drugs that inhibit the CYP3A4 enzyme, which is responsible for processing the medicine in the liver.

Taking alfuzosin with medications that block the CYP3A4 enzyme, like itraconazole, ritonavir, or ketoconazole, could increase alfuzosin levels in your system, raising the risk of experiencing side effects.

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. 

Flomax Vs Alfuzosin- About The Effectiveness

Is alfuzosin the same as Flomax? What about their effectiveness? 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. However, alfuzosin might be a preferred alternative for sexually active men, mainly because it has lower odds of ejaculatory abnormalities. 

Sexual Health Considerations

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.  

Safety And  Comparative Studies

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. 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 versus Alfuzosin side effects.

Alfuzosin Side Effects

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

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

More serious side effects of alfuzosin can include:

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

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:

  • a 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. 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. 

Can you change between Flomax and Uroxatral?

Your healthcare provider might recommend switching from Tamsulosin to Alfuzosin or vice versa if you’re not responding to the first drug as expected or if your insurance provider prefers the other drug.


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.

Considering Alfuzosin vs Tamsulosin is like embarking on a journey where understanding the details is key. It’s important to grasp these details and get personalized guidance from a healthcare pro to make the right decision in this debate.

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  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.
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  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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