What Happens When You Stop Taking Flomax (Tamsulosin)?

The fear of withdrawal syndrome often gives people pause before embarking on medical treatment. Withdrawal is a common concern linked to substances like alcohol, illegal drugs, and certain prescription meds, particularly powerful pain relievers and sleep aids. While not every medication triggers withdrawal, the worry is relatable.

Every patient should receive clear medical advice on what steps to take if they’re thinking of stopping treatment. Flomax, unlike opioids and other drugs with notorious withdrawal issues, doesn’t fall into the same category. Yet, it does influence nerve transmission through cell receptors. So, what unfolds when you bid goodbye to this medication?

This article is here to uncover what happens when you stop taking Flomax. We’ll dive into the reasons for discontinuation, outline the risks and potential withdrawal symptoms, and spill all the details you need to know.

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What are the side effects of Flomax?

Flomax is the commercial name of a drug known as tamsulosin. This is an oral prescription drug commonly given to patients with an enlarged prostate

Flomax is used in benign prostatic hyperplasia and prostate cancer. The medication doesn’t directly reduce the size of the prostate gland. Instead, its mechanism involves altering nerve transmission to induce relaxation in the urinary bladder. By doing so, it alleviates urinary symptoms, making the process of emptying the bladder feel less challenging.

It is an alpha-adrenergic blocker, which means that it targets receptors in the cell, blocking them and not allowing stimulation. That is how the muscles in the prostate and bladder relax, and the urine flow improves.

This enlarged prostate treatment may trigger the following side effects. The most common include (1,2):

  • Priapism, which is a long-lasting and painful erection
  • Abnormal ejaculation
  • Blurry vision
  • Low blood pressure
  • An allergic reaction with rash, hives, itching, fever, trouble breathing, or swelling of your throat.

They are not common side effects but should be reported if you recently started treatment for benign prostatic hyperplasia. Some patients may also experience erectile dysfunction. It is difficult to tell when it is triggered by drugs or an underlying medical or psychogenic cause. Still, it is worth your attention if the symptoms start right after taking your first dose.

What are the side effects after stopping taking Flomax (Tamsulosin)?

Flomax side effects after stopping are usually related to a return of the original BPH symptoms. This drug improves the urine flow in patients with an enlarged prostate. If patients stop taking it the bladder and prostate tissue no longer receive the drug. 

The blocked alpha-adrenergic receptors are activated once again. Thus, the urinary tract does not relax properly. Patients may end up with the same urinary symptoms experienced before treatment.

However, not all patients will experience a return of BPH symptoms. For instance, there is a study about it published in the journal Urologia Internationalis. 

The study evaluated a group of Japanese men who achieved symptom improvements after being treated with tamsulosin. After stopping Flomax, not all patients suffered a return of BPH symptoms. At 24 weeks, 68.9% of them still experienced improved urinary tract symptoms (3).

This research was reviewed in a meta-analysis with nine other studies. The researchers, this time, evaluated data from 1081 participants in total. Flomax side effects after stopping the treatment were more evident in patients in monotherapy. Patients under combination therapy did not have significant short-term or long-term consequences.

When you want to quit Flomax (that’s tamsulosin), you might wonder how to stop taking tamsulosin safely and what flomax withdrawal symptoms to anticipate. If you’re taking more than one thing for your pee issues, stopping Flomax shouldn’t cause much trouble. But if Flomax is the only thing you’re taking, there’s a good chance you might feel some side effects. Just remember, not everyone gets the same issues (4).

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Reasons for stopping Flomax

The most important reason for stopping Flomax is experiencing the rare side effects listed above. Some can be potentially life-threatening. Others are very annoying and difficult to handle. Thus, the main reason for stopping Flomax is the onset of an adverse event after taking the drug.

Also, your doctor may recommend discontinuing the treatment if you are receiving Flomax for your enlarged prostate and need cataract surgery. If you continue taking it, Flomax may cause a complication known as intraoperative floppy iris syndrome. 

Other patients may need to discontinue Flomax after reducing their urinary symptoms. Some patients may need to take drugs that will interact with tamsulosin. For example, the antidepressant paroxetine changes the way your body metabolizes tamsulosin. Combining it with erectile dysfunction drugs may lower your blood pressure. Moreover, some blood pressure medications may also interact with tamsulosin (2).

The above are valid medical reasons to stop taking tamsulosin. Still, it would help if you talked to your doctor before discontinuing your treatment or changing your dose. 

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How to stop taking Flomax (Tamsulosin) safely

Flomax is a prescription medication, and it should be taken following medical advice. Stopping Flomax should also be guided by your doctor to reduce the risk of worsening urinary symptoms. 

Your doctor should also know if you stop taking tamsulosin because it interacts with other medications. So, if you are taking multiple drugs, your doctor probably adjusted the dose based on this interaction.

Moreover, the study reviewed above shows that patients receiving combination therapy have better results after stopping tamsulosin. Then, your doctor could make changes to your treatment for a few weeks before discontinuing Flomax. 

As noted, the first recommendation is to communicate to your doctor your decision and receive medical advice.

According to the Japanese study mentioned above, patients with successful discontinuation of tamsulosin had the following common traits:

  • They only required a single tamsulosin dose of 0.2 mg
  • They initially had mild or moderate urinary tract symptoms
  • At the moment of discontinuation, they had a significant improvement in their symptoms
  • They didn’t have severe prostatic hyperplasia

The patients discontinued the treatment under these circumstances and required no dose reduction in preparation (3).

However, some doctors would prefer to discontinue Flomax over days or weeks, reducing the dose gradually and monitoring your blood pressure.

How long does Flomax stay in your system after stopping?

Flomax has a half-life of 9 to 15 hours. In other words, it is metabolized by your liver in this time frame. After being metabolized, it is converted into an inactive substance and excreted in the urine. Thus, you could say that most patients will still have Flomax in their system for no more than 15 hours after the last dose.

During this time, tamsulosin will reach the prostate tissue and keep relaxing the urethra. No studies have been made to determine if tamsulosin will be detected in your saliva, urine, and hair for longer than its half-life.

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Flomax withdrawal

A withdrawal syndrome is defined as a set of signs and symptoms that show up after discontinuing treatment. The withdrawal symptoms are very pronounced in some drugs, as in opioids and antidepressants. These medications often cause a rebound effect, and patients experience worse symptoms than they initially tried to relieve.

Flomax is different in this regard. The withdrawal syndrome only features a return of BPH symptoms in some patients. Not all will experience this effect, though. 

Prevalence is different across studies and is around 30% at 24 weeks. However, some patients may experience a temporary worsening of the symptoms at four weeks.

This symptomatic worsening may include:

  • Nocturia: An increase in urinary frequency at night that wakes up patients repeatedly.
  • Increased urinary frequency: This symptom is measured throughout the day, contrary to nocturia.
  • Urinary urgency: A sudden urge to urinate that isn’t easy to control
  • Terminal dribbling: After the main urinary stream is over, you keep dribbling urine, and it will probably stain your clothes.
  • Interrupted and weak urinary stream: The stream is not thick and can be interrupted and resumed at times.
  • Difficulty starting to urinate: Patients will probably need to push hard before starting the urinary stream.

As noted, Flomax’s side effects after stopping treatment depend on various factors. For example, the risk reduces significantly if you receive additional treatment for your BPH symptoms.

Interactions with Other Medications

  • Alpha-Blockers: Tamsulosin belongs to the class of alpha-blockers, and concurrent use with other medications in this class may lead to an additive effect, potentially causing excessive blood pressure reduction or increased side effects.
  • Antihypertensive Medications: Tamsulosin can interact with antihypertensive drugs, leading to a further drop in blood pressure. Close monitoring is essential when using tamsulosin alongside medications intended to lower blood pressure.
  • Phosphodiesterase-5 Inhibitors (PDE5 Inhibitors): There is a potential for interactions with drugs like sildenafil or tadalafil, commonly used for erectile dysfunction. Combining tamsulosin with PDE5 inhibitors may result in a significant drop in blood pressure.
  • CYP3A4 Inhibitors: Tamsulosin is primarily metabolized by the cytochrome P450 3A4 enzyme. Co-administration with medications that inhibit this enzyme, such as ketoconazole or ritonavir, can increase tamsulosin levels in the body, potentially leading to an increased risk of side effects.
  • CYP3A4 Inducers: Conversely, drugs that induce CYP3A4, like rifampin or St. John’s Wort, may reduce tamsulosin levels, affecting its efficacy. Adjustments to tamsulosin dosage may be necessary in such cases.
  • Warfarin and Anticoagulants: Tamsulosin may alter the metabolism of warfarin, an anticoagulant. Close monitoring of the International Normalized Ratio (INR) is recommended when these medications are used concomitantly.
  • Nitrates: Tamsulosin may enhance the hypotensive effects of nitrates, leading to a significant drop in blood pressure. Caution is advised when using these medications together.
  • Other Alpha-Adrenergic Blockers: Concurrent use of tamsulosin with other alpha-adrenergic blockers may result in increased side effects, such as dizziness or lightheadedness. This combination should be approached with caution and under medical supervision.
  • Selective Alpha-1A Receptor Antagonists: Tamsulosin specifically targets alpha-1A receptors. Concurrent use with other medications that also selectively block these receptors may lead to an additive effect, potentially increasing the risk of adverse reactions.

Flomax alternatives for prostate problems

What type of treatment can your doctor include as an alternative to Flomax?

Here’s a list of medications and natural alternatives worth trying (5):

  • Other alpha-blockers: Tamsulosin is a common medication for prostate cancer and benign prostatic hyperplasia. But it is not the only one. Other alpha-blockers with a similar effect include alfuzosin, doxazosin, silodosin, and terazosin.
  • Herbal treatment: Many natural options improve urinary flow and may help you maintain a good quality of life after stopping Flomax. They include Pygeum africanum and Saw palmetto, among others.
  • Lifestyle changes: You can also opt for a few lifestyle changes to relieve your symptoms. For example, you should consider limiting your alcohol and caffeine intake, controlling your weight, and trying bladder retraining to reduce the number of times you need to urinate every day.

Conclusion

Flomax’s side effects after stopping the medication are not life-threatening or deeply concerning. This medication is prescribed to control the symptoms of an enlarged prostate, and you’re expected to experience the symptoms again if you stop taking it.

However, some studies suggest that, after achieving symptomatic improvements, some patients may not need long-term therapy to maintain treatment success. Many patients do not experience a rebound effect, but only when certain conditions are met.

Thus, we encourage readers to talk about their BPH treatment with their doctor before making any changes or discontinuing altogether. Each patient may need a different strategy to reduce the risk of side effects and maintain a good quality of life.

Explore More

flomax alternatives

6 Natural Alternatives To Flomax.

Sources

  1. Dunn, C. J., Matheson, A., & Faulds, D. M. (2002). Tamsulosin. Drugs & aging, 19(2), 135-161. https://pubmed.ncbi.nlm.nih.gov/11950378/ 
  2. Lowe, F. C. (2005). Summary of clinical experiences with tamsulosin for the treatment of benign prostatic hyperplasia. Reviews in Urology, 7(Suppl 4), S13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1477611/ 
  3. Kobayashi, M., Tokue, A., & Morita, T. (2006). Discontinuation of tamsulosin treatment in men with lower urinary tract symptoms: a pilot study. Urologia internationalis, 76(4), 304-308.  ​https://pubmed.ncbi.nlm.nih.gov/16679830/ 
  4. van der Worp, H., Jellema, P., Hordijk, I., Lisman-van Leeuwen, Y., Korteschiel, L., Steffens, M. G., & Blanker, M. H. (2019). Discontinuation of alpha-blocker therapy in men with lower urinary tract symptoms: a systematic review and meta-analysis. BMJ open, 9(11), e030405. https://pubmed.ncbi.nlm.nih.gov/31699724/
  5. Sun, J., & Zhang, X. (2014). Pharmacotherapy and herbal treatment of benign prostatic hyperplasia. Frontiers in Bioscience (Landmark Edition), 19, 789-797. https://pubmed.ncbi.nlm.nih.gov/24389223/

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