Tamsulosin: Side Effects and Risks In The Elderly

If you are over 60s and have been prescribed Tamsulosin (Flomax generic) for benign prostatic hyperplasia (BPH), you might want to know more about potential Tamsulosin side effects in the elderly. 

This and similar conditions feature an enlarged prostate and lower urinary tract symptoms. 

One of the most common treatments is Tamsulosin. But is it a harmless drug? Is there anything you need to know before taking it for your prostate health?

Like any other drug, using tamsulosin may give you side effects. 

Not all patients experience them, but it is essential to be aware of them before starting treatment. 

This article will review all of the side effects of Tamsulosin with particular emphasis on the elderly. Are tamsulosin side effects in the elderly different compared to younger patients?

What is tamsulosin?

Tamsulosin is commonly known by its commercial name Flomax. It is an anticholinergic medication for benign prostatic hyperplasia. 

Tamsulosin blocks nerve receptors in muscle cells to make them less reactive to stimulation. The muscle tissue relaxes, and lower urinary tract symptoms improve.

Tamsulosin as a Flomax generic, works with very specific receptors in very specific cells. So, it is meant to relax the smooth muscle tissue of the urinary tract and a few other cells. However, a tamsulosin oral capsule can also trigger muscle relaxation in other organs. That is where side effects come from.

BPH medication is useful for treating a variety of other conditions. It may also provide relief in patients with an overactive bladder. Some studies also suggest that tamsulosin helps eliminate kidney stones.

What are the side effects of tamsulosin in the elderly?

Tamsulosin is associated with a list of adverse effects. Most of them are common in young patients and older adults. 

Common Side Effects

These common side effects are usually not very intense. They can be temporary or last for a more extended period. 

It is recommended to report any of these to your doctor, even if they are not severe. If they last longer than one or two weeks, your doctor may choose an alternative medication.

Uncommon Side Effects that need further investigations

Other side effects are not so common. Among them, we have severe problems, as you can see in this list. 

If you experience any of these, talk to your doctor immediately (1,2):

  • Abnormal ejaculation 
  • A long-lasting and painful erection known as priapism
  • Low blood pressure
  • Visual problems
  • Allergic reactions with rash, hives, itching, fever, trouble breathing, or swelling of your throat.

Some patients also report erectile dysfunction. Also, some studies suggest that seniors may have an increased risk of dementia

Among these less common side effects, we should highlight blood pressure changes. Tamsulosin has a relative hypotensive effect. 

This means that taking this medication may lower your blood pressure. If you are already taking blood pressure medication, the effect adds up. The most common manifestation is orthostatic hypertension, which is felt as dizziness when changing your posture.

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Are the side effects of tamsulosin different in the elderly compared to younger patients?

Tamsulosin’s side effects in the elderly are usually the same compared to young patients. There are a few exceptions, however. 

For instance, an older adult is more likely to take a blood pressure medication. Thus, they have an increased risk of interaction with hypotensive drugs.

Older adults are more likely to suffer from cataracts. One of the treatments is cataract and glaucoma surgery, which causes floppy iris syndrome if you are being treated with alpha 1 blockers, including tamsulosin. Thus, doctors would recommend stopping the BPH medication before moving ahead with the surgery.

Another difference between the elderly and younger patients is their dementia risk. They all experience some cognitive decline as a part of aging. But dementia is a more severe problem that affects their close relationships and daily living. 

Recent studies suggest that taking tamsulosin for an extended period may increase the risk of dementia in seniors. Thus, doctors may recommend discontinuing BPH medications after some time instead of leaving tamsulosin as a life-long treatment in older adults.

Still, the evidence linking tamsulosin with dementia risk is insufficient. There are many incongruities in the studies. Thus, these studies should be repeated in longer intervals to confirm the findings  (3,4).

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How long can you be on tamsulosin?

As noted, tamsulosin’s side effects in the elderly may include an increased risk of dementia. This only happens when you take tamsulosin as a long-term treatment. 

So, how long can you take tamsulosin as an older adult without increasing your risk?

A 2018 review published in Current Urology Reports, evaluated the risk of dementia in seniors taking tamsulosin. They brought together many other studies and analyzed their findings.  They found that men taking tamsulosin have a higher risk of developing dementia when compared to men taking other α-adrenergic antagonists or no α-adrenergic antagonists. 

However, the follow-up period of the most recent research was only 18 months. After this time, they found a significant increase in dementia and other cognitive impairments (2).

Another study had a longer follow-up, and the investigators found a significant association only between 48 and 72 months of follow-up. 

As noted, the studies so far do not provide clear evidence about how long to take tamsulosin. But some urologists may decide to discontinue BPH treatment after 2-5 years. There are many cases of successful discontinuation in patients who have already found relief of their lower urinary tract symptoms (4).

What drugs should not be taken with tamsulosin?

The side effects of Tamsulosin in the elderly are often caused by drug interactions with medications they already consume. So, it is essential to take notes of the drugs you should not take with this oral capsule. 

There are moderate interactions where medications should be taken with care. There are also severe interactions where your doctor may decide to use alternative medications.

Moderate interactions:

  • Verapamil, Dronedarone, Diltiazem: These medications increase the level of tamsulosin in the blood. There is a higher risk of postural hypotension and a drop in blood pressure. You can still take the medication under medical supervision if there is no replacement therapy.
  • Vardenafil, tadalafil, sildenafil, avanafil: They are alpha-blockers, and their mechanism is similar to that of tamsulosin. Thus, they will have an additive effect on your cardiovascular system. They lower your blood pressure when taken along with a benign prostatic hyperplasia medication. As a moderate interaction, you can still take these medications, but only under medical supervision.
  • Other blood pressure-lowering drugs: For example, benazepril and captopril.

Severe interactions:

  • Antiviral medications such as boceprevir, ritonavir, paritaprevir, dasabuvir, and ombitasvir.
  • Protease inhibitors and strong CYP3A4 inhibitors.

What happens when you stop taking tamsulosin?

It depends on various factors, and there is something called successful discontinuation. Some patients can stop taking tamsulosin without significant adverse effects. Others will experience the same symptoms they were trying to avoid with a BPH medication. 

One of the most feared side effects of stopping tamsulosin is acute urinary retention. It happens in severe cases of benign prostatic hyperplasia and prostate cancer. The enlarged prostate presses on the urethra and causes a severe urinary obstruction. 

More common symptoms include:

Ways to reduce the side effects of tamsulosin

The side effects of Tamsulosin in the elderly can be monitored if they take many drugs. However, it is possible to reduce the side effect of this medication in all patients with benign prostatic hyperplasia. 

Keep in mind these recommendations to reduce the incidence of tamsulosin side effects:

  • Report any change in your medication to your doctor, especially when it comes to blood pressure medications.
  • Do not take symptoms of dizziness lightly if they started after taking tamsulosin.
  • Ask your doctor before using erectile dysfunction drugs such as Viagra.
  • Discontinue tamsulosin before a cataract surgery as instructed by your doctor.
  • Follow your doctor’s advice if they recommend tamsulosin discontinuation.

Natural alternatives to tamsulosin

There are plenty of natural alternatives for benign prostatic hyperplasia. In some cases, patients with an enlarged prostate do not have a very severe condition. Thus, their symptoms improve with natural remedies only. 

In other cases, patients with a more severe prostate condition use natural remedies to go along with medical treatment for better results.

These supplements and herbs can help with your urinary tract symptoms in benign prostate hyperplasia:

Boron supplements

Boron is an interesting addition to your arsenal. It slows the progression of BPH and may also help control the urinary symptoms. 

Boron supplements are also known to prevent prostate cancer, and it is a trace mineral found naturally in many foods (5).



We should ideally get 90 mg of zinc every day. Doing so improves the immune system and counters inflammation in the prostate gland. 

There is some evidence that zinc triggers cell death in the prostate, which is positive in the case of BPH. It is probably why consuming zinc helps relieve the symptoms of an enlarged prostate (6).

Ellagic acid

This is also a component of many foods, and it is a powerful antioxidant. You can find it in berries, and it also triggers cell death in the prostate. As such, ellagic acid prevents prostate problems and may reduce prostate-related symptoms (7).


Stinging Nettle

This herbal remedy is commonly used to treat various prostate-related problems. It has scientific studies that confirm it improves urinary symptoms. 

Stinging nettle is known to help patients achieve complete bladder emptying. It may help eliminate the sensation of incomplete voiding (8).


It contains a substance known as curcumin, which has potent anti-inflammatory properties. It is useful to reduce prostate swelling and may also reduce the risk of prostate cancer. As such, it is a suitable alternative to tamsulosin that treats the problem instead of only relieving the symptoms (9).

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Saw Palmetto

This is likely one of the most popular plants for BPH patients. It contains many flavonoids and essential fatty acids known to control prostate inflammation. This herb reduces the incidence and severity of urinary tract symptoms (8, 10).


The side effects of Tamsulosin in the elderly are very similar compared to younger adults. However, consider that older adults are more likely to use blood pressure drugs and others that interact with this medication.

Some studies suggest a likely increase in the dementia risk when tamsulosin is taken as a long-term treatment. However, more research is needed to confirm this as a side effect. Remember, before taking medication it is important to talk to a health care professional.

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what drugs should not be taken with tamsulosin

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  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. Frankel, J. K., Duan, Y., & Albertsen, P. C. (2018). Is tamsulosin linked to dementia in the elderly?. Current urology reports, 19(9), 1-6. https://pubmed.ncbi.nlm.nih.gov/29971698/ 
  4. Andrade, C. (2018). How to read a research paper: an exercise in critical thinking in the context of an epidemiologic study on tamsulosin and the risk of dementia. The Journal of Clinical Psychiatry, 79(6), 8357. https://pubmed.ncbi.nlm.nih.gov/30549500/ 
  5. 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/ 
  6. Cui, Y., Winton, M. I., Zhang, Z. F., Rainey, C., Marshall, J., De Kernion, J. B., & Eckhert, C. D. (2004). Dietary boron intake and prostate cancer risk. Oncology reports, 11(4), 887-892. https://pubmed.ncbi.nlm.nih.gov/15010890/ 
  7. Feng, P., Li, T. L., Guan, Z. X., Franklin, R. B., & Costello, L. C. (2002). Direct effect of zinc on mitochondrial apoptogenesis in prostate cells. The Prostate, 52(4), 311-318. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4465826/ 
  8. Bell, C., & Hawthorne, S. (2008). Ellagic acid, pomegranate and prostate cancer—a mini review. Journal of Pharmacy and Pharmacology, 60(2), 139-144. https://pubmed.ncbi.nlm.nih.gov/18237460/ 
  9. Koch, E. (2001). Extracts from fruits of saw palmetto (Sabal serrulata) and roots of stinging nettle (Urtica dioica): viable alternatives in the medical treatment of benign prostatic hyperplasia and associated lower urinary tracts symptoms. Planta Medica, 67(06), 489-500. https://pubmed.ncbi.nlm.nih.gov/11509966/ 
  10. James, M. I., Iwuji, C., Irving, G., Karmokar, A., Higgins, J. A., Griffin-Teal, N., … & Morgan, B. (2015). Curcumin inhibits cancer stem cell phenotypes in ex vivo models of colorectal liver metastases, and is clinically safe and tolerable in combination with FOLFOX chemotherapy. Cancer letters, 364(2), 135-141. https://pubmed.ncbi.nlm.nih.gov/25979230/
  11. Barry, M. J., Meleth, S., Lee, J. Y., Kreder, K. J., Avins, A. L., Nickel, J. C., … & McCullough, A. (2011). Effect of increasing doses of saw palmetto extract on lower urinary tract symptoms: a randomized trial. Jama, 306(12), 1344-1351. https://pubmed.ncbi.nlm.nih.gov/21954478/

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