Flomax (tamsulosin), in recent medical advancement, has emerged as a potential treatment for kidney stones, repurposed from its original use in benign prostatic hyperplasia (BPH). But how effective is Flomax in treating kidney stones? Can it replace surgical procedures and other therapeutic options for this condition?
While small kidney stones may pass unnoticed, larger ones result in severe pain and distressing symptoms that lead individuals to seek immediate medical attention. Symptoms of kidney stones include flank pain, blood in urine, nausea, vomiting, and a burning sensation while urinating. The pain, often intense, can radiate to various parts of the body, sometimes accompanied by sweating and may signal the stone’s movement through the urinary tract (1)(2).
It is estimated that most people will experience symptoms of kidney stones at some stage in their lives. They form from calcium oxalate crystals or uric acid crystals.Not all cases of kidney stones exhibit all symptoms, but the presence of blood in urine is a crucial indication of stone passage or potential urinary tract injury (1).
For individuals considering Flomax (tamsulosin) as a treatment for kidney stones, understanding how does Flomax work in cases of kidney stones, the effectiveness, side effects, and its role in replacing traditional therapies is crucial.
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How does Flomax work for kidney stones?
Flomax is an alpha-blocker, and in the urinary tract, there are various forms of alpha-adrenergic receptors. These receptors link to smooth muscle. When they become activated would trigger muscle contraction.
This leads to a relaxation of the smooth muscle, that limits not only to the prostatic urethra but the rest of the urinary tract as well. This effect is more pronounced in the distal portion of the ureters and the bladder neck, areas with a higher concentration of alpha 1D receptors (4).
When kidney stones are working their way through the ureters, the smooth muscle typically contracts. This can lead to a risk of entrapment of the stone and limiting its progression through the urinary tract (5).
In these cases, Flomax mediates relaxation of smooth muscles in the ureters. This, in turn, improves the flow of urine and solves the obstruction triggered by kidney stones and aggravated by smooth muscle contraction.
This effect by tamsulosin would also reduce the consequences of mechanical obstruction in the urinary tract. Such as hydronephrosis (swelling of the kidney that results from a backward flow and accumulation of urine). And complete urinary obstruction (an emergency situation attended by the urologist) (6).
Recommend Dosage of Flomax for Kidney Stones
The standard dosage of Flomax for kidney stones is 0.4 mg, taken orally once a day, continuing until the passage of the stone.
Is Flomax an effective treatment for kidney stones?
Flomax (tamsulosin) is efficient in various studies. It can significantly reduce the time of the expulsion of these stones from the urinary tract.
Flomax for kidney stones
For instance, one study reports a 72% frequency of kidney stone expulsion in patients using Flomax against 30% in patients receiving placebo medications (7).
Studies have also revealed that Flomax is an effective treatment to eliminate kidney stones smaller than 10 millimeters (9).
Tamsulosin Significantly Reduces Passage Time for Kidney Stones
Studies show Tamsulosin can reduce elimination time in cases of kidney stones significantly. For example, one clinical trial reported that the elimination of kidney stones in a study took a mean of 7 days for the study group. This is in comparison to 9 days in patients who took placebo medications (7).
Moreover, in a subgroup of patients who had kidney stones smaller than 10 millimeters and located in the distal portion of the ureters, tamsulosin promotes expulsion of calculi in 4 days. This is in comparison to other traditional medications to manage kidney stones, which took a mean of 7 days (9).
Flomax is more useful for kidney stones located in the distal portions of the ureters. But, although lower, there’s still a significant reduction in elimination time for stones located in proximal areas of the urinary tract as well (10).
The role of Flomax to treat kidney stones also includes emergency settings.
More on What Research Says
According to various clinical trials performed over the years, elimination is more efficient with Flomax for ureteral calculi located in the distal portion of the ureters. This is the area where there is a higher concentration of alpha-adrenergic receptors (8).
Studies have evaluated the use of tamsulosin in patients with acute renal colic.
The results show that patients receiving tamsulosin in the emergency room have a lower requirement of pain medication and anesthetics. They also have a significant reduction in their hospital stay and lower the need for surgical removal (11).
These results of applying Flomax in the treatment of kidney stones may even lead to an estimated reduction of 29% in frequency of visits to the emergency department and a 24% reduction in healthcare expenses (12).
Alpha-Blockers for Stones Under 10mm
The 2016 American Urological Association guidelines for the management of stones indicates that alpha-blockers may be beneficial for stones that are less than 10mm. However, research is not conclusive on the use of tamsulosin in the treatment of kidney stones.
Recent research in the Journal of the American Medical Association concludes that tamsulosin was not effective in increasing the passage time for stones less than 9mm when compared with placebo.
Other treatment options for kidney stones
There are plenty of therapeutic strategies for kidney stones. And there are both pharmacological and surgical options to choose from. However, this depends on the size and location of the calculi (3).
Thiazide diuretics
They are commonly prescribed to encourage the urinary flow and reduction of urinary calcium that may reduce the recurrence of kidney stones in individual patients (2).
Potassium citrate
Should encourage in calcium stone-forming patients to reduce the risk of kidney stone recurrence. It also increases the urinary pH and reduces the formation of uric acid stones. Potassium supplementation may also be required when thiazide diuretics are prescribed (2).
Allopurinol
A drug employed to reduce the production and accumulation of uric acid. Doctors may prescribe it to patients with kidney stones, normal urinary calcium, and high levels of uric acid in the urine (2).
Dietary modifications
Patients are often encouraged to increase liquid intake throughout the day, reduce sodium consumption and non-dairy animal protein, aiming at 1,000 to 1,200 mg of dietary calcium per day. Reducing the use of oxalate-rich foods is more important than reducing the consumption of calcium sources (2).
Surgical measures
There are various minimally invasive and invasive procedures to clear kidney stones. These include extracorporeal shock wave lithotripsy, ureteroscopy, and percutaneous nephrolithotomy. Some of them require a postoperative ureteral stent, and the majority are outpatient procedures (3).
Conclusion
Flomax is now becoming an essential part of the treatment in cases of kidney stones. However, despite being commonly prescribed, it can have severe side effects that patients should know.
Flomax has the potential to interfere with a large number of medications to include warfarin and vasodilators. Therefore, it is imperative to speak with your doctor about any current medications you may be taking.
We know Flomax can induce relaxation of the smooth muscle in the urinary tract. It may also reduce the effect of entrapment that often leads to urinary obstruction in cases of kidney stones.
Guidelines for the management of stones indicate that alpha-blockers may be beneficial for stones that are less than 10mm. However, some research concludes that tamsulosin was not effective in increasing the passage time for stones less than 9mm in comparison to placebo.
Before taking Flomax, discuss both the benefits and the drawbacks of this medication with your doctor. Depending on the size of your kidney stones, it can be an effective treatment. But for smaller stones, dietary changes and reduce sodium intake may speed up the passing of kidney stones.
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