Switching From Tamsulosin To Alfuzosin: How To Safely Change Drugs

Tamsulosin (brand name Flomax) and Alfuzosin (brand name Uroxatral) are medications used to treat symptoms of an enlarged prostate in men, along with lower urinary tract symptoms (LUTS). 

Both medications help to ease symptoms of an enlarged prostate by relaxing the muscles around the bladder and prostate gland. 

According to the National Institute of Diabetes and Digestive and Kidney Diseases, BPH affects around 50% of men between the ages of 51 and 60 and up to 90% of men over the age of 80. 

If you’re diagnosed with BPH and take tamsulosin, how can you safely change to alfuzosin to treat your symptoms? 

In this article, we’ll review the considerations for switching from tamsulosin to alfuzosin, conversion dose, and safety tips.

Can you switch from Tamsulosin to Alfuzosin?

Yes. Because tamsulosin and alfuzosin work similarly (they are both alpha-blockers), it’s possible to switch from tamsulosin to alfuzosin and vice versa. 

If you’re taking tamsulosin and want to transition to alfuzosin, you’ll need to consult your healthcare provider to determine if alfuzosin is a good option for you. 

You need a prescription for both medications and should only switch under the guidance of your healthcare provider.

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Tamsulosin to Alfuzosin conversion dose

The typical starting dose of tamsulosin is 0.4 milligrams 30 minutes after the same meal each day. If that dose isn’t enough to treat your symptoms, then the dose can be increased to 0.8 milligrams once daily.

Alfuzosin is only available as an extended-release tablet. The dose is 10 milligrams per day immediately following a meal.

If you’re switching from tamsulosin to alfuzosin, your healthcare provider will help guide you on how to convert your dose. 

Alfuzosin can have a greater impact on your blood pressure compared to tamsulosin (especially among elderly patients), so you shouldn’t change drugs without consulting your prescribing healthcare provider. 

Why do people change from Tamsulosin to Alfuzosin?

There are many potential reasons for switching from tamsulosin to alfuzosin. Some of these reasons can include:

Side effects

Tamsulosin and alfuzosin have similar rates of side effects. One study noted that both medications have the “lowest propensity to cause side effects” among other medications used to treat BPH.

Some of the most common side effects of tamsulosin and alfuzosin are:

  • Dizziness
  • Weakness
  • Headache
  • Postural hypotension (a drop in blood pressure upon standing)
  • Fainting
  • Rhinitis (nasal congestion, runny nose, sneezing)
  • Ejaculation abnormalities

Between the two medications, alfuzosin appears to have a lower likelihood of causing ejaculation issues, so it might be preferred for more sexually active patients. 

This factor alone is one reason patients might switch from tamsulosin to alfuzosin.

Drug allergies

While drug allergies to antibiotics (like penicillin) are the most common, it’s possible to be allergic to any medication. 

If you’re allergic to tamsulosin, your healthcare provider might recommend you try alfuzosin. Drug allergies, especially serious ones, are rare for both tamsulosin and alfuzosin.

Efficacy

Studies have found that tamsulosin and alfuzosin are comparable in terms of their efficacy. According to one study, “Tamsulosin was found to be as effective as alfuzosin in [reducing symptoms of BPH], except for sexual side effects.” 

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Cost/insurance coverage

The cost for tamsulosin and alfuzosin will vary depending on the pharmacy you use, your insurance coverage, and any coupons you might have access to.

According to GoodRx at the time this article was written, these are the average out-of-pocket cost ranges at popular pharmacies in the United States (Walgreens, Costco, CVS, etc.):

  • Tamsulosin – 30-day supply of 0.4 milligram tablets: $12-$22
  • Alfuzosin – 30-day supply of 10-milligram tablets: $12-$36

If your healthcare insurance or prescription drug coverage prefers one drug over the other, then the preferred medication will be less expensive for you. 

If a healthcare insurance prefers alfuzosin over tamsulosin, then it’s likely that patients will opt for the preferred drug since the out-of-pocket cost will be lower.

Blood pressure considerations

Alfuzosin is more likely to impact blood pressure levels compared to tamsulosin, especially in elderly patients. 

According to a small study, alfuzosin doesn’t impact blood pressure levels among young, healthy men.

If you have a history of low blood pressure (especially if you’re older), then alfuzosin might not be the ideal medication for you. 

On the other hand, if you suffer from high blood pressure (hypertension), then it could be a benefit to take alfuzosin vs tamsulosin

One study concluded that taking alfuzosin alone or combined with a blood pressure medication lowered blood pressure among patients with uncontrolled hypertension. 

That means that if you’re already taking blood pressure medication, then adding alfuzosin can lower your blood pressure even more. 

For that reason, it’s important to monitor your blood pressure upon adding alfuzosin to your medication regimen. 

If you have any symptoms of low blood pressure (hypotension), then reach out to your healthcare provider for guidance.

Some common symptoms of low blood pressure can include lightheadedness, blurred vision, confusion, fainting, and nausea.

Things to consider when switching from Tamsulosin to Alfuzosin

As mentioned earlier, there are a few things to consider when switching from tamsulosin to alfuzosin. Some of the main considerations include:

CostAlfuzosin might be more expensive than tamsulosin, depending on the pharmacy you use and your insurance coverage.
Side effectsAlfuzosin might be less likely to cause sexual side effects than tamsulosin. It also appears to have a greater impact on blood pressure than tamsulosin, which can be positive or negative depending on your typical blood pressure levels.
EfficacyAlfuzosin and tamsulosin have similar efficacy in treating BPH symptoms. However, you might have better results with one medication over the other.

How to safely titrate from Tamsulosin to Alfuzosin

When switching from tamsulosin to alfuzosin, your healthcare provider will offer guidance on how to safely titrate (adjust the dose) of the medications. 

Does alfuzosin work better than tamsulosin?

Alfuzosin and tamsulosin have similar effectiveness in treating symptoms of BPH. Alfuzosin may have a lower risk of sexual side effects and appears to have a greater impact on blood pressure levels compared to tamsulosin.

Can you take Tamsulosin and Alfuzosin on the same day?

It’s not recommended to take tamsulosin and alfuzosin both on the same day. They act in similar ways, so taking both can increase your risk of side effects, some of which can be dangerous, like low blood pressure.

If you need to switch from tamsulosin to alfuzosin, your healthcare provider will likely suggest that you discontinue tamsulosin and begin taking alfuzosin the next day or within a few days. 

The half-life of tamsulosin is around 14-15 hours, which means that half of the dose will remain in your system for around 15 hours after you take it. 

It takes several days for all of the medication to be cleared from your system after your last dose, which is one reason healthcare providers may suggest waiting a day or two before starting a new medication.

Ben’s Natural Flomax Alternative: Total Health

Ben’s Total Health for The Prostate is an all-natural, clinical-grade, prostate-relief supplement formulated to help lower your PSA, shrink your prostate, and relieve urinary symptoms. 

It has a complete spectrum of 21 vitamins, 69 trace minerals, and natural herbs developed for the nutritional demands of men.

Clinical trials and meta-studies show that the active ingredients in Total Health for The Prostate have a positive impact on prostate volume, improve lower urinary tract symptoms, increase peak urinary flow, and decrease the risk of acute urinary retention.

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Total Health contains 825mg of beta-sitosterol, the most effective and clinically proven natural Flomax substitute for men with prostate problems. Beta-sitosterol has been shown in studies to improve urinary symptoms and acts as a natural inhibitor of the 5 alpha-reductase enzyme to shrink the prostate.

Another important ingredient in Total Health is quercetin. One study found that quercetin supplementation results in significant symptomatic improvement for men with impaired prostate health.

Conclusion

  • Tamsulosin and Alfuzosin are both alpha blockers, a type of medication that relaxes the muscles near the bladder and prostate gland in men. They are used to reduce symptoms of an enlarged prostate and lower urinary tract symptoms.
  • Tamsulosin and Alfuzosin have similar efficacy. Alfuzosin has a greater impact on blood pressure levels compared to tamsulosin and may have a slightly lower risk of causing sexual side effects.
  • Follow your prescribing healthcare provider’s guidance regarding switching from tamsulosin to alfuzosin. Avoid taking both medications at the same time, which can increase your risk of unwanted side effects.

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Ben’s Prostate Supplement: Total Health for the Prostate.

Sources

  1. Urology Care Foundation. Benign Prostatic Hyperplasia (BPH).
  2. National Institute of Diabetes and Digestive and Kidney Diseases. Prostate Enlargement (Benign Prostatic Hyperplasia).
  3. Chapple CR. A Comparison of Varying alpha-Blockers and Other Pharmacotherapy Options for Lower Urinary Tract Symptoms. Rev Urol. 2005;7 Suppl 4(Suppl 4):S22-30. PMID: 16986051; PMCID: PMC1477612.
  4. Agrawal MS, Yadav A, Yadav H, Singh AK, Lavania P, Jaiman R. A prospective randomized study comparing alfuzosin and tamsulosin in the management of patients suffering from acute urinary retention caused by benign prostatic hyperplasia. Indian J Urol. 2009 Oct-Dec;25(4):474-8. doi: 10.4103/0970-1591.57917. PMID: 19955671; PMCID: PMC2808650.
  5. Buzelin JM, Fonteyne E, Kontturi M, Witjes WP, Khan A. Comparison of tamsulosin with alfuzosin in the treatment of patients with lower urinary tract symptoms suggestive of bladder outlet obstruction (symptomatic benign prostatic hyperplasia). The European Tamsulosin Study Group. Br J Urol. 1997 Oct;80(4):597-605. doi: 10.1046/j.1464-410x.1997.00205.x. Erratum in: Br J Urol 1998 Mar;81(3):510. PMID: 9352699.
  6. Mondaini N, Giubilei G, Ungar A, Gontero P, Cai T, Gavazzi A, Bartoletti R, Geppetti P, Carini M. Alfuzosin (10 mg) does not affect blood pressure in young healthy men. Eur Urol. 2006 Dec;50(6):1292-6; discussion 1297-8. doi: 10.1016/j.eururo.2006.06.016. Epub 2006 Jun 28. PMID: 16837126.
  7. Zhang LT, Lee SW, Park K, Chung WS, Kim SW, Hyun JS, Moon DG, Yang SK, Ryu JK, Yang DY, Moon KH, Min KS, Park JK. Multicenter, prospective, comparative cohort study evaluating the efficacy and safety of alfuzosin 10 mg with regard to blood pressure in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia with or without antihypertensive medications. Clin Interv Aging. 2015 Jan 17;10:277-86. doi: 10.2147/CIA.S74102. PMID: 25653511; PMCID: PMC4303366.

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