I was prescribed Tamsulosin for enlarged prostate and shortly after I had my first episode of AF.
This went on for about 8 years getting AF approximately once a month which lasted about 6 to 8 hours. Anyway, three years ago I went privately to see a Urologist who after several tests and scans said that I did not need to be on Tamulosin. I stopped taking it three years ago and I have not had an episode of AF. Having recently Googled Tamsulosin and atrial fibrillation it would seem that there might be a connection, the adverse effects on the printed leaflet with Tamsulosin contained one clause stating "could cause irregular heart beats".
I am surprised that there has not been further investigation into this possible linkage.
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lofty1
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Good to know this as I have been on these types of medication for years. Trying all types and mixtures. At the moment I am on vesomni a mix of tamsulosin and another medication. After having had Prostate Cancer back in 2016 with Hormone Treatment and a month of radiotherapy I do wonder whether or not at this stage I also need the tamsulosin. Something to think about for my next urology check. I was at my best when my Af journey started when taking "water tablets" as although it meant I was urinating frequently in the few hours after taking them I didn't go to the lavatory so much later in the day and at night.
Most studies, investigations are funded by drug companies who are not keen on funding enquiries into the adverse events of their money making drugs. Same thing happened to me after the second dose of an anti inflammatory called Celebrex . What I did was report it myself . It is the yellow card system you can Google it and report it to the MHRA yourself as doctors often don’t report it
Well, I have been on similar drugs, first doxazosin, then alfuzosin, and I knew there was a link but hadn't really thought much of it, so what you say is interesting. I was switched to tamsulosin recently, too. It's a standard drug and most people are said to be fine with it, so I wouldn't be critical of your doctor. Only a minority of people have issues with drugs, relatively speaking as they are tested very heavily before being prescribed. I used to work in the industry and still have great faith in it, overall.
I'm finding that tamsulosin certainly works okay in the daytime quite well for me, but nighttime is a major issue with having to get up regularly to have a wee!
My permanent AF started a couple of months after I started taking Tamsulosin. I think I'd had undiagnosed paroxysmal AF previously but I can't be sure. AF was diagnosed after several episodes of syncope (passing out).
My suspicion, based entirely on my own experience, is that, if you have a propensity for AF, Tamsulosin can make it a reality. I'm not sure it 'causes' it - but the effect isn't very different....
As part of a GP review and complaints about frequent peeing at night I was switched from Doxazosin to Tamsulosin about a year ago. Supposedly this would also help my enlarged prostate, although the last physical examination showed nothing to worry about for a man of my age (72)! I have really started to question this as still frequent trips at night, with poor flow, although no symptoms during day. Also confused as leaflet in pack says must be taken after breakfast, but GP specifically prescribed take one around 6-8 pm. Leaflet says always take exactly as doctor has told you, so I have done. Think I should check this again, it all seems a bit dubious, should I be on it anyway? RLS seems to be more bothersome than ever.This possibly all links to my medications for paroxysmal AF, and the frequent RLS (although that's been going on for years). Oh, and diabetes as well, which has insinuated itself into how my body works. Too many suspects at play here.
I have recently switched to tamsulosin from alfuzosin and find my nocturnal loo visits have, if anything, worsened - pretty dreadful, really as I also have insomnia. I’ve tried changing them about but to no effect. My bladder seems linked to my bowel issues though, as I easily get mildly constipated and that most definitely seems to make it all worse.
I have been taking tamsulosin for approx 10 years now. Seven years ago prostate cancer was successfully resolved by a course of radiotherapy (daily for about 6 weeks) together with hormone treatment. I was diagnosed with paroxysmal AF early in 2022, but I doubt tamsulosin was the cause.
I take 400mg of tamsulosin every morning with breakfast, which regulates my urine flow during the day, but loses its effect at night leading to 2 or 3 trips to the loo...... I asked my doctor if I could take a second tablet in the evening aswell. He said NO!!!!
I have BPH and was prescribed Tamsulosin back In Jan 2023. I have PAF and have irregular events but its manageable. About 3 days after starting Tamsulosin, I had 6 consecutive days of AF events. Many at a high heart rate of 140+. Really unpleasant. I stopped the Tamsulosin and consulted my EP. He noted that Tamsulosin was an Alpha blocker and I was already on a Beta blocker. He agreed that Tamsulosin should not have been prescribed to an AF sufferer without prior discussion with a cardio or EP.
I’m going to expand on the tamsulosin question, and possible relation to AF, as I am about (?) to begin that route, for the obvious reasons!
Tamsulosin (Flomax) is an ⍺-1A and ⍺-1B antagonist (blocker). The “A” variety is in the prostate where it will relax smooth muscle, which is desired in our condition. The “B” variety is in the blood vessels, and blocking those will cause dilation of them and subsequent lowering of blood pressure (in theory, anyway!). This is probably why a doc may question its use along with a β-blocker? Flomax will not shrink an enlarged prose, but merely relax the muscles that control urinary flow. (In theory).
A complementary product, dutasteride (Avodart) is often prescribed along with tamsulosin. (A combination pill, Jalyn, by GSK is available). Dutasteride is an 5-⍺-reductase inhibitor, which inhibits the production of dihydrotestosterone, the active form of testosterone. As such it will slow the growth of prostatic tissue, and actually can shrink the prostate. (Again, in theory!). Of course, by combining the two drugs, you get to double the side effects!!
Pretty complicated stuff just to make me pee faster!!
Unfortunately, finasteride and similar, although they do shrink an enlarged prostate, and significantly, I was told by a urologist, rarely improve flow. i gather this is perhaps because the impedance of flow is often not directly caused by the enlarged size of the prostate but perhaps more by the way it presses inwardly against the urethra, especially when lying down at night. My other belief is that the bowel, which naturally pushes up tightly against the bladder and prostate, is somehow involved.
A neighbour told me a while back that his GP has prescribed him a small dose of sildenafil (I.e. Viagra when in larger doses) for night time urinary frequency and it is helping.
Thanks for that link. I notice that the dosage is the same as its other uses, so I'm intrigued by that (I know little about this drug only from the popular media). I'll ask my neighbour next time I see him. It can't be well known for the LUTS use in the UK as I've asked my GP more than once if there's anything else apart from the alpha blockers, and he said not. I wonder if it's safe with arrhythmias as it is a heart drug, I believe.
Steve: I'm attaching a very long and detailed article from the journal "Circulation" with addresses the heart issues, sort of. Main concern seems to be concomitant usage with nitrates, as this may precipitate a blood pressure crash. From a brief scan (which means skipping over the real techy stuff, LOL!), Viagra is a selective and reversible PDE5 inhibitor with a 4,000 fold selectivity over PDE3 inhibition. As there is little/no PDE5 activity in the heart proper, but mainly PDE3, then theoretically any effects should be minimal. In theory, but not conclusively proven.
As an aside, the dose for the urinary issue (50mg) does seem to be more than the "very small dose" your neighbor told you about-the recommended dose for ED is 100mg. Perhaps the 50mg dose would provide a 50% erection, which to be honest, at my age I am happy with! JimF
Thanks for that but at the moment all I am getting is the login page from the link. I am guessing that my neighbour was slightly embarrassed to mention it, hence the way he coached his comment. I'll ask him the next time we meet, though, as my night time troubles have worsened since a small op on my rear end for a harmless but troublesome polyp has, although been a wonderful success, has also managed to make by constipation issues rather worse. What a life at times. Oh to be young again!
Hmm, when I click the link I'm automatically logged as a "guest". Just as well, any article that starts with an "Executive Summary" is too long to begin with! But anyway, follows a few paragraphs from that summary about cardio risk:
JimF
From "Circulation" 99:1, 1999-
>>Reported cardiovascular side effects in the normal healthy population are typically minor and associated with vasodilatation (ie, headache, flushing, and small decreases in systolic and diastolic blood pressures). However, although their incidence is small, serious cardiovascular events, including significant hypotension, can occur in certain populations at risk. Most at risk are individuals who are concurrently taking organic nitrates.<<
>>Other patients in whom the use of Viagra is potentially hazardous include those with active coronary ischemia; those with congestive heart failure and borderline low blood volume and low blood pressure status; those with complicated, multidrug, antihypertensive therapy regimens; and those taking medications that may affect the metabolic clearance of Viagra. <<
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