Tamsulosin, and interesting paper on genetic variants affecting side effects

[LAJ12345]

mdpi-res.com/d_attachment/i...

This is interesting in general because it is a case of drugs affecting people with different genetic variation differently.

Btw is anyone taking tamsulosin and how do you find it?

“1. Introduction

Nowadays, it is well recognized that genetic polymorphisms in genes coding for enzymes responsible for drug metabolism and drug disposition are of great importance for the efficacy and toxicity of medicines [1]. It is generally agreed that the cytochrome P450 (CYP) superfamily of enzymes, with more than 1000 isoenzymes, five of which (CYP3A4, CYP2D6, CYP2C9, CYP2C19, and CYP1A2) metabolize 90% of all drugs, contributes greatly to the metabolization of drugs in the human body. Identifying polymorphisms of these CYPs is mostly done to predict or explain drug target serum levels, e.g., a reduced CYP metabolism leads to increased serum drug levels and to increased toxicity. “

I feel this explains hubby’s severe side effects from most drugs. Doctors seem unaware. He has variations in cyp1a2, cyp2c9,cyp2d6

And this

nature.com/articles/jhg2012126

[Millbrook]

Here is an interesting article on how tamsulosin may potentate neurodegeneration

pubmed.ncbi.nlm.nih.gov/338...

My husband was on tamsuloxin for a month then changed to alfuzoxin.

[LAJ12345 in reply to Millbrook]

Interesting. He was needing a slight increase in madopar I thought so went to dr and he gave him a slow release madopar for night and this Tamsulin for night peeing and he is so bad now he is threatening to jump under truck . I’ve been going down rabbit holes all day trying to get to the bottom of it.

Looks like tamsulin is an alpha blocker and relaxes smooth muscles. He also take Kemadrin which is anticholergenic to offset side effect of madopar which also says it relaxes smooth muscles. Also zopiclone as he can’t sleep now which apparently interacts with Kemadrin. Grrrrr.

[Hikoi in reply to LAJ12345]

LAJ what side effects of Madopar does Kemadrin treat? I thought it was used for tremor.

[LAJ12345 in reply to Hikoi]

It is supposed to balance the pyramidal affects of other drugs. “Anticholinergics may help with rigidity, slowness of movement, tremor, speech and writing difficulties, gait, sweating, involuntary movements of the eyes and feeling depressed.” These are exactly his problems.

1/4 twice a day plus the rest of his supplements and he was excellent for 9 months until before Christmas and he has gone steadily downhill since despite no changes until the recent visit to the dr this week and now it’s even worse.

[Juliegrace in reply to LAJ12345]

I don’t know how old you and your husband are, but has he been checked for an underlying infection? I know I suggest this often, but UTIs in older people can go undetected and wreak havoc before they are treated. We have seen it repeatedly with my mom.

[LAJ12345 in reply to Juliegrace]

Hi, yes, I wondered that too and asked the dr to do urine test but it was all fine. So I really think it is the tamsulosin or the madopar slow release. He is 62

[Juliegrace in reply to LAJ12345]

After reading through your responses to Hikoi, it does seem like those two are the most likely culprits.

[LAJ12345 in reply to Juliegrace]

I stopped the tamsulosin yesterday so he had only had 2 and today he seems a little better. Last night he still had the night horrors so we'll see how that goes tonight

[Hikoi in reply to LAJ12345]

Thanks for your reply LAJ, I think it is all beyond my wee brain!But those problems he has are classic PD symptoms aren't they?

[LAJ12345 in reply to Hikoi]

I don’t know as he has never had them before and they appeared practically over a week of the new drugs. Apart from the wearing off that I took him to dr for in the first place, but even that went from him being better than he has been for years to much worse over just a few months.

[Hikoi in reply to LAJ12345]

LAJ I get more confused. You are saying your husband now has these symptoms - rigidity, slowness of movement, tremor, speech and writing difficulties, gait, sweating, involuntary movements of the eyes and feeling depressed and he never had them before. They started when he went on the tamsulosin and slow release madopar. Do I have it right?

[LAJ12345 in reply to Hikoi]

He had them a year ago as his worst problems although not terribly bad, just annoying. Then he went through very good period after a few months on the Kemadrin, plus cinnamon, Ambroxol , and rhodiola rosea as new things on top of his regular supplements. He was more normal than I have seen him for many years. Then he began to deteriorate before Christmas to the point a week or so ago I took him to the doctor. He was on 3 62.5 madopar per day and I felt they were wearing off before the end of the evening as by bedtime he couldn’t get up easily from a chair. He was now struggling to sleep too whereas the melatonin was enough before. Mainly because he needed to pee in the night but couldn’t get back into bed easily. So he would worry about having to pee and not being able to sleep. He started taking 1/2 a zopiclone sleeping pill in the middle of the night to get back to sleep, and had to have 1/4 clonazapam to calm himself.

Doctor put him on an overnight madopar, and tamsulosin and now he is suicidal, shaking all over about 2 hours after taking it, or if he eats. He is suicidal to the point I’m getting a locksmith to put locks on doors so he can’t escape in the night which is his threat at the moment. Something he is taking has made him 10x worse seemingly over night.

To be honest I feel the second dose of the vaccine was the start of his deterioration as he was seeming to be getting better and better before that. But that could be coincidental and not having it was not an option either as covid would have been worse I’m sure.

The symptoms he started Kemadrin for were stiffness and rigidity and tremor.

[Hikoi in reply to LAJ12345]

I do feel for him. I think his condition has worsened and he is on insufficient Levadopa. Personally I notice my condition may deteriorate slowly but then it is like I take a big step backward (or in your words I am 10xs worse overnight) and I may need to readjust everything but especially my Levadopa. Your husband is on 150mg Levadopa a day. I believe if that was increased to more like 600 - 800 day he would be in a much better place.

All the supplements in the world don't touch PD nearly as effectively as Levadopa. I find I can live with off phases as I know I will get on phases but living with PD and not getting any relief is like a living hell.

It is very difficult to get the medications right and can take a long time. There also may be an issue with the introduced drug Terazosin but I have had no experience of it. It doesn't t detract from the low dose of Levadopa he is on. It is very difficult being a carer.

"The symptoms he started Kemadrin for were stiffness and rigidity and tremor " - THE symptoms used to diagnose PD and all are improved / relieved with Levadopa.

[LAJ12345 in reply to Hikoi]

Yes but was when the extra levodopa was added with the tamsulosin the real problem started.

[Hikoi in reply to LAJ12345]

Well as I said my Parkinsons has progressed dramatically it seems like over night at times.

I don't know if it was long acting madopar, tamsulosin or natural progression that has had this effect on your husband but good on you for looking for the cause. You may be like me and never have a definitive answer to your question. You may just have to go with what you have and treat him for the symptoms he has now.

All I know is that we pwp have a lack of dopamine and without it we have problems with movement like getting getting out of chairs, we feel fatigued and weak, we loose motivation, we get depressed, we have anxiety attacks, we have sleep problems, we tremor, we have urinary urgency and constipation, and we have low or labile blood pressure, we have cognitive issues, we have hallucinations and nightmares and they all get progressively worse though at different speeds. It's certainly not a disease for the faint hearted!

[LAJ12345 in reply to Hikoi]

Yes, it’s just disappointing as he was actually seeming to be improving for a while😢

[Hikoi in reply to LAJ12345]

LAJ I only know what it is like to live with this unwelcome guest. You have the harder task of watching. I commend anyone who is a carer. Without you we pwp, are stuffed.

[LAJ12345 in reply to Hikoi]

Thanks but I’m sure you have the harder experience,

[Despe in reply to LAJ12345]

medicines.org.uk/emc/medici...

This link might help you understand the reason for his demise.

[LAJ12345 in reply to Despe]

He was only taking 1,25 mg x2 per day and has had 9 months feeling better than he has for years, and the usual maintenance dose is 10-30mg. I had read about the side effects and was worried but it is supposed to treat all the main problems he had before so we thought it was worth trying and it appeared to work. He has been on it well over a year now and has only started having these problems now the tamsulosin and slow release madopar has been added.

[Despe in reply to LAJ12345]

Some days, even weeks are/will be bad. . .personal experience. I am sure he will come around.

Do weather extreme changes affect his symptoms? We have been having extreme changes in weather (thunder storms, tornadoes, winds 60-70 mph) and these conditions have affected not only my husband but me, too.

[LAJ12345 in reply to Despe]

Not usually. He usually likes the sound of rain, and it hasn’t been windy or too hot.

[LAJ12345 in reply to Millbrook]

Is terazosin the same as tamsuloxin?

[JCRO in reply to LAJ12345]

Tamulosin vs. Terazosin on PD:

“Tamsulosin is another drug commonly used to treat enlarged prostate, but unlike terazosin {TZ), tamsulosin has no effect on cellular energy production, which the team’s lab studies suggest is important in terazosin’s protective effect. “ Source - medicine.uiowa.edu/content/... (Feb 2021).

Note TZ can cause fainting in certain circumstances (and there are other contraindications) so the switch between the two drugs has to be considered and monitored by your urologist.

BUT.

There’s been an update in April 2021 only two months later indicating that TZ may in fact not be disease modifying just that tamulosin makes things worse for people with PD - jci.org/articles/view/145112

Extract.

“CONCLUSION. These results suggest that zosins may not confer a protective effect against Parkinson disease, but rather that tamsulosin may in some way potentiate Parkinson disease progression.”

I’m not a doctor but I thought it best to make a switch from tamulosin to TZ a while back. I’ve tolerated the drug well. Hope this helps.

[LAJ12345 in reply to JCRO]

Thanks, I have sent to his dr, and stopped him taking it now. He had a better night last night.

[Millbrook in reply to LAJ12345]

No. It’s a distant cousin and does not have the bad effects of tamsuloxin. My husband takes xatral which is alfuzoxin. It improved his night urination but when I added Honopure it seemed to be even better. - better sleep n less night urination.

[LAJ12345 in reply to Millbrook]

What is honopure?

[Millbrook in reply to LAJ12345]

Honopure is manufactured by Econugenics and is Honokiol made from Magnolia Bark.

Bolt wrote an extensive post on Honokiol so much so that I dug it out of my supplement cupboard. I had read good things about it but hubby was already taking so many things it was put on the back burner.

[LAJ12345 in reply to Millbrook]

I know what you mean😅

[Despe in reply to LAJ12345]

Magnolia bark extract.

nootropicsexpert.com/magnol...

[MBAnderson]

I've been taking it for a couple years, but can't say much for it. I was hoping it would diminish night time peeing, but doesn't seem to do that. Maybe it's slowing progression. Who knows?

[sharron2]

My husband used Tamsulosin for years for enlarged prostate. As his orthostatic hypotension became worse this drug was discontinued for him. It helped some. He still took prostate meds, but he finally had laser surgery for his prostate and is off all prostate meds and is urinating (according to his surgeon) like a 15 year old and having much less OH. He is able to sleep through the night, often without needing to toilet and is emptying his bladder completely and quickly. I wanted this surgery to reduce the chance of UTI's, reduce sleep deprivation and shorten his time to urinate. All issues that could contribute to problems as his Parkinson's advances. I would recommend this to any PWP that is a candidate for this procedure as his quality of life has improved significantly since his surgery last June.

[LAJ12345 in reply to sharron2]

Thanks so much, I will ask neurologist today if he can refer him to urologist .

[Despe in reply to LAJ12345]

Me, too, although our FD suggested it. I am very excited now!

[sharron2]

The surgery my husband had is call TURP. Some people can do this on an outpatient basis, but my husband has multiple health issues (including being on blood thinners for a heart valve) and he was kept overnight for observation.

[LAJ12345 in reply to sharron2]

Where are you from?

[sharron2]

Near Dallas, Texas, USA.