Autonomic Nervous System Regulation

4.10 Alpha-1 Antagonists

Tamsulosin is an Alpha-1 antagonist.

Mechanism of Action:  Tamsulosin selectively blocks alpha receptors in the prostate, leading to the relaxation of smooth muscles in the bladder, neck, and prostate, thus improving urine flow and reducing symptoms of benign prostatic hypertrophy (BPH).

Indications for Use: Tamsulosin is used to treat BPH.

Nursing Considerations Across the Lifespan: Alpha-1 antagonists are not recommended for children under the age of 2 years old.  They are safe to use in older adults, but dose adjustments need to be made based on kidney function.  There is limited information about whether alpha-1 antagonists, such as tamsulosin, can be used in pregnancy.

Avoid using with other alpha-blockers. Tamsulosin is contraindicated with strong CYP3A4 inhibitors such as ketoconazole. Assess and monitor blood pressure, especially after first dose because tamsulosin may cause orthostatic hypotension.

Patient Teaching & Education: Advise clients to change positions slowly because the drug may cause orthostatic blood pressure changes.  Additionally, the client should take the medication at the same time each day.  The client should follow up with their healthcare provider to assess the effectiveness of the medication.[1]

Tamsulosin Medication Card

Now let’s take a closer look at the medication grid on tamsulosin.[2][3] Because information about medication is constantly changing, nurses should always consult evidence-based resources to review current recommendations before administering specific medication.

Medication Card 4.10.1: Tamsulosin

Class: Alpha-1 Antagonist

Prototypes: Tamsulosin

Therapeutic Effects

  • Relaxes smooth muscle in bladder/prostate to improve urine flow

Administration

  • PO
  • should be administered ~30 minutes following the same meal each day.
  • avoid using with other alpha-blockers

Indications

  • Benign prostatic hyperplasia: Treatment of signs and symptoms of benign prostatic hyperplasia (BPH)
  • Off-label use in chronic prostatitis/chronic pelvic pain syndrome in males; lower urinary tract symptoms in males; ureteral calculi expulsion; ureteral stent-related urinary symptoms.

Side Effects

  • orthostatic hypotension
  • ejaculation failure
  • infection
  • dizziness
  • headache
  • rhinitis

Nursing Considerations

  • Monitor blood pressure, especially after first dose
  • Advise client to change positions slowly

  1. uCentral from Unbound Medicine. https://www.unboundmedicine.com/ucentral
  2. This work is a derivative of Daily Med by U.S. National Library of Medicine in the public domain.
  3. UpToDate (2021). Tamsulosin. https://www.uptodate.com/contents/search

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Fundamentals of Nursing Pharmacology - 1st Canadian Edition Copyright © 2023 by Chippewa Valley Technical College; Amanda Egert; Kimberly Lee; and Manu Gill is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

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