Evaluating a double dose of tamsulosin in the management of patients with BPH not responding to standard tamsulosin treatment

This study evaluated the effectiveness and safety of giving a double dose of tamsulosin (Flomax; 0.8 mg per day) to patients with benign prostatic hyperplasia (BPH) who did not respond to the standard tamsulosin dose (0.4 mg per day) and who could not have prostate surgery. The data showed that a double dose of tamsulosin was an effective and safe temporary option for these patients.

BPH is a non-cancerous condition where the prostate gland becomes enlarged. This causes urinary problems. These problems can include needing to urinate more frequently and needing to urinate more often throughout the night (nocturia).

Tamsulosin is a commonly used drug to help manage the symptoms of BPH. It works by relaxing the muscles around the bladder and prostate gland. However, some patients do not respond to the standard dose of 0.4 mg per day. When this happens, surgery to remove parts of the prostate (transurethral resection of the prostate, TURP) may be suggested. However, some of these patients may not be suitable for surgery if they have other medical conditions or if they decline. It is not known whether a double dose of tamsulosin is safe and effective for these patients.

This study included 111 patients with severe BPH symptoms. All patients did not respond to the standard tamsulosin dose of 0.4mg per day and were classified as unsuitable for TURP surgery. All patients received a double dose of tamsulosin (0.8 mg per day) for 1 month. Urinary symptoms and peak urinary flow rate (Qmax) were evaluated. Qmax is the highest flow rate achieved during urination, which is reduced in patients with BPH. Urinary symptoms were evaluated through the International Prostate Symptom Score (IPSS). A higher score means more severe symptoms.

93 patients reported improved urinary symptoms. The average overall scores of the IPSS improved from 24.03 to 16.41. The Qmax also improved from 7.72 to 12.08 ml/sec. Side effects included dizziness in 6 patients and abnormal ejaculation and decreased semen in 4 patients. 

This study concluded that a double dose of tamsulosin (0.8 mg per day) was safe and effective for the management of patients with severe BPH symptoms who were not suitable for prostate surgery or who did not respond to the standard tamsulosin dose.

This study had a small number of participants and only followed them for one month. Larger and longer-term studies are needed.