Tamsulosin (Flomax) belongs to a class of drugs called alpha blockers. These drugs treat benign prostatic hyperplasia (BPH), also known as prostate enlargement, in men.

The prostate wraps around a man’s urethra. The urethra is the tube that urine flows through to leave the bladder and exit the body. As the prostate grows, it squeezes down on the urethra, making it harder to urinate. Flomax relaxes muscles in the prostate and bladder to help urine flow more easily.

Flomax can help with BPH symptoms, but it’s not for everyone. Certain men might not be able to take this drug. Keep reading to learn more about alternative treatments for BPH, plus who is and is not a good candidate for Flomax.

Flomax isn’t the only alpha blocker available to treat BPH. Some men may be able to take another alpha blocker. Doctors also prescribe four other drugs in this class to treat the symptoms of BPH:

These alpha blockers can interact with many of the same medicines that Flomax does. These medicines include high blood pressure and erectile dysfunction drugs. These drugs also have side effects and risks.

Some of the side effects common to alpha blockers include:

  • dizziness, especially when standing too quickly
  • nausea
  • headache
  • fatigue
  • trouble breathing or shortness of breath
  • sore throat
  • nasal congestion or frequent sneezing

Each of these medications also has unique side effects, so if you take one and find the side effects bothersome, talk to your doctor about trying another type of alpha blocker.

Alpha blockers aren’t right for everyone, though. If you have a history of liver or kidney disease, or low blood pressure, you may need to try a different type of medication to manage your BPH.

Read more: Find out about other traditional treatments for enlarged prostate »

If you’re unable to take alpha blockers, you may have other options. In addition to other prescription medications, like 5-alpha reductase inhibitors, a few complementary and herbal remedies are also used to treat the symptoms of BPH. However, it’s not clear how well these alternative treatments work.

Pygeum africanum

Doctors in France have been prescribing this herbal remedy for BPH for decades. More studies are needed on how pygeum africanum works. Pygeum africanum improves the flow of urine and slows prostate enlargement. Side effects include headache and gastrointestinal (GI) problems.

Saw palmetto

This herb helps relax muscles in the bladder and prostate to relieve urinary symptoms. It may work as well as the medication finasteride (Proscar) to treat BPH. Finasteride is a type of 5-alpha reductase inhibitor. There is anti-inflammatory action that reduces swelling and increases blood flow. Saw palmetto has numerous medicinal constituents, as do many herbs, so the effects are complex. Saw palmetto has fewer side effects than finasteride, and most are mild, like headache, GI problems, and less interest in sex.

Secale cereal

This extract is produced when bacteria digest plant pollen. It seems to relax muscles in the bladder and urethra. In studies, secale cereal relieved nighttime urgency in men with BPH, but it didn’t reduce prostate size or increase the flow of urine. Side effects include allergic and skin reactions, and GI symptoms.

Along with taking medicines, making these changes to your daily routine can help relieve BPH symptoms:

  • Retrain your bladder. Go to the bathroom at set time intervals, such as every one or two hours. Gradually increase the amount of time between bathroom visits. Eventually your bladder will be able to hold more liquid, and you’ll feel less of an urgent need to go.
  • Empty your bladder, and then go again. This is called double voiding.
  • Limit alcohol and caffeine. They can worsen BPH symptoms by irritating your bladder and making your body produce more urine.
  • Drink small amounts of fluid throughout the day. Stop drinking an hour or two before bed, so you won’t have to get up in the middle of the night to go.
  • Eat nutritious foods and exercise every day to control your weight. Being overweight accelerates prostate growth.
  • Avoid antihistamines such as diphenhydramine (Benadryl) and decongestants, which can cause urinary retention.

Check with your doctor before trying any herbal remedies or supplements. Some of these products can cause side effects, and they could interact with other medicines you take.

Here are a few questions about BPH to ask your doctor:

  • Which medicines can help my symptoms?
  • Can herbal remedies help? Which ones?
  • What can I do at home to improve my symptoms?
  • Which foods or drinks should I avoid?
  • What kinds of exercises are best for people with BPH?
  • If the first treatment I try doesn’t work, what should I do?

Your symptoms should improve with treatment. Ask your doctor how long you need to stay on your medicine. You might have to keep taking it long-term to manage your BPH symptoms. Or, you may need to switch to a new treatment if the first drug you try doesn’t help, or it stops working.

Continue to see your urologist or primary care provider for regular check-ups. You’ll need a digital rectal exam (DRE) once a year, or more often, so your doctor can look for any new prostate growth.

Flomax might not be right for you if:

  • You’re allergic to this medicine, or to sulfa drugs. Rarely, Flomax can cause a severe allergic reaction, including swelling of the face or throat, trouble breathing, and skin blisters.
  • You have low blood pressure, also known as hypotension. Flomax might make it worse.
  • You have severe kidney or liver disease. Damaged kidneys or liver might not be able to clear Flomax from your body quickly enough. This can lead to increased side effects.
  • You’re planning to have cataract or glaucoma surgery. Flomax has been linked to a complication called intraoperative floppy iris syndrome (IFIS), which can make the surgery more difficult.

Learn more: Side effects of Flomax »

Flomax can also interact with certain medicines. Your doctor might suggest that you take a different BPH medicine if you use one of these drugs:

  • acid reflux drugs, such as cimetidine (Tagamet)
  • antibiotics, like clarithromycin (Blaxin) or telithromycin (Ketek)
  • antidepressants, including nefazodone (Serzone) or paroxetine (Paxil, Pexeva)
  • antifungal drugs, such as itraconazole (Sporanox), ketoconazole (Nizoral), posaconazole (Noxafil), or voriconazole (Vfend)
  • cancer drugs, including ceritinib (Zykadia), dabrafenib (Tafinlar), idelalisib (Zydelig), and nilotinib (Tasigna)
  • erectile dysfunction drugs, like avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra)
  • glaucoma drugs, including carteolol (Ocupress), mepindolol, or metipranolol (OptiPranolol)
  • hepatitis C drugs, such as boceprevir (Victrelis) or telaprevir (Incivek)
  • high blood pressure or heart rhythm drugs, including acebutolol (Sectral), metoprolol (Lopressor, Toprol), penbutolol (Levatol), pindolol (Visken), and timolol (Timoptic)
  • HIV/AIDS drugs, such as atazanavir (Reyataz), cobicistat (Tybost), indinavir (Chemet, Crixivan), nelfinavir (Viracept), ritonavir (Norvir), or saquinavir (Invirase)