# Urology question -- Flomax & Avodart **URL:** \ **Category:** Factual Questions\ **Created:** [September 28, 2010, 2:40pm UTC](https://boards.straightdope.com/t/urology-question-flomax-avodart/555351 "2010-09-28T14:40:55Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![Gary\_T](https://avatars.discourse-cdn.com/v4/letter/g/3ec8ea/32.png) [@Gary\_T](https://boards.straightdope.com/u/Gary_T)\ **Post date:** [September 28, 2010, 2:40pm UTC](https://boards.straightdope.com/t/urology-question-flomax-avodart/555351/1 "2010-09-28T14:40:55Z")
Are these drugs (used to treat enlarged prostrate) typically taken for the remainder of one’s life, or is one usually able to stop taking them once the prostrate has reduced in size? ---
**Author:** ![Hirka\_T\_Bawa](https://avatars.discourse-cdn.com/v4/letter/h/db5fbb/32.png) [@Hirka\_T\_Bawa](https://boards.straightdope.com/u/Hirka_T_Bawa)\ **Post date:** [September 28, 2010, 3:23pm UTC](https://boards.straightdope.com/t/urology-question-flomax-avodart/555351/2 "2010-09-28T15:23:44Z")
Tamsulosin (Flomax) is an Alpha-1 blocker, and it works by way of relaxing the smooth muscle in the prostrate that constrict the urethra, allowing urine to flow more easilly. It does not actually reduce the size of the prostrate. If you stop taking the medication, its effects will wear off quickly (within a week). Dutasteride (Avodart) is a 5-alpha reductase inhibitor, which blocks the conversion of testosterone to 5-alpha-dihydrotestosterone, which is partly responcible for the enlargement of the prostrate, and will actually help to shrink the prostrate. The effects of this take a little longer to be noticeble, but if you stop taking it, the prostrate will return to its original size. It takes about 2-3 months to get full effect, and would take another 2-3 months to go back to its original size. So, to answer your question, yes, these drugs are normally taken for the rest of a person’s life. ---
**Author:** ![Kent\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kent_clark/32/105_2.png) [@Kent\_Clark](https://boards.straightdope.com/u/Kent_Clark)\ **Post date:** [September 28, 2010, 3:37pm UTC](https://boards.straightdope.com/t/urology-question-flomax-avodart/555351/3 "2010-09-28T15:37:36Z")
Also, because of the risk of birth defects, [people taking Avodart should not donate blood](http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000210). That would extend as long as you’re on the drug. ---
**Author:** ![Gary\_T](https://avatars.discourse-cdn.com/v4/letter/g/3ec8ea/32.png) [@Gary\_T](https://boards.straightdope.com/u/Gary_T)\ **Post date:** [September 28, 2010, 3:46pm UTC](https://boards.straightdope.com/t/urology-question-flomax-avodart/555351/4 "2010-09-28T15:46:58Z")
Answered well, thank you. ---
**Author:** ![KarlGauss](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/karlgauss/32/3713_2.png) [@KarlGauss](https://boards.straightdope.com/u/KarlGauss)\ **Post date:** [September 28, 2010, 8:30pm UTC](https://boards.straightdope.com/t/urology-question-flomax-avodart/555351/5 "2010-09-28T20:30:01Z")
And, guys, it’s spelled **prostate** (not “prostrate”, which may be how you feel after it’s massaged, I admit ;)) ---
**Author:** ![Gary\_T](https://avatars.discourse-cdn.com/v4/letter/g/3ec8ea/32.png) [@Gary\_T](https://boards.straightdope.com/u/Gary_T)\ **Post date:** [September 28, 2010, 9:00pm UTC](https://boards.straightdope.com/t/urology-question-flomax-avodart/555351/6 "2010-09-28T21:00:07Z")
> [@KarlGauss](#): > > And, guys, it’s spelled **prostate** (not “prostrate”, which may be how you feel after it’s massaged, I admit ;)) Crap, I knew that and still managed to get mixed up. :o ---
**Author:** ![janeslogin](https://avatars.discourse-cdn.com/v4/letter/j/df788c/32.png) [@janeslogin](https://boards.straightdope.com/u/janeslogin)\ **Post date:** [September 28, 2010, 10:07pm UTC](https://boards.straightdope.com/t/urology-question-flomax-avodart/555351/7 "2010-09-28T22:07:09Z")
Recently Tamsulosin hydrochloride, generic Flomax became available. My price dropped about 90%. ---
**Author:** ![NOLA\_Cajun](https://avatars.discourse-cdn.com/v4/letter/n/ea666f/32.png) [@NOLA\_Cajun](https://boards.straightdope.com/u/NOLA_Cajun)\ **Post date:** [September 30, 2010, 1:29am UTC](https://boards.straightdope.com/t/urology-question-flomax-avodart/555351/8 "2010-09-30T01:29:11Z")
> [@janeslogin](#): > > Recently Tamsulosin hydrochloride, generic Flomax became available. My price dropped about 90%. I’ve been taking the generic flowmax for more then 2 weeks and haven’t noticed any difference. If it remains this way after the rest of the pills are gone (30 days worth) then I’m notnwasting anymore money on it. What little I read online said it should have started working within 5 days. I’ll be back to the doctor after 30 days requesting something else. ---
**Author:** ![panache45](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/panache45/32/64_2.png) [@panache45](https://boards.straightdope.com/u/panache45)\ **Post date:** [September 30, 2010, 2:59am UTC](https://boards.straightdope.com/t/urology-question-flomax-avodart/555351/9 "2010-09-30T02:59:15Z")
I know you didn’t ask this, but . . . I’ve been taking [this](http://www.puritan.com/mens-vitamins-006/extra-strength-prosta-metto-006052?searchterm=prostametto&rdcnt=1&page=1&sortOrder=2) for about 15 years, and the problem hasn’t recurred. ---
**Author:** ![Jackknifed\_Juggernaut](https://avatars.discourse-cdn.com/v4/letter/j/9de053/32.png) [@Jackknifed\_Juggernaut](https://boards.straightdope.com/u/Jackknifed_Juggernaut)\ **Post date:** [September 30, 2010, 3:03am UTC](https://boards.straightdope.com/t/urology-question-flomax-avodart/555351/10 "2010-09-30T03:03:34Z")
> [@NOLA\_Cajun](#): > > > [@janeslogin](#): > > > > Recently Tamsulosin hydrochloride, generic Flomax became available. My price dropped about 90%. > > I’ve been taking the generic flowmax for more then 2 weeks and haven’t noticed any difference. If it remains this way after the rest of the pills are gone (30 days worth) then I’m notnwasting anymore money on it. What little I read online said it should have started working within 5 days. > > I’ll be back to the doctor after 30 days requesting something else. You may want to also consider Uroxatral, if the Flomax doesn’t kick in. ---
**Author:** ![OldGuy](https://avatars.discourse-cdn.com/v4/letter/o/3bc359/32.png) [@OldGuy](https://boards.straightdope.com/u/OldGuy)\ **Post date:** [September 30, 2010, 3:59am UTC](https://boards.straightdope.com/t/urology-question-flomax-avodart/555351/11 "2010-09-30T03:59:42Z")
Well you can stop after you’ve had prostate cancer surgery, but I don’t suppose that’s what you were thinking of. ---
**Author:** ![Hirka\_T\_Bawa](https://avatars.discourse-cdn.com/v4/letter/h/db5fbb/32.png) [@Hirka\_T\_Bawa](https://boards.straightdope.com/u/Hirka_T_Bawa)\ **Post date:** [September 30, 2010, 5:12am UTC](https://boards.straightdope.com/t/urology-question-flomax-avodart/555351/12 "2010-09-30T05:12:14Z")
> [@panache45](#): > > I know you didn’t ask this, but . . . I’ve been taking [this](http://www.puritan.com/mens-vitamins-006/extra-strength-prosta-metto-006052?searchterm=prostametto&rdcnt=1&page=1&sortOrder=2) for about 15 years, and the problem hasn’t recurred. According to your link, the active ingredient in this is Saw Palmetto. As a pharmacist-to-be (in 268 days, not that I’m counting), you would expect me to say nothing but bad things about a herbal medication… But, Saw Palmetto has actually been proven to help with BPH. The active ingredient in it actually acts as a 5-alpha reductase inhibitor, the same as Avodart. However, it isn’t as potent as the prescription medications that do the same thing. Now, what does that mean? It means it does the same thing as Avodart, but not quite as well… It also has many drug-drug interactions, so make sure your pharmacist and doctor know that you are taking it (along with any other herbal medications). It does work, but if you have severe BPH, you would need something stronger, like Avodart, or Proscar (finesteride). Oh, and just a warning… If you are taking Warfarin (or any other blood thinner), do not take Saw Palmetto! (there are other interactions, but that’s the main one that might kill you) ---
**Author:** ![barbitu8](https://avatars.discourse-cdn.com/v4/letter/b/839c29/32.png) [@barbitu8](https://boards.straightdope.com/u/barbitu8)\ **Post date:** [September 30, 2010, 9:27pm UTC](https://boards.straightdope.com/t/urology-question-flomax-avodart/555351/13 "2010-09-30T21:27:31Z")
> [@Hirka\_T\_Bawa](#): > > > [@panache45](#): > > > > I know you didn’t ask this, but . . . I’ve been taking [this](http://www.puritan.com/mens-vitamins-006/extra-strength-prosta-metto-006052?searchterm=prostametto&rdcnt=1&page=1&sortOrder=2) for about 15 years, and the problem hasn’t recurred. > > According to your link, the active ingredient in this is Saw Palmetto. As a pharmacist-to-be (in 268 days, not that I’m counting), you would expect me to say nothing but bad things about a herbal medication… But, Saw Palmetto has actually been proven to help with BPH. The active ingredient in it actually acts as a 5-alpha reductase inhibitor, the same as Avodart. However, it isn’t as potent as the prescription medications that do the same thing. > > Now, what does that mean? It means it does the same thing as Avodart, but not quite as well… It also has many drug-drug interactions, so make sure your pharmacist and doctor know that you are taking it (along with any other herbal medications). It does work, but if you have severe BPH, you would need something stronger, like Avodart, or Proscar (finesteride). Oh, and just a warning… If you are taking Warfarin (or any other blood thinner), do not take Saw Palmetto! (there are other interactions, but that’s the main one that might kill you) You meant, I’m sure, to say that saw palmetto acts as tamsulosin (Flomax), not Avodart. (It acts through the same pathways as tamsulosin.) Neither tamsulosin nor saw palmetto, however, is effective for everybody. I don’t have any cites now, but I’ve read that in the past, and I, for one, was one of those that did not receive benefits from either one. Years ago, my urologist prescribed Flomax. After doing some reading, I asked him if I could switch to saw palmetto. He had no objections. After surgery for a ripped Achilles’ tendon, I was not able to urinate at all, and was actually discharged from the hospital in that condition. An anesthesiologist told me later that this is a common occurrence after surgery due to the pain drugs used during the anesthesia. Anyway, I had laser surgery for my BPH, and no longer take any medication. So, you do have the option to have laser surgery. You don’t have to have cancer first. However, I don’t think anybody would recommend surgery when it is not necessary. You might want to discuss that with your doctor. ---
**Author:** ![Hirka\_T\_Bawa](https://avatars.discourse-cdn.com/v4/letter/h/db5fbb/32.png) [@Hirka\_T\_Bawa](https://boards.straightdope.com/u/Hirka_T_Bawa)\ **Post date:** [September 30, 2010, 10:44pm UTC](https://boards.straightdope.com/t/urology-question-flomax-avodart/555351/14 "2010-09-30T22:44:52Z")
> [@barbitu8](#): > > You meant, I’m sure, to say that saw palmetto acts as tamsulosin (Flomax), not Avodart. (It acts through the same pathways as tamsulosin.) Neither tamsulosin nor saw palmetto, however, is effective for everybody. No, I meant to say Avodart. Saw palmetto works as a 5-alpha reductase inhibitor, inhibiting the conversion of testosterone to 5-alpha-dihydrotestosterone. Tamsulosin works as an alpha-blocker (see post #2). Cite: > [@Micromedex](#): > > Several pharmacological activities have been documented for saw palmetto in vitro and in vivo (animals). Several of these properties, such as inhibition of 5-alpha-reductase activity, inhibition of androgen binding and spasmolytic activity, are thought to explain, at least in part, the effects of saw palmetto in BPH. I will agree though that pharmacological treatment doesn’t work for everyone with BPH, every body is different. ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [September 30, 2010, 11:23pm UTC](https://boards.straightdope.com/t/urology-question-flomax-avodart/555351/15 "2010-09-30T23:23:52Z")
> [@Hirka\_T\_Bawa](#): > > According to your link, the active ingredient in this is Saw Palmetto. As a pharmacist-to-be (in 268 days, not that I’m counting), you would expect me to say nothing but bad things about a herbal medication… But, Saw Palmetto has actually been proven to help with BPH. The active ingredient in it actually acts as a 5-alpha reductase inhibitor, the same as Avodart. However, it isn’t as potent as the prescription medications that do the same thing. > > Now, what does that mean? It means it does the same thing as Avodart, but not quite as well… It also has many drug-drug interactions, so make sure your pharmacist and doctor know that you are taking it (along with any other herbal medications). It does work, but if you have severe BPH, you would need something stronger, like Avodart, or Proscar (finesteride). Oh, and just a warning… If you are taking Warfarin (or any other blood thinner), do not take Saw Palmetto! (there are other interactions, but that’s the main one that might kill you) Well said. However you forgot to mention that when the doctor wants a follow up PSA, the client should stop taking Saw Palmetto for a week or so before the test, as it can cause a falsely low reading. (Or so we’re taught in nursing school.) 🙂 Do you have to stop taking Avodart for the same reason, since it works the same way? That was NOT mentioned. Which makes me suspect that, like so many of the herb warnings we’re supposed to give, it may be entirely theoretical in nature, not evidence based. ---
**Author:** ![Ignatz](https://avatars.discourse-cdn.com/v4/letter/i/3be4f8/32.png) [@Ignatz](https://boards.straightdope.com/u/Ignatz)\ **Post date:** [October 1, 2010, 3:00am UTC](https://boards.straightdope.com/t/urology-question-flomax-avodart/555351/16 "2010-10-01T03:00:02Z")
> [@barbitu8](#): > > \ (or \) > > So, you do have the option to have laser surgery. You don’t have to have cancer first. However, I don’t think anybody would recommend surgery when it is not necessary. You might want to discuss that with your doctor. So, would laser surgery be “necessary” if I just wanted to stop taking finasteride AND tamsulosin ( now generic) AND saw palmetto after 15 years of them? How long before I might need them again after getting lased? ---
**Author:** ![Eggerhaus](https://avatars.discourse-cdn.com/v4/letter/e/d2c977/32.png) [@Eggerhaus](https://boards.straightdope.com/u/Eggerhaus)\ **Post date:** [October 1, 2010, 4:20am UTC](https://boards.straightdope.com/t/urology-question-flomax-avodart/555351/17 "2010-10-01T04:20:45Z")
I had a kidney stone and to help it pass, the doc put me on tamsulosin. It gave me another damned drug allergy. My blood pressure dropped to 75/40, I was loopy with dizziness, looked like death warmed over and felt like hell. (Luckily I come from a long line of healthy prostates and won’t need such a med when I’m a bit older.) ---
**Author:** ![Hirka\_T\_Bawa](https://avatars.discourse-cdn.com/v4/letter/h/db5fbb/32.png) [@Hirka\_T\_Bawa](https://boards.straightdope.com/u/Hirka_T_Bawa)\ **Post date:** [October 1, 2010, 5:26am UTC](https://boards.straightdope.com/t/urology-question-flomax-avodart/555351/18 "2010-10-01T05:26:44Z")
> [@Eggerhaus](#): > > I had a kidney stone and to help it pass, the doc put me on tamsulosin. It gave me another damned drug allergy. My blood pressure dropped to 75/40, I was loopy with dizziness, looked like death warmed over and felt like hell. (Luckily I come from a long line of healthy prostates and won’t need such a med when I’m a bit older.) Tamsulosin (Flomax) has a cross reaction to Sulfa drugs. Are you allergic to other sulfa based drugs? (Bactrim, Septra, Sulfonurea’s [used for Diabetes], among others) ---
**Author:** ![barbitu8](https://avatars.discourse-cdn.com/v4/letter/b/839c29/32.png) [@barbitu8](https://boards.straightdope.com/u/barbitu8)\ **Post date:** [October 1, 2010, 9:57am UTC](https://boards.straightdope.com/t/urology-question-flomax-avodart/555351/19 "2010-10-01T09:57:34Z")
> [@Ignatz](#): > > > [@barbitu8](#): > > > > \ (or \) > > > > So, you do have the option to have laser surgery. You don’t have to have cancer first. However, I don’t think anybody would recommend surgery when it is not necessary. You might want to discuss that with your doctor. > > So, would laser surgery be “necessary” if I just wanted to stop taking finasteride AND tamsulosin ( now generic) AND saw palmetto after 15 years of them? How long before I might need them again after getting lased? I believe that you should be taking one but not more than one. Flomax or saw palmetto. Not both. You’d have to talk to your urologist about the laser surgery. It is a simple in-office (no hospitalization necessary) procedure. I had to use a Foley catheter for a while afterwards, but I needed one before the operation. ---
**Author:** ![Ignatz](https://avatars.discourse-cdn.com/v4/letter/i/3be4f8/32.png) [@Ignatz](https://boards.straightdope.com/u/Ignatz)\ **Post date:** [October 4, 2010, 12:33am UTC](https://boards.straightdope.com/t/urology-question-flomax-avodart/555351/20 "2010-10-04T00:33:34Z")
> [@barbitu8](#): > > > [@Ignatz](#): > > > > So, would laser surgery be “necessary” if I just wanted to stop taking finasteride AND tamsulosin ( now generic) AND saw palmetto after 15 years of them? How long before I might need them again after getting lased? > > I believe that you should be taking one but not more than one. Flomax or saw palmetto. Not both. You’d have to talk to your urologist about the laser surgery. It is a simple in-office (no hospitalization necessary) procedure. I had to use a Foley catheter for a while afterwards, but I needed one before the operation. I’ve been taking all my meds and herbals with me to m.d. (g.p.) every trip and he has never so advised. My annual physical in this month so I will check on that and maybe go for the green monster. [Next page](https://boards.straightdope.com/t/urology-question-flomax-avodart/555351.md?page=2)