Fed up with the well known side effects of Tamsulosin, so asked my GP if I could switch to Cialis. He said no as it was ' red listed '. Should have asked if this is based on safety or cost. Since found out that this has been approved by NICE. Anybody else in the UK had a similar experience?
I recently switched from Flomax to alfuzosin (generic for Uroxatral). I take the alpha blocker with dutasteride (generic for Avodart). For me alfuzosin works better that Flomax for lessening lower urinary tract symptoms. The sexual side effects are much less as well. I mentioned this switch to my GP and he's going to switch as well. He's been suffering from BPH for quite a while as well. I was amazed that he wasn't more aware of the different types of alpha blockers that are available.
I did take low-dose Cialis for a short period while on Flomax/Avodart. If you're taking Cialis and an alpha blocker you have to take them at least 4 hours apart otherwise blood pressure might be lowered too much causing even more dizziness. However, I stopped taking Cialis because the nasal congestion from the combination of Flomax and Cialis was simply too much for me to take (especially at night). With the switch to alfuzosin, I don't feel that I need to take low-dose Cialis.
Cialis in 10mg or 20mg is recommended for ED. My GP rescrib es it. I get a private prescription. I also buy over the counter in a number of countries. If you have BPH problems, you might think of a physical treatment which does not affect sexual performance. TURP has a poor reputation on this site and probably best avoided if you are still sexual active
I had this problem. It isn't red listed it's just not approved for BPH any more. Doctor said he could issue a private prescription but that is expensive. Asked about buying it on-line as that is much cheaper and he said that would be a good idea. KTC is the on line pharmacy I got mine from. Hope this helps.
Thanks Guys. Very helpful.
Any side effects taking the Alfuzosin and Avodart combination?
Tadalafil (Cialis) should be available in Generic form in UK now.
Tesco Pharmacy is about £35 for 8 tablets
I still have congestion. The last couple of nights it was less (I find nasal strips helpful). I have been noticing some dizziness, but I don't think it is any worse than when I was on Flomax (my blood pressure is typically "low" normal without the alpha blockers). I've noticed a slight eye blurriness lately, but I spend a lot of time looking at monitors. It actually feels more like a stickiness of my lid to my eye, so I'm not sure this is due to the medications (my mother had a similar problem when she was my age). Tinnitus is much better now on alfuzosin (which is one of the reasons I switched).
I keep a daily urination journal. Here are the differences in the averages while using flomax/avodart and alfuzosin/avodart (1st number is flomax/avodart and second is alfuzosin/avodart)
24 hour amount urinated is 2120 mL versus 1943 mL
Number of daytime trips to urinate (does not include defecation trips): 10.7 versus 8.1
Average amount urinated per trip during the daytime: 126 mL versus 146 mL
Number of times I get up at night to urinate: 3.0 versus 2.6
With regards to the nighttime trips, the journal has shown me that I am producing too much urine at night. Typically, if the amount urinated during sleeping time is greater than 30 percent of the 24 hour total, then a person is considered to have nocturnal polyuria. I exceed 30% about 1/3rd of the time and have gotten close to 50% a number of times. So, I am now looking at "lifestyle" changes to get my kidneys to shift urine production from the nighttime to daytime. Since I prefer not to take prescription drugs, I'm trying natural diuretics (cranberry and I might even try dandelion). My goal is to get down to 20% on a consistent basis. When that has happened in the past, I never get up more than twice (which I can live with).
Don't underestimate lifestyle changes when dealing with LUTS. In addition to BPH, often times men have overactive bladder, or simply drink too much at night or have nocturnal polyuria or sleep apnea. These are discussed in many posts on this forum. Good luck.
I should mention that with diuretics (natural or prescription), you have to be careful when you take the diuretic. If taken too late in the day, they might actually increase urine production at night. I've seen recommendation for taking prescription diuretics late in the afternoon. I'm going to start taking the natural diuretics in the late morning/early afternoon and then adjust as needed.
One last thing, Andy. I assume you are aware that many decongestants tighten the bladder neck and sphincters and should not be taken if you have BPH. I wish I had known this 5 years ago when I had almost complete/acute urinary retention and the pain and agony that goes with it (a subsequent MRI indicated that none of my organs were damaged). That episode occurred during the holidays, when I was sitting more than usual, drinking alcohol and took Sudafed.
Did you tell him it is the low dose one a day that you need? Several friends of mine get it on NHS prescriptions.
Also many cardiologists take and advise it as it is good for the heart.
Ps Soon the cheaper generic versions will be available in the UK just as Viagra now is.
To recap my story, I had a PAE done for bad BPH symptoms about 2.5 yrs ago. It initially worked spectacularly well, and I quickly was able to stop taking tamsulosin. But after about 6-9 months I was back to my pre-op baseline symptoms. I did not restart tamsulosin because I never thought it did much for me anyway, and because I may need cataract surgery in the near future, and do not want to risk the floppy iris syndrome which can occur with tamsulosin. Then recently, I tried a short course of Cialis [half-of-a 5 mg tab/day] for the urinary symptoms and found that it really helped a lot -- reducing daytime urgency/control and nocturia. The cost of continuing Cialis through my insurance was prohibitive, however. So i spoke to my primary doc, and got an Rx that I sent off to a Canadian pharmacy--and about 2 weeks later my new 90 day supply arrived via express mail from India. The Canadian/Indian tabs seem to work as well as the Eli Lilly branded meds--but cost me less than 25 cents per day for the 1/2 tab dosing.
Side effects? Both the Cialis and the tadalafil seemed to cause heartburn symptoms for several days, but after I got through the first week by taking some Pepcid or TUMS antacid tablets, the daily episode of gastric reflux subsided and disappeared (with both formulations). In the beginning when taking it for the first few days, I made a point of having the tadalafil with breakfast, and not at bedtime, to avoid the terrible reflux symptoms that could occur if I was lying down. I have had no other side effects.
The tadalafil tabs are irregularly shaped [for both the branded and generic forms] and difficult to split cleanly --- but tadalafil has a long half life so as long as I split and take the fragments obtained from just one pill over 2 days in a row, it seems to work well for me.
I had issues with BPH, big median lobe. Urologist prescribed Tamsulosin and recommended Turp, as it is considered the Gold standard, starting out with a biopsy since the PSA was high. Took the med for two weeks and had retro ejaculation almost immediately. Due
to urinary blockage it was already little before. Refused the biopsy and started to read about all this. After a lot of research and 8 months later I had a combination of PAE and Rezum. 11 months later all still works fine. This doctor did a miracle on me and I am so grateful for this additional time of youth I got back at my age of 65.
Hi Derek, the low dose on-a-day Cialis is still under patent and is subject to the SLS (Selected List Scheme) restrictions. 5mg/day was recommended for the treatment of BPH, not the one-off dose of 10mg or 20mg. As you say, the generic tadalafil version of the one-off dose should be available eventually. If you have had prostate surgery then you can ask for the low dose one-a-day as treatment for erectile dysfunction (as you can if you have other conditions such as Parkinsons or diabetes).
The 'Selected List' can be found in Schedule 2 of the NHS (General Medical Services Contracts) (Prescription of Drugs etc.) Regulations 2004 which is reproduced in Part XVIIIB of the Drug Tariff. The items included on the list may only be prescribed for the patient groups and for the purpose listed in the Tariff.
It seems that many GP's and urologists are ignoring the ruling for the one a day pills.
My GP happily prescribes the 20mg version for what you describe as one-off dose to deal with ED. In some other countries it can be bought OTC eg Dubai and Argentina without that formality. Now that viagra patent has expired I presume it won't be long before the same happens to cialis