In studies in vitro liver microsomal fractions (model drug metabolism enzyme cytochrome P450) found that tamsulosin does not come into engagement with finasteride pharmacokinetic during metabolism in the liver.
Additional tamsulosin interaction with other drugs and other forms of interaction
There were no interactions with the concomitant use of tamsulosin and atenolol, enalapril, nifedipine or theophylline. The combined use of cimetidine may increase the plasma concentration of tamsulosin, while furosemide causes its decrease. However, to change the dose is not required, as the concentration of tamsulosin remains within the normal range. With In vitro, diazepam, propranolol, trichlormethiazide, chlormadinone, amitriptyline, diclofenac, glibenclamide, simvastatin and warfarin do not change the content of the free fraction of tamsulosin in human plasma. Also tamsulosin does not change the content of the free fractions of diazepam, propranolol, trichlormethiazide and chlormadinone. In studies in vitro liver microsomal fractions (drug metabolism model enzyme system cytochrome ) at the level of hepatic metabolism were observed interactions with amitriptyline, salbutamol, glibenclamide and finasteride. However, Diclofenac and Warfarin may increase the elimination rate of tamsulosin. Theoretically, it is possible that the combined use of tamsulosin may enhance the hypotensive effect of other drugs, such as funds for general anesthesia or other alpha-1 blockers.
Additional finasteride interaction with other drugs and other forms of interaction
There were no clinically significant interactions when used together finasteride with the following drugs: warfarin, angiotensin converting enzyme inhibitors, alpha-1-blockers, theophylline, acetylsalicylic acid, paracetamol, beta-blockers, diuretics, nitrates, blockers of slow calcium channel blockers, anticonvulsants, nonsteroidal anti-inflammatory , benzodiazepines, quinolones, blockers of histamine H2-receptor inhibitors Z-reductase .
When evaluating indicator of prostate-specific antigen should take into account the fact that the treatment with finasteride decreases concentration. In most patients, the concentration declines rapidly during the first month of treatment and then stabilized at a new baseline. This “postterapevtichesky baseline” is approximately equal to half the value doterapevticheskogo. Thus, in typical cases finasteride treatment for six months or more, PSA doubling rate necessary for comparison with the normal values in patients not taking finasteride. It does not reveal any other difference in standard laboratory parameters between patients receiving placebo or finasteride. Treatment patient should be examined to exclude the presence of other diseases, which manifest the same symptoms . Before treatment and regularly during treatment is necessary to carry out a digital rectal examination and, when necessary, determination of andriol bodybuilding. Patients with large residual urine volume and / or severe difficulty urinating should be examined to identify obstructive uropathy.
Precautions for the use of tamsulosin:
– As with other blockers, alpha-1-adrenergic receptors, may reduce blood pressure during treatment with tamsulosin, which in rare cases leads to fainting. At the first signs of postural hypotension (such as dizziness, weakness) should sit or put the patient to complete disappearance of symptoms.
– Intraoperative atonic iris syndrome (andriol bodybuildingvariant small pupil syndrome) has been observed during cataract surgery in some patients taking tamsulosin. Intraoperative complications may increase the frequency of operation. It is not recommended to start treatment with tamsulosin patients undergoing cataract surgery. Discontinuation of tamsulosin 1-2 weeks prior to surgery usually reduces the risk, but has not yet set the optimum time of termination of reception. To prevent the development of intraoperative iris syndrome atonic surgeon and preoperative ophthalmologists need to figure out whether the patient has previously tamsulosin or continues its reception hosted. This will take the appropriate steps during planning and during surgery. alpha pharma usa