It is an understandable mix-up. Tamsulosin and Viagra are both commonly prescribed to men of middle age and beyond, and both may come up in a conversation about the troubles “down there.”
They do, however, have completely different jobs.
Tamsulosin helps urine get out of the bladder, whereas Viagra helps blood get into the penis during an erection.
Tamsulosin, often sold as Flomax, is commonly prescribed for urinary symptoms due to an enlarged prostate. A man may notice that his stream has lost its force. There is a delay to getting started, there is dribbling at the end, and he gets up repeatedly during the night.
The prostate surrounds part of the urethra, the tube that the urine passes through to exit. When prostate tissue and the surrounding muscles constrict the space, it is more difficult.
Tamsulosin relaxes these muscles. It does not reduce the size of the prostate, and it does not usually have a noticeable effect after consuming the first capsule. Many men experience a gradual improvement over the following days or weeks.
Viagra is another story. Its active ingredient, sildenafil, improves blood flow through the body during sexual arousal. It is not taken as a regular remedy for a weak urine stream.
It cannot create desire, nor will it produce an erection while a man sits waiting for the tablet to ‘switch on.” There still needs to be sexual stimulation.
So, if the trouble is achieving or staying hard, tamsulosin is not a substitute for Viagra. If the trouble is standing by the toilet for five minutes waiting for urine to come out, it is unlikely to be the solution either.
Of course, a man can have both problems. That is common enough.
Why tamsulosin sometimes causes a bedroom surprise
Tamsulosin may not improve erections, but it can change ejaculation.
This is the side effect that men find themselves surprised by. The orgasm occurs, but there is little or no semen to see. Sometimes the urine takes on a cloudiness look after the event, as semen has travelled backwards into the bladder. Otherwise, semen is just not propelled in the usual manner.
It is not usually dangerous, but it can be alarming to find oneself in this situation without having been warned, and it can be important if you are trying to conceive.
The effect is very different from erectile dysfunction. A man can have a firm erection and a dry orgasm. He can also ejaculate normally despite having trouble maintaining firmness. Erections and ejaculation are connected parts of sex, not the same physical event.
Viagra mainly helps the former. It is not designed to correct delayed ejaculation, low semen volume or lack of orgasm.
There is another drug that probably adds to the confusion: Cialis.
Cialis contains tadalafil. Unlike Viagra, daily tadalafil is approved for both erectile dysfunction and urinary symptoms caused by an enlarged prostate. One medicine may therefore help a man urinate more easily and improve his erections.
That does not make Cialis automatically better than tamsulosin. The choice may depend on how severe the urinary symptoms are, whether ED is present, blood pressure and other medication.
Can a man take tamsulosin and Viagra together?
Doctors do prescribe them together. The combination just needs some care.
Tamsulosin and sildenafil can both reduce blood pressure. A man may feel fine sitting down, and then become dizzy on standing. The risk is greater after alcohol, in hot weather or when other blood-pressure medicines are involved.
Usually, the prescriber wants the patient to be settled on tamsulosin before adding sildenafil. The ED medicine may be started cautiously.
This is not a combination to test using a friend’s Viagra tablet after several drinks.
Nitrate medicines are completely forbidden with Viagra. This includes nitroglycerin, isosorbide and recreational poppers containing nitrites. The resulting drop in blood pressure can be dangerous.
Tamsulosin has its own practical quirks. It is generally taken after the same meal each day because food alters its absorption. Early doses may cause a head rush, so it is sensible not to get out of bed too quickly.
If you stop taking it for several days, ask before restarting. The dizziness experienced at the beginning can return.
And let your eye surgeon know about tamsulosin before cataract or glaucoma surgery, even if you stopped it some time ago. It can affect the iris during the procedure.
Anyone who is unable to pass urine at all needs urgent care. Blood in the urine, fever, painful urination or worsening urinary symptoms also deserve an assessment rather than another tablet.
Other erectile dysfunction treatments may be considered if there is a problem with erections.
Tamsulosin is a prostate and bladder-outlet medicine, and Viagra is an erection medicine. Same territory, entirely different address.
