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Managing complications

Patients with untreated or improperly managed BPH may develop specific complications, such as urinary retention or (rarely) renal insufficiency.1 Complications of BPH can also result in the need for surgery. Clinicians need to be aware of these complications, make proper evaluations and provide referrals when appropriate.

American Urological Association (AUA) Treatment Algorithm

This algorithm for the treatment and diagnosis of benign prostatic hyperplasia was developed by the AUA. It includes initial evaluation as well as recommended approaches to invasive and noninvasive therapy.

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Important Safety Information
FLOMAX is indicated to treat the signs and symptoms of benign prostatic hyperplasia (BPH). FLOMAX is not indicated to treat hypertension. As with other alpha-adrenergic blocking agents, there is a potential risk of syncope. Patients beginning treatment with FLOMAX should be cautioned to avoid driving or hazardous tasks for 12 hours after their first dose or increase in dose should syncope occur. The most common side effects are dizziness, abnormal ejaculation, and rhinitis.

Caution should be exercised with concomitant administration of warfarin and FLOMAX. In addition, FLOMAX should be used with caution in combination with cimetidine, particularly at doses higher than 0.4 mg. FLOMAX is contraindicated in patients known to be hypersensitive to tamsulosin HCl or any component of FLOMAX.

Before prescribing FLOMAX, please see the full Prescribing Information.

* In patients with clinically significant prostatic bleeding, a course of a 5 alpha-reductas expectancy for whom knowledge of the presence of prostate cancer would change management or patients for whom the PSA measurement may change the management of voiding symptoms.

‡ After exhausting other therapeutic options as discussed in detail in the text.

§ Some diagnostic tests are used in predicting response to therapy. Pressure-flow studies are most useful in men prior to surgery.

AUA, American Urological Association; DRE, digital rectal exam; IPSS, International Prostate Symptom Score; PE, physical exam; PSA, prostate-specific antigen; PVR, postvoid residual urine; UTI, urinary tract infection.

1. Barry MJ, Goodson JD. Approach to benign prostatic hyperplasia. In: Goroll AH, May LA, Mulley AG Jr, eds. Primary Care Medicine. 4th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2000:794-798.