Silodosin vs. Tamsulosin for Benign Prostatic Hyperplasia: Important Differences and Potential Risks.

Key takeaways

Silodosin (Rapaflo) and tamsulosin (Flomax) are both alpha-1 blockers used to treat symptoms of benign prostatic hyperplasia (BPH), which is an enlarged prostate. They work by relaxing the muscles in the prostate and bladder to make urination easier. However, there are some differences between the two medications. Silodosin is typically taken as an 8 mg capsule once daily with a meal, while tamsulosin is usually taken as a 0.4 mg capsule 30 minutes after the same meal each day. Both medications are available as a lower-cost generic. Common side effects of silodosin include retrograde ejaculation and dizziness, while tamsulosin may cause headaches, dizziness, and abnormal ejaculation. Both medications can cause a drop in blood pressure, especially when standing up, but tamsulosin is less likely to cause this side effect. Both medications have a number of important drug interactions, so be sure your prescriber and pharmacist have a complete list of your medications.

Silodosin

(Rapaflo)

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Tamsulosin

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Summary for Silodosin

Prescription only

Silodosin (Rapaflo) is used to treat symptoms of benign prostatic hyperplasia (BPH), or having an enlarged prostate. This medication is available as a brand-name and generic version, and it comes as a capsule that you take by mouth. The dosage is typically just once daily with a meal, but it can affect your ejaculation as a side effect (for example, causing you to orgasm with less or no semen).

Indications for Silodosin

Benign prostatic hyperplasia (BPH)

Pros and Cons for Silodosin

Pros

Helps improve symptoms of BPH
Once-daily dosing
Can open capsules and sprinkle the powder inside on applesauce if it's hard to swallow the capsules whole
Lower-cost generic version available

Cons

Has some side effects related to low blood pressure, such as dizziness
Can cause retrograde ejaculation (an orgasm with little or no semen), but is reversible when you stop the medication
Might complicate cataract surgery
Can't use if you have severe kidney or liver problems

Common Side Effects for Silodosin

Retrograde ejaculation (orgasm with less or no semen; 28%)
Dizziness (3%)
Diarrhea (3%)
Drop in blood pressure when standing from a seated or lying down position (3%)

Warnings for Silodosin

Low blood pressure
Higher risk for side effects in people with kidney problems
Interactions with other medications
Should rule out prostate cancer
Floppy iris syndrome (a cataract surgery complication)

Summary for Tamsulosin

Prescription only

Tamsulosin is an alpha-1 blocker used to treat benign prostatic hyperplasia (BPH), also known as enlarged prostate. It works by relaxing the muscles in your prostate and bladder, making it easier to urinate. The medication comes as a capsule that you take once a day, usually 30 minutes after the same meal each day. Side effects include headache, dizziness, and abnormal ejaculation.

Indications for Tamsulosin

Enlarged prostate (benign prostatic hyperplasia or BPH)

Pros and Cons for Tamsulosin

Pros

Is a first-choice treatment option for BPH
Taken by mouth once a day
Typically starts to work right away
Less likely to cause a sudden drop in blood pressure when changing positions compared to similar medications