Alfatam Special Precautions

As with other α1-blockers, reduction in blood pressure can occur in individual cases during treatment with Tamsulosin hydrochloride, as a result of which, very rarely, syncope can occur. At the first signs of orthostatic hypotension (dizziness, weakness), the patient should sit or lie down until the symptoms have disappeared.
Before therapy with Tamsulosin hydrochloride 0.4 mg is initiated, the patient should be examined in order to exclude the presence of other conditions which can cause the same symptoms as benign prostatic hyperplasia. Digital rectal examination and, when necessary, determination of prostate specific antigen (PSA) should be performed before treatment and at regular intervals afterwards.
The treatment of severely renally impaired patients (creatinine clearance of <10 ml/min) should be approached with caution as these patients have not been studied.
Intra-operative Floppy Iris Syndrome: 'Intra-operative Floppy Iris Syndrome' (IFIS) has been observed during cataract surgery in some patients taking or who have previously been treated with α1-adrenoceptor antagonists. This variant of small pupil syndrome is characterised by the combination of a flaccid iris that billows in response to intra-operative irrigation currents, progressive intra-operative miosis despite pre-operative dilation with standard mydriatic drugs, and potential prolapse of the iris toward the phacoemulsification incisions. The patient's ophthalmologist should be prepared for possible modifications to their surgical technique, such as the utilisation of iris hooks, iris dilator rings, or visco-elastic substances. There does not appear to be a benefit of stopping α1-adrenoceptor antagonist therapy prior to cataract surgery.
Effects on Ability To Drive And Use Machines: No data is available on whether Tamsulosin hydrochloride 0.4 mg adversely affects the ability to drive or operate machines. However, in this respect patients should be aware of the fact that dizziness can occur.