Re: help for nocturnal urgency (& Flomax)

[Guest guest]

For those of us that are older and reaching the age that there may be

some worry about cataracts, a caution is in order about Flomax.

There is a reason that you hear that " Warning " (very quickly) on the

TV ads for Flomax about telling your eye doctor that you use Flomax

(or have used it in the past) if you have cataracts and are

considering cataract surgery. From:

http://www.ascrs.org/press_releases/Medical-Societies-Issues-Advisory-

to-Patients-Taking-Prostate-Medications.cfm

" The iris, the part of the eye that gives it its color, opens and

closes in response to varying light levels. Because the iris is

located in front of the cataract, the pupil (opening in the iris)

must be widely dilated in order to perform the surgery. A large pupil

is obtained by using dilating drops that stimulate the iris dilator

muscle. Chang and found that Flomax appears to block this

iris muscle, leading to troublesome behavior of the iris during eye

surgery. The iris tends to be floppy and the pupil may suddenly

constrict during the middle of surgery. If the iris problems are not

anticipated or prevented, there is an increased risk of having

surgical complications. Interestingly, they still found IFIS in some

patients who had been off the medication for two years. " Flomax does

not affect vision or eye health, " Dr. Chang said. " But it impairs the

dilator muscle in the iris, and during cataract surgery the pupil

needs to stay dilated. "

Following the publication of Chang and 's findings, and after

receiving corroborative reports from other ophthalmologists, the U.S.

Food and Drug Administration (FDA) instituted a new label warning for

Flomax and other alpha-blocker drugs that reads: " The patient's

ophthalmologist should be prepared for possible modifications to

their surgical technique. " In 2005, frequent discussion among

ophthalmic surgeons of problems posed by patients on Flomax resulted

in the formation of an ASCRS task force, chaired by Dr. Chang,which

developed recommendations for surgical techniques to be used during

cataract surgery on patients taking Flomax or other alpha-blockers.

The Academy will be including this information in its evidenced-based

Preferred Practice Pattern® guide (PPPs) for cataract care. These

PPP guides are followed by ophthalmologists worldwide. "

and: (from one of the authors of a study about this problem.)

" Flomax is an excellent prostate medication, and there is no need for

patients to avoid it or stop taking it out of concern over eye

problems. However, the key is for patients to inform their

ophthalmologist when they are taking this or any other prostate drugs

prior to eye surgery. This is not something that you would ordinarily

think to tell your eye doctor. "

Google Flomax cataracts for more.

I know personally of one man that lost part of his vision as a result

of this problem and having cataract surgery.

Fuller

>

> Flomax is a member of the class of alpha inhibitor drugs that is

used as a supplemental blood pressure management aid. Cardura (a

brand name) is another example. I was in a clinical trial previous to

my PRP surgery for almost two years for Silodosin, that promises to

be a more selective BPH treatment. Silodosin is of the alpha blocker

class. As far as I know, it has not been approved for general use.

>

> Because the blood pressure lowering effect of alpha blockers is

relatively mild, these are not usually used by itself, but in

conjunction with another class of blood pressure treatment drugs.

>

> Louis. . .

>

>