Flomax goes generic; more choices for men with enlarged prostate

If you need a drug to relieve symptoms of an enlarged prostate, you will soon have another low-cost option. The first generic version of Flomax (tamsulosin) was approved yesterday by The Food and Drug Administration. Flomax is one of the most expensive brand-name drugs for treating the condition.

In our Best Buy Drugs report, we recommend another drug, doxazosin, as the first choice if you need a medicine for an enlarged prostate. The generic version of tamsulosin may be a drug to consider if you don't respond well to doxazosin. We don't know the price of generic tamsulosin yet, so we can't say how it will compare to doxazosin, which costs $10 or less for a month's supply. But generic tamsulosin is shipping nationwide, according to the manufacturer, so it should be available in pharmacies soon.

When it comes to treating the symptoms of an enlarged prostate, no one drug in the class of alpha-blockers (which includes doxazosin and tamsulosin) has been shown to be clearly superior in effectiveness or safety. Doxazosin has been around for decades so its effectiveness and safety profile is well established. Tamsulosin may have a convenience advantage when it comes to dosing, however. With the older drugs, such as doxazosin, your doctor should start you on a low dose and build up to a higher dose over a period of a few weeks to give your body time to adjust to the medicine. That process is not necessary with tamsulosin or the other newer alpha-blockers, alfuzosin (Uroxatral) and silodosin (Rapaflo).

An enlarged prostate, also known as benign prostatic hypertrophy, or BPH, is a normal part of aging for men. This may cause problems with urinating, primarily in men age 50 and older. BPH is usually not a serious or life-threatening condition and many men will either have no symptoms or symptoms that are not that bothersome. But for millions of others, the symptoms can interfere with their quality of life. Lifestyle changes may provide relief and should be tried first. These include: go to the bathroom when you first feel the urge, reduce or eliminate your intake of alcohol and caffeine, and limit your fluid intake before bedtime.If your symptoms persist or worsen, the next step is usually to consider medication. Alpha blocker drugs like doxazosin are generally used first because they act fast and can relieve urination problems in a matter of days or weeks.

If you and your doctor decide that a drug is appropriate for your condition, we still recommend the alpha-blocker doxazosin as your first option. We picked it as our Best Buy because it has a long track record of being both safe and effective. It's also available as an inexpensive generic drug, costing $10 or less for a month's supply. The savings would be significant vs. taking one of the costly brand-name alpha-blockers, such as alfuzosin (Uroxatral), which can run more than $100 per month.

—Steve Mitchell, associate editor, Best Buy Drugs

For more about drugs for treating enlarged prostate symptoms, check out our free Best Buy Drugs report.