|Ideal sources for Wikipedia's health content are defined in the guideline Wikipedia:Identifying reliable sources (medicine) and are typically review articles. Here are links to possibly useful sources of information about Tamsulosin.|
|WikiProject Pharmacology||(Rated Start-class, Mid-importance)|
|WikiProject Medicine||(Rated C-class, Mid-importance)|
Proposed change to 'adverse effects' section
I invite other editors to help me clarify the 'adverse effects' section in this article, as several of the bullet points seem misleading.
Specifically, the reference to the American Heart Association article "Drugs That May Cause or Exacerbate Heart Failure" is not related to tamsulosin as it relates to prostatic disease, but describes problems encountered by a separate alpha blocker used in the context of patients participating in a clinical trial designed to prevent heart disease. Increased risks of cardiac failure in these patients was described as being due to inappropriate lowering of blood pressure (presumably in hypertensive patients who would have otherwise benefited from other drugs used for hypertension); misdiagnosis; or masking of otherwise diagnosable HF, etc. The point being, this section and the issues raised don't appear directly relevant to men being treated specifically for prostate disease. I propose removing, or at the very least, qualifying this excerpt - if it must be kept in.
Another misleading bullet is "Congestive Heart Failure" (also in the Adverse Effects section). This bullet, in the subsection 'Adverse Events' makes it appear as though Tamsulosin and CHF are directly correlated. But the abstract linked to this bullet point is simply listing alpha blockers as contraindications in people already suffering from heart failure, among other cardiac diseases. Thanks for your assistance.Ronsword (talk) 23:40, 23 January 2018 (UTC)
- UPDATE on above proposed edit: In the American Heart Association article discussed in my previous post, there is, in fact, reference to tamsulosin - among other drugs - and a possible increased incidence of CHF. I've thus clarified these points in "Adverse Effects" subsection, and included possible explanations of how alpha blockers with/or without concurrent use of b-blockers, might mitigate or alter CHF incidence in susceptible populations, as per the American Heart Association article.Ronsword (talk) 17:49, 25 January 2018 (UTC)
Regarding effects on the heart, I know first hand from trying this medication, that it can cause irregular heartbeat. This was my personal experience --- heart palpitations. I understand that because it was my personal experience, this does not qualify for the article. Nevertheless, this factor should be considered in the context of the above remarks with respect to any prospective change to the article. ---Dagme (talk) 17:46, 1 October 2018 (UTC)
: Should we include mention of risk re: dementia?
I am aware of the guidelines for source material for medical pages, and that review articles or meta-analyses are preferred. However, I wonder if we should consider adding information to the Tamsulosin page based on a recent well-done analysis that shows the risk of tamsulosin over other agents in its class, in terms of incidence of dementia. I know that Wikipedia referencing rules serve a purpose but also that there is flexibility when it is for the greater good. In this case I would argue the latter applies as a prospective trial for this will never be done. No Institutional Review Board would ever approve a prospective trial when the harm was this great.
Given this circumstance I would ask if it would be acceptable to this information to the Tamsulosin page:
- Preliminary evidence suggests that tamsulosin has a significantly higher incidence of dementia than all other agents used to treat benign prostatic hypertrophy. According to a large database analysis of Medicare published in 2018, the incidence of dementia was 31.3/1000 person‐years in the tamsulosin cohort, in comparison to 25.9/1000 person‐years in the no‐benign prostastic hyperplasia‐medication cohort. The risk of dementia was significantly higher in the tamsulosin cohort, when compared with the no‐BPH‐medication cohort (HR [95% CI]: 1.17 [1.14, 1.21]) and each of the alternative‐BPH‐medication cohorts: doxazosin (1.20 [1.12, 1.28]), terazosin (1.11 [1.04, 1.19]), alfuzosin (1.12 [1.03, 1.22]), dutasteride (1.26 [1.19, 1.34]), and finasteride (1.13 [1.07, 1.19]).
- Duan, Yinghui; Grady, James J.; Altertsen, Peter C.; Wu, Z. Helen (2018). "Tamsulosin and the risk of dementia in older men with benign prostatic hyperplasia". Pharmacoepidemiology & Drug Safety. Wiley. 27 (3): 340–348. doi:10.1002/pds.4361. Retrieved 5 April 2018.