ModerateTricyclic antidepressants (TCA)×Alpha-adrenergic blockers for prostatic disorders
Updated · Methodology
Mechanism
Additive orthostatic hypotension. Both block α1-adrenoceptors: tamsulosin selectively (for the prostate), amitriptyline systemically. Effects add up.
Symptoms
Postural dizziness, syncope, fatigue. Older patients: fall and fracture risk.
Management
On the combination, begin amitriptyline at 10 mg at bedtime. In older patients, do not exceed 25 mg/day. Take tamsulosin in the evening. Check standing/sitting BP at 1–2 weeks. For neuropathic pain, alternatives: gabapentin or pregabalin.
Check the full regimen, not just this pair
Opens the checker with these two drugs prefilled. Add the rest of the regimen and recompute additive risks.
Summary of a multi-drug list →
Medicine list: everything you take in one place →
Sources
- FDA: Tamsulosin hydrochloride capsule (Rising Pharma Holdings, Inc.) – Prescribing Information (2014)– ; DailyMed setid a242c8dc-576e-4a1f-a9e7-a05d7ebc0e0a
- AEMPS: Ficha técnica: Tamsulosina (nº registro 67308), sección 4.5 (2024)– AEMPS, CIMA, nº registro 67308, sección 4.5