Saw Palmetto With Flomax (Tamsulosin)

In our latest question and answer, the pharmacist discusses whether or not there is an interaction between saw palmetto and Flomax (tamsulosin).

Jul 27, 2018

Pre asked

I am taking Flomax and while it is working, it has not completed eliminated my symptoms. Is it okay to take with saw palmetto?

Answer

There are no documented interactions between saw palmetto and Flomax (tamsulosin). While they are both used to treat BPH (benign prostate hyperplasia), they do so via different mechanisms. In fact, using both together may provide better symptom relief than either alone.

How Does Saw Palmetto Work?

Saw palmetto has antiandrogenic and anti-inflammatory properties. It works in a similar way to the prescription drug Proscar (finasteride). Specifically, it inhibits the conversion of testosterone to DHT (dihydrotestosterone) by inhibiting 5-alpha-reductase. DHT is more potent than testosterone and elevated levels have been linked to an enlarged prostate and male pattern baldness.

Studies have also shown that saw palmetto can decrease tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta, which are known to be elevated in those with an enlarged prostate.

How Does Flomax (Tamsulosin) Work?

Tamsulosin is an antagonist at alpha-1-receptors, which are involved in the contraction of smooth muscle in the prostate, urethra, and bladder. There are a variety of alpha-1 receptors in the body (alpha-1a, alpha-1b etc...) and Flomax has a greater affinity for alpha-1a-receptors, which are most abundant in the prostate.

When alpha-1a receptors in the prostate are antagonized (i.e. "blocked"), smooth muscles in the bladder and prostate relax, which improves urine flow and reduces other symptoms of BPH (like sexual dysfunction).

Using Saw Palmetto With Flomax

Due to their different mechanism of action, saw palmetto and Flomax are considered safe together. However, it should be noted that both Flomax and saw palmetto can cause dizziness, at least when therapy is first started, so caution is recommended in that regard. Overall though, they can be used together without issue.

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