Is there a connection between Flomax and cataracts?

I take Flomax (tamsulosin) to manage my BPH. The commercials say something about having cataract surgery. What’s the connection between the drug and cataracts? If I’m taking  Flomax, do I have to forgo having my cataracts removed?

Kevin R. Loughlin, M.D., M.B.A., director of Urologic Research at Brigham and Women’s Hospital, says:

Flomax works by blocking certain cellular receptors, causing the smooth muscle in the neck of the bladder and the urethra to relax. As a result, urine flow improves. Although they aren’t particularly abundant, these same receptors exist elsewhere in the body, including the iris in your eye. The iris opens and closes to adjust the amount of light entering the pupil. When the receptors that control the iris are blocked, the pupil constricts.

During cataract surgery, the ophthalmologist removes the clouded lens, which sits beneath the iris inside the lens capsule (see illustration). When the pupil is small, the relatively large iris obscures the cataract. The iris can also slip out of its normal position during surgery, making it even harder for the ophthalmologist to remove the old lens and insert a new one. This condition, dubbed floppy iris syndrome, increases the chance of complications, including vision loss.

Some researchers have suggested that patients on Flomax should temporarily stop taking it several days before cataract surgery. However, the benefit of discontinuing the drug has not been proven. Instead, tell your eye surgeon that you take this drug. He or she can modify the surgery to minimize the risk of any problems.

Cataracts and Flomax

Cataracts and Flomax

Flomax (tamsulosin) can affect the opening and closing of the iris, causing the pupil to constrict. If this occurs during surgery, or if the iris slips out of position, the surgeon may have a harder time removing and replacing the lens, which sits beneath it.

SOURCE: Chang DF, Osher RH, Wang L, Koch DD. Prospective Multicenter Evaluation of Cataract Surgery in Patients Taking Tamsulosin (Flomax). Ophthalmology 2007;114:957–64. PMID: 17467530.

Originally published April 1, 2008; Last reviewed April 18, 2011


  1. Alfredo

    Prostate was enucleated due to hypertrophy & capsule left intact. Do not know if nerve bubble was saved. Is erection and coitus possible under these conditions?

  2. Mike Reynolds

    Dx COP – Gleason 6 age 50.

    Radical age 50; successful except positive margins; no ED

    Age 52 12 PSA rose to point where salvage radiation recommended; 38 treatments; PSA back to <0.1, but ED developed.

    PSA continues to this day <@ 0.1 just shy of age 70.

    Low T at age 50 (mid 200s)
    Low T at age 55 (241.8) — last time tested
    Suspect still low

    Question: since its been almost 20 years since salvage
    radiation with all PSAs since then <0.1–If low T still in 200s now, why not consider Low T treatment?

  3. Jose Olvera, age 79; first diagnosed in October 1993 and had metastasized to the bones resulting in 8 tumors after an MRI in 2012. An MRI taken one year ago showed no metastatic tumors evident. I have been on elegard ( a shot every 90 days for almost 2 ye

    My father who died in 1976 at age 64 had cancer of the bladder that had metastasized to his colon.

    The fact that cancer of the prostate was not evident during his lifetime, what are my risks?

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