Flomax

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I am approved for Plavix, and a few other mid life prescriptions. The MD wants to start me on Flomax. Should I immediately send in a note to Ok Cty that I am taking it, ( along with the MD's letter that there are no side effects ?? ) or can I wait for my next ME exam?
 
Flomax can lower your blood pressure. If it's already low, like mine, it can be disastrous.

Dan
 
Dan Thomas said:
Flomax can lower your blood pressure. If it's already low, like mine, it can be disastrous.

Dan
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Am on Norvasc ( already approved ) and totally under control... watch my sodium etc. I just want to do the right procedure to add the flomax without delays etc ...
 
Flomax (tamsulosin) is a drug designed to relax the prostate and relieve symptoms of poor urinary flow which is fairly common in older men. It can lower blood pressure but this is usually not a problem even in those with normal blood pressures. This was much more common problem with older alpha blockers like Cardura (doxazosin) which were also used to treat high blood pressure as well as enlarged prostate. Flomax has a number of drug interactions that might cause or exacerbate the blood pressure lowering affect and dizziness. It might help to take the medication at bedtime. The AOPA site indicates that Flomax is FAA allowed if there are no side effects.

The FAA allows at least seven drugs for enlarged prostate so if one doesn't work or has unacceptable side effects there are others to try. If drug therapy is not effective and symptoms are severe, then a urologist might recommend a TURP (roto rooter) or TUMT (microwave) surgical procedure or whatever they are doing these days.

We will need to wait on Dr. Bruce or another AME to find out about the FAA reporting requirements.
 
Unregistered said:
Am on Norvasc ( already approved ) and totally under control... watch my sodium etc. I just want to do the right procedure to add the flomax without delays etc ...
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Your physician can decrease or stop the Norvasc if your blood pressure is too low with the Flomax (unlikely). Norvasc should be much more effective in lowering BP than Flomax. Get a good quality over the arm home blood pressure cuff for about $60. This will make it easier for your physician to adjust your meds if you can report what your BP runs.
 
If you go on Flomax (brand name for Tamsulosin), the FAA says you are grounded at least temporarily until its effects on you are evaluated. According to Drugs.com dizziness is a side effect in 17% of men studied, and that's probably why the FAA's position is what it is. The manufacturer even advertise that you should not drive or operate heavy equipment until you know its effects. Consult an aviation medical expert like Bruce before going on Flomax.
 
Ron Levy said:
If you go on Flomax (brand name for Tamsulosin), the FAA says you are grounded at least temporarily until its effects on you are evaluated. According to Drugs.com dizziness is a side effect in 17% of men studied, and that's probably why the FAA's position is what it is. The manufacturer even advertise that you should not drive or operate heavy equipment until you know its effects. Consult an aviation medical expert like Bruce before going on Flomax.[/QUOTE

For how long? Can you self ground and perhaps then after 30 days have the MD write a letter saying you have no side effects ( if true ) ,,,, send his letter with tmy letter informing Ok C I am using the drug??
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Practically all medications used to control blood pressure can cause dizziness. I suspect that there is a mandatory grounding peroid for these medications as well. Flomax was designed to have less effect on blood pressure than the drugs it replaced. The blood pressure related side effects are usually most noticeable the first few days of use and may improve over time. We will need to wait for Dr. Bruce's input to learn how long the FAA wants you to wait before you can fly.
 
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And whatever you do, if you decide to have cataract surgery, tell your surgeon beforehand that you are on flowmax (the same mechanism that controls urine flow controls the iris of the eye, flomax does funny things to that part of your eye and it can be a nasty suprise during surgery, much less of an issue if anticipated).
 
Tamsulosin is okay. I would self ground for a week just to make sure you haven't got any side effects.

If you are certified at the level of CFI, you should inform your AME. Then skip to the last paragraph.

If you are certified below that level, you've never read part 67 and you are goverened by 61.53, "what a reasonable pilot would do".

At the end of the week, I would obtain the letter from the urologist in any case (visit the nurse, get her to write, sign doc's name with her initials after the signature or however that office does that), that you are taking the med without side effects, and file it away for your next 8500-8 encounter.

http://www.faa.gov/library/reports/medical/fasmb/media/201101_color.pdf
Think of Tamsulosin as yet another antihypertensive. You can tell in a week. Tamsulosin escaped this round of specifications, see the bottom of page 3.
 
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Thank you so much !! Does the letter have to be from a urologist or is an Internist OK?
 
Dr. Bruce... just wondering if I should ask the MD about Detrol or Uroxatrol since they, according to the article, seem to be OK without question ? My MD seemed to feel the Flomax ( Tamsulosin HCL .4) was the preferred drug for urinating more normally.
Thanks !
 
An internist letter is just fine.
Personally I dont' think there's much difference between any of the 4 meds. If I were to choose, I'd do it by cost.
 
bbchien said:
Tamsulosin is okay. I would self ground for a week just to make sure you haven't got any side effects.

If you are certified at the level of CFI, you should inform your AME. Then skip to the last paragraph.

If you are certified below that level, you've never read part 67 and you are goverened by 61.53, "what a reasonable pilot would do".

At the end of the week, I would obtain the letter from the urologist in any case (visit the nurse, get her to write, sing doc's name with her initials after the signature or however that office does that), that you are taking the med without side effects, and file it away for your next 8500-8 encounter.

http://www.faa.gov/library/reports/medical/fasmb/media/201101_color.pdf
Think of Tamsulosin as yet another antihypertensive. You can tell in a week. Tamsulosin escaped this round of specifications, see the bottom of page 3.
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Is a week an adequate time for grounding for new anti-hypertensive medications or changes in an existing anti-hypertensive?
 
bbchien said:
DEPENDS ON THE MED. Got specifics?
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No. How does a pilot determine how long to wait after a medication change? Is there a reference a pilot can check? Should we call an AME when there is a medication change?
 
Ron Levy said:
When in doubt, I call the Regional Flight Surgeon's office to ask. Your FSDO will have the number.
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That is inefficient for both the pilot and Flight Surgeon's office. I wonder why the FAA can't have a website listing medications and the required waiting period or if there is a need to be reevaluated by an AME before resuming flying.
 
Gary F said:
That is inefficient for both the pilot and Flight Surgeon's office. I wonder why the FAA can't have a website listing medications and the required waiting period or if there is a need to be reevaluated by an AME before resuming flying.
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It's the goverment, don't go looking for efficiency.

Administrations like to keep their little kingdom ruled by ambiguity. This leaves more need for minions to be employed, budgets to be maintained and punishment to be handed out :wink2: .
 
The government refuses to publish a list of what's acceptable. So why would they publish a list of what needs-how-much-wait?

It's all about liability.
 
bbchien said:
The government refuses to publish a list of what's acceptable. So why would they publish a list of what needs-how-much-wait?

It's all about liability.
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AOPA publishes a list of medications it claims are acceptable to the FAA. Should we call our AME whenever there is a medication change? How much discretion does an individual AME have? Do they have an unpublished list of acceptable meds or how can they advise us?
 
I actually help edit, at times the AOPA medication list. Sometimes the med is not the problem- it's the marker for an unacceptable underlying condition. Sometimes it's the med itself.

As to whether you call your AME or not, that depends on your level of pilot certification. Generally speaking, if you have accomplished your CFI, you call your AME. Below that level of cert, there is nothing that tells that you have had to even find part 67. So you are governed then by 61.53, which is "what a reasonable pilot would do" as far as self certification/self-grounding.

What the AME advises, is if that medication would cause difficulty on you history at your next re-up. Prof. pilots esp. like to avoid that minefield and get advice prior to entering the minefield. If you have a special issuance, then you have to talk to the AME/FAA as the SI dictates.
 
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I recently started Flomax and experienced very low blood pressures (110/68) and high pulse rates (75-90). After a few weeks, things have settled down a bit so I guess your body sort of gets used to it.
Thanks for the clarification, Dr. Bruce. I never thought about how it would affect my flying as the only time I was a little dizzy was when I stood up quickly. Fortunately, the weather kept me from flying for a couple of weeks.
 
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