Concomitant administration of cimetidine with tamsulosin resulted in a moderate increase in plasma levels of tamsulosin and should therefore be used with caution particularly at doses higher than 400 mcg per day. Concomitant administration of furosemide led to a slight and clinically insignificant decrease in the plasma level of tamsulosin and would not require any dose adjustment. Concomitant administration of diclofenac or warfarin may increase the elimination rate of tamsulosin though drug-drug interaction studies have yet to produce conclusive results. Though a study has shown that the concomitant administration of tamsulosin with nifedipine, atenolol or enalapril in stable hypertensive patients did not necessitate any dose adjustment of the anti-hypertensive medications, there is a theoretical risk of an enhanced hypotensive effect when it is given concurrently with drugs which may reduce blood pressure especially other alpha adrenergic blockers but which will also include anesthetic agents, calcium channel blockers and beta blockers.
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