Tamsulosin and Finasteride Together: What Changes With Both

Yes, you can take tamsulosin and finasteride together when your doctor prescribes both. Tamsulosin (Flomax) and finasteride (Proscar) are a pair that doctors choose on purpose for an enlarged prostate. Tamsulosin relaxes the muscle that squeezes your urine tube, and it starts helping within about a week. Finasteride slowly shrinks the prostate itself. With both, three things need care: when you take each one, how your PSA test is read, and what you tell an eye surgeon.

The timing gap is written into the labels. The tamsulosin prescribing information shows symptom scores dropping "starting at 1 week after dosing." The Proscar label says a trial "of at least 6 months" is usually needed to tell whether finasteride is helping.

This article is for informational purposes only and does not constitute medical advice. It explains what the tamsulosin, finasteride and tadalafil labels say, so your doctor and pharmacist can apply it to your own situation.

Why Are Tamsulosin and Finasteride Prescribed Together?

Finasteride and tamsulosin work on different parts of the same problem. The tamsulosin label says an enlarged prostate (BPH) blocks urine in two ways: the size of the gland, and tight muscle around the urine tube. Tamsulosin loosens the muscle. Finasteride works on the size.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) makes the case for the pair in one line: "a combination of an alpha blocker and a 5-ARI may work better than one medicine alone." Finasteride is a 5-ARI.

The big trial behind that line used a different alpha blocker. MTOPS followed 3,047 men for about 4.5 years on finasteride, doxazosin, both, or placebo. Compared with placebo, the risk of BPH getting worse fell 39% on doxazosin, 34% on finasteride and 66% on both. Only the groups taking finasteride were less likely to end up unable to pee or needing surgery.

That is why the Proscar label names doxazosin as finasteride's partner. Tamsulosin does not appear anywhere in the Proscar label. UK guidance from NICE names tamsulosin among its alpha blockers and says to consider combining an alpha blocker with a 5-ARI for men with bothersome, moderate to severe symptoms and a prostate estimated at more than 30 g or a PSA above 1.4 ng/ml.

Studies of this exact pair are small. In a 92-man study in Nepal, symptom scores dropped significantly over six months on both drugs, but not significantly on tamsulosin alone. A 90-man trial in Nigeria found tamsulosin alone and the pair about equal for symptoms at six months. Prostate size dipped on the pair and rose on tamsulosin alone, a gap that was statistically significant, though neither group's own change was. The big long-term tamsulosin trial, CombAT, used dutasteride, a cousin of finasteride.

Table sources: the tamsulosin label and the Proscar label, sections 2, 5, 6, 7 and 14 and the patient leaflets.

Can You Take Tamsulosin and Finasteride at the Same Time?

Only one of the two labels ties the pill to food.

The tamsulosin label says to take it "approximately one-half hour following the same meal each day," and its own example is 30 minutes after dinner. The meal matters. On an empty stomach, your body absorbs about 30% more, and the peak level runs 40% to 70% higher.

Finasteride is easygoing by comparison. The Proscar label says "PROSCAR may be administered with or without meals," and the leaflet only suggests the same time every day so you do not forget.

So tamsulosin sets the clock. For finasteride, the NHS says "it does not matter what time of day you take it," as long as it is around the same time each day. Your pharmacist can check that plan against your other medicines. For more on stacking pills, see can you take all your medications at the same time, and for picking a slot, morning vs night medication timing.

Do the two drugs affect each other? The tamsulosin label mentions finasteride once, in a lab test with human liver cells that "showed no evidence of clinically significant metabolic interactions." The Proscar label says it was used alongside alpha blockers in studies "without evidence of clinically significant adverse interactions," though formal interaction studies were not done.

A 2015 study did test the pair in 14 healthy men in China. Blood levels stayed inside the limits the researchers had set in advance. Still, once both were taken daily, tamsulosin levels ran about 18% to 23% higher with finasteride, and the authors said a stricter test might not have passed. The study also used a lower tamsulosin strength than the usual U.S. capsule.

If you read UK advice, the NHS says tamsulosin can go "with or without food," while the U.S. capsule label and MedlinePlus tie it to a meal. Ask your pharmacist which rule fits the bottle you have.

Tamsulosin and Finasteride Side Effects Together

Most side effects come from one drug or the other. Two kinds can stack up when you take both.

The first is dizziness when you stand. Does the pair lower blood pressure? Tamsulosin is not meant to treat blood pressure. Still, its label lists dizziness and blood pressure drops on standing more often than placebo, with "a potential risk of syncope" (fainting). The leaflet says this is most likely "after the first dose or when changing doses." It says to change positions slowly, to sit or lie down if you feel dizzy, and to call your doctor if dizziness is severe or does not improve. In MTOPS, the Proscar label reports, men on finasteride plus doxazosin had this kind of dizziness more often than men on either drug alone.

The second is sexual changes, and each drug brings its own:

• Tamsulosin: ejaculation problems in 8.4% of men on the usual dose, versus 0.2% on placebo (label, Table 1).
• Finasteride: impotence, lower sex drive, less semen, and breast swelling or tenderness (Proscar label, 6.1).

A review of 23 trials found ejaculation problems more likely on both kinds of drug than on either one alone, at roughly three times the odds.

Report any breast lump, pain or nipple discharge to your doctor promptly, as the Proscar label asks. Get help right away for a painful erection that will not go away. The tamsulosin label warns that this rare problem can cause lasting impotence if it is not treated.

Finasteride and Your PSA Test, Tamsulosin and Cataract Surgery

Finasteride changes your PSA number. It lowers PSA by about half within six months, says the Proscar label. Doctors set a new starting point at least six months in. Then they watch for any confirmed rise from your lowest number, even one that still looks normal. The leaflet also says Proscar "may increase the chance of a more serious form of prostate cancer." The tamsulosin label says it had "no significant effect" on PSA in studies of up to 12 months. So tell anyone who orders a PSA test that you take finasteride.

Tamsulosin carries the label warning for cataract or glaucoma surgery. Its label links it to intraoperative floppy iris syndrome (IFIS). The colored part of the eye can go limp during surgery. The label says this may raise the risk of eye problems during and after the operation. In a few cases, IFIS showed up 5 weeks to 9 months after men had stopped the drug. The label adds that the benefit of stopping it before surgery "has not been established," and that starting tamsulosin is not recommended when that surgery is already scheduled. Tell your eye surgeon you take, or have taken, tamsulosin.

The Proscar label has no eye-surgery warning. Still, a 2022 review of 38 studies linked both drugs to IFIS, tamsulosin far more strongly. Name both pills to your eye surgeon.

Can You Take Tamsulosin, Finasteride and Tadalafil Together?

Tadalafil (Cialis) treats erectile dysfunction (ED), and it is also approved for BPH. The Cialis label answers differently depending on why you take it:

• If it is for BPH, the label says Cialis is "not recommended in combination with alpha-blockers," because the pairing has not been studied enough for BPH and can lower blood pressure.
• If it is for ED, "Caution is advised." The label tells prescribers that men should be "stable on alpha-blocker therapy" before starting Cialis, and to start it at the lowest recommended dose.

The tamsulosin label agrees from its side. Both drug types widen blood vessels, and together they "can potentially cause symptomatic hypotension," a blood pressure drop you can feel.

Finasteride and tadalafil are a different story. The Cialis label allows the two together to start BPH treatment "for up to 26 weeks." The FDA approved a capsule with both, Entadfi, in 2021. It is taken "on an empty stomach," and its label also advises against using it with alpha blockers for BPH. The FDA's database now lists the Entadfi brand as discontinued, with a generic version still listed.

On all three? Ask your prescriber which reason the tadalafil is for. For BPH, the Cialis and Entadfi labels tell prescribers to stop the alpha blocker at least one day before starting daily tadalafil. That switch is your prescriber's to make, so do not stop tamsulosin or start tadalafil on your own.

Tamsulosin and Finasteride Not Working? It May Not Be the Pills

Some signs should not wait. Tell a health care professional right away, per NIDDK, if you:

• cannot urinate at all
• have painful, frequent, urgent urination with fever and chills
• have blood in your urine
• have great discomfort or pain in your lower belly or urinary tract

If none of those apply, check the calendar. The Proscar leaflet says you may need it "for six (6) months or more" to see whether it helps.

If it has been longer, the cause may be something other than BPH. NIDDK says urinary symptoms can also come from bladder problems, UTIs, prostatitis or prostate cancer. The tamsulosin label notes that prostate cancer and BPH "frequently co-exist," which is why screening continues while you take it.

Some medicines can make BPH symptoms worse, NIDDK adds: cold and cough medicines with decongestants or antihistamines, tranquilizers, antidepressants and diuretics. If a cold pill is the new thing, cold medicine and high blood pressure covers which labels carry an enlarged-prostate warning.

Missed a Dose of Tamsulosin or Finasteride?

With tamsulosin, take it when you remember. If you miss the whole day, take the next dose on your regular schedule. "Do not take two doses at the same time." If you stop or forget it for several days, the leaflet says to talk with your doctor before starting again. Took more than prescribed? The leaflet says to call your doctor right away. See what to do after a double dose of tamsulosin for more.

Finasteride is simpler: "do not take an extra tablet. Just take the next tablet as usual."

Missed finasteride doses can also skew your PSA, so the leaflet asks you to tell your doctor if you have not been taking it as prescribed. For a broader plan, see what to do if you missed a dose of medication.

Can You Stop Tamsulosin or Finasteride Later?

That is your urologist's call. A few facts help that conversation.

Finasteride wears off. In the Proscar label, healthy men who took it for 14 days had DHT back at its starting level about 2 weeks after stopping. In men treated for three months, a prostate that had shrunk about 20% returned close to its old size about three months after stopping. The NHS says to talk to your doctor before stopping, because symptoms "will usually come back."

If you stop finasteride, tell whoever orders your next PSA test. The leaflet says not taking it as prescribed can affect PSA results.

Keep telling eye surgeons you took tamsulosin, even months after you stop.

Some men later drop the alpha blocker with their doctor's OK. An older study followed men on finasteride plus doxazosin who had done well on both. Most who stopped the doxazosin after 9 to 12 months had no worse symptoms a month later. That study used doxazosin, not tamsulosin.

How Pillo Helps

Tamsulosin's rule is about a meal, not a clock. Pillo's Meal Status Checker checks a dose against whether you have eaten, and the persistent alarm keeps going until you deal with it. Finasteride can share that reminder or get its own.

Before a PSA test, Pillo's adherence reporting shows which days you logged finasteride, so you can tell your doctor about any you missed. Refill reminders flag when either pill is running low, and the health tracker can log blood pressure if dizziness is a worry. Juggling these with other daily pills? Managing multiple medications covers the bigger routine.

Helping your dad with his prostate pills? Pillo's Dependents feature lets you manage his schedule from your own app, free for up to two dependents (a third or more needs the paid plan). If he is just home from the hospital, this discharge guide for parents walks through the first week.

Download Pillo on Google Play

Frequently Asked Questions

Is there one pill that has both tamsulosin and finasteride?

Not in the U.S. The FDA's drug database lists no product that combines finasteride and tamsulosin (checked November 2026). The U.S. combination capsule that does contain tamsulosin, Jalyn and its generics, pairs it with dutasteride instead. So in the U.S., this pair means two separate pills.

My PSA went up while on finasteride. Should I worry?

Tell your doctor rather than waiting it out. The Proscar label says any confirmed rise from your lowest PSA "may signal the presence of prostate cancer and should be evaluated, even if PSA levels are still within the normal range." Missed doses can also move the number, so mention those too.

Is Proscar the same as the finasteride used for hair loss?

Same ingredient, different product. Propecia is the 1 mg tablet for male pattern hair loss. Proscar is the 5 mg tablet for an enlarged prostate. This article is about Proscar, so do not swap one for the other.

Can my wife or daughter handle my finasteride tablets?

Women who are or may be pregnant should not handle crushed or broken Proscar tablets. The Proscar label says finasteride may harm a male baby. The tablets are coated, which prevents contact during normal handling as long as they are not broken. If a woman who is or may be pregnant touches a crushed or broken tablet, the label says to wash the area right away with soap and water. If she is pregnant, the leaflet says she should talk to a doctor.

This article is for informational purposes only and does not constitute medical advice. Consult your doctor or pharmacist for advice specific to your medications.