Drug Interactions, Kratom Guides

Kratom & Tamsulosin: Are They Safe to Use Together?

Does Kratom Interact With Tamsulosin?                                            

An antagonistic interaction occurs between tamsulosin and kratom, meaning kratom can hinder tamsulosin’s effects and cause it not to work effectively. This interaction can be moderate to high.

Do not consume these drugs together without consulting your physician.

The interaction of kratom with tamsulosin can occur in the following way:

1. Decreased Effects (Agonistic Interaction)

Kratom and tamsulosin have an antagonistic reaction. Kratom is an alpha-2 adrenergic receptor agonist [1]. It acts on presynaptic alpha 2 inhibitory neurons that decrease nor-epinephrine release, ultimately reducing sympathetic activity, including alpha-1 adrenergic activity. The net result is vasoconstriction, papillary constriction, and constriction of smooth muscles in the genitourinary tract.

Tamsulosin is an alpha-2 adrenergic receptor antagonist. It blocks the constricting activity of the alpha-2 adrenergic receptors, resulting in vasodilation, papillary dilation, and dilation of smooth muscles in the genitourinary tract. Thus, kratom and tamsulosin have opposite effects on the body, mediated by the alpha-adrenergic receptors.

2. Slowed Elimination (Metabolic Competition)

When a common liver enzyme metabolizes two drugs, they can accumulate in the blood when consumed together. This action leads to an increase in the half-life of both drugs, and they remain in the bloodstream for a longer time and can cause adverse side effects, sometimes severe.

Tamsulosin is mainly metabolized in the liver by cytochrome P450. The main sub-variants responsible are CYP3A4 and CYP2D6 [2]. CYP3A4 can deacetylate tamsulosin to the M-1 metabolite, and CYP2D6 can hydroxylate tamsulosin to the M-3 metabolite or demethylate tamsulosin to the M-4 metabolite.

CYP3A4 is also responsible for the metabolization of kratom. Consumption of kratom and tamsulosin increases the half-life of both drugs, causing them to accumulate in the body and remain in the bloodstream for longer.

Kratom & Alpha Adrenergic Receptor Blocker Interactions

Tamsulosin is an alpha-adrenergic receptor blocker. The drug mainly acts on alpha-1 adrenergic receptors. The medication dilates blood vessels, resulting in hypotension. It is helpful in benign prostatic hyperplasia, prostatitis, voiding dysfunction, and ureteric stones.  

Other alpha-adrenergic receptor blockers with kratom will have similar reactions and include the following:

  • Alfuzosin
  • Doxazosin (Cardura)
  • Phenoxybenzamine
  • Phentolamine
  • Prazosin (Minipress)
  • Terazosin
  • Tolazoline
  • Trazodone
  • Silodosin

Is it Safe to Take Kratom With Tamsulosin?

No. It is not safe to take kratom with tamsulosin.

The interaction between kratom and tamsulosin is considered moderate to high.

Kratom and tamsulosin act via alpha-adrenergic receptors. Kratom increases blood pressure in higher doses, while tamsulosin decreases blood pressure. Similarly, kratom reduces tamsulosin’s effect of relaxing smooth muscles in the genitourinary tract.

Consult a physician before consuming kratom and tamsulosin together. A severe drop in blood pressure requires quick medical intervention.

What is Tamsulosin?

Tamsulosin is an alpha-1A and alpha-1B adrenergic receptor antagonist. The drug affects smooth muscles, especially the bladder, neck, and prostate detrusor muscles, enabling a free urine flow. In addition, it also acts on smooth muscled of blood vessels, resulting in decreased blood pressure.

 It is primarily for treating benign prostatic hyperplasia and prostatitis in men. It is also used for the symptomatic treatment of ureteral stones and female voiding dysfunction. A common side effect of this drug is low blood pressure and dizziness on suddenly standing up from a sitting or laying down position.

Tamsulosin Details & Specifications:

Drug Name Tamsulosin
Trade names Betamsal, Contiflo XL, Flomax, Flomaxtra, Harnal D, Maxrin, Mecir, Omexel, Omipro, Omix , Omnic, Pradif, Ranomax, Salover, Secotex, Stronazon, Tamsact, Tamsol, Tamsul, Urimax
Classification  Alpha Adrenergic Receptor Blockers
CYP Metabolism CYP3A4, CYP2D6
Interaction With Kratom Antagonistic
Risk of Interaction Moderate

What is Tamsulosin Used for?

Tamsulosin is used in the treatment of various urinary pathologies. The indications for the use of tamsulosin are:

Benign Enlargement of Prostate

Tamsulosin helps treat benign enlargement of the prostate. The drug acts by blocking alpha-1 adrenergic receptors in the genitourinary tract’s smooth muscles, especially the bladder’s detrusor muscles and prostatic muscles, allowing easy passage of urine through the urethra.

The drug aids easy urination in men who have benign prostatic hyperplasia. Benign prostatic hyperplasia patients present with lower urinary tract symptoms. These symptoms are classified into two sub-categories. The irritative or storage symptoms include frequency, urgency, and nocturia. The obstructive or voiding symptoms include weak stream, intermittency or hesitancy, straining, and sensation of incomplete voiding. Tamsulosin is very effective in the treatment of obstructive symptoms [3].

Prostatitis

Tamsulosin is used in the symptomatic treatment of prostatitis. Inflammation of the prostate gland can occur secondary to various causes, such as bacterial infections. The mechanism is similar to that in benign enlargement of the prostate. The inflamed prostate gland often blocks the urethral pathway. Tamsulosin causes the blockade of alpha receptors in the smooth muscles of the prostate gland and urinary bladder. Ultimately, there is a wider urethral pathway and relief of urinary symptoms.

Ureteric Stones

Dilation of the genitourinary pathway by tamsulosin allows the passage of ureteric stones. The drug is effective for stones less than 10 mm [4]. It appears to be more effective in patients with slightly bigger stones, ranging from 4-10 mm in size. Stones less than 4 mm are likely to be passed spontaneously, even without the use of this drug. Larger stones require surgical intervention and do not pass through, even with the help of smooth muscle relaxants such as tamsulosin.

Voiding Dysfunction

Female voiding dysfunction can be treated with tamsulosin [5]. The drug can help to prevent acute urinary retention. Some people may experience difficulty voiding after the removal of a urinary catheter. In such patients, the use of tamsulosin aids self-voiding. This drug also reduces the need for re-insertion of a urinary catheter.

What’s the Dose of Tamsulosin?

Tamsulosin comes in the form of a tablet. The usual dose of tamsulosin is 0.4 mg, consumed once daily. The amount can increase to 0.8 mg in patients who do not respond to the usual dose within four weeks.

Generic & Brand Name Versions

  • Betamsal
  • Contiflo OD
  • Flomax
  • Flomaxtra
  • Harnal D
  • Maxrin
  • Mecir
  • Omexel
  • Omipro
  • Omix
  • Omnic
  • Pradif
  • Ranomax
  • Salover
  • Secotex
  • Stronazon
  • Tamsact
  • Tamsol
  • Tamsul
  • Urimax

What Are the Side Effects of Tamsulosin?

These are some of the side effects that can arise from tamsulosin consumption [6]:

  • Abnormal ejaculation
  • Back pain
  • Blurred vision
  • Body aches or pain
  • Confusion
  • Cough or hoarseness
  • Decreased sexual drive and erectile dysfunction
  • Dizziness or lightheadedness on suddenly standing up from a lying or sitting position
  • Drowsiness or sleepiness
  • Headache
  • Large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • Lower back or side pain
  • Pain or tenderness around the eyes and cheekbones
  • Sneezing
  • Sores, ulcers, or white spots in the mouth or on the lips
  • Stuffy or runny nose
  • Syncope
  • Tachycardia
  • Tender, swollen glands in the neck
  • Tightness of the chest

What is Kratom?

Kratom is a tropical plant in Southeast Asia. The leaves are either chewed (by the locals) or processed into whole leaves or powder. It’s been popular for centuries in its native land but only recently spread to the rest of the world.

Though current research shows it’s safe, and the World Health Organization backs this, many people are concerned about its safety due to misinformation.

When used properly, kratom is safe and a good replacement for strong prescription drugs like opioids and anti-depressants. However, never stop taking a prescription or start kratom if you’re on medication without speaking to your doctor.

Related: Clearing the Air: Kratom Myths & Misinformation

What’s Kratom Used for?

Kratom has many uses, some seemingly contradictory. Small amounts are stimulating, while more significant amounts are sedating, so be careful with how much you take. Too much, and you’ll fall asleep, not become more energized!

Because it works on opioid receptors and other systems, it is very effective for the following:

Related: Is Kratom An Opioid?

What is the Dose of Kratom?

As we mentioned, the dose is significant with kratom. If you’re starting, use the lowest amount and see how it affects you. Not only is much more likely to cause side effects, but it can lead to addiction quicker — we’ll cover those issues next.

You’ll need more if you’re looking for strong pain relief or help with insomnia. Use less if you want energy, focus, and a good mood. Again, start small and work your way up. If 2 g does the trick, why take more?

Generally, the general dosing guidelines are as follows:

  • Small dose: 2-5 g
  • Medium dose: 6-8 g
  • Large dose: 9-12 g

What Are the Side Effects of Kratom?

Kratom’s side effects usually come when taking more significant amounts. Most people don’t suffer from them when they use it responsibly.

Still, here’s what you might have to deal with:

More serious side effects typically come only after long-term and heavy use. This can include liver disease and addiction. However, kratom dependence and addiction are less powerful than opioid addiction, and overdose is unlikely.

Related: Is Kratom Dangerous?

What Are the Different Types of Kratom?

Thanks to varying alkaloid levels, kratom has different strains. This is largely due to when the leaves are harvested, though other factors, such as location, come into play.

The colors refer to the leaf vein color and give a clue as to what effects to expect.

White Vein Kratom

White vein strains are seen in the early stages of the life cycle. These ten improve cognitive brain capacity, help with concentration and creativity, and improve mood. These strains are known as potent energy boosters.   

Red Vein Kratom

Red vein kratom is derived from leaves at the end of their life cycle and acts as a sleep-inducing agent. Because of their alkaloid levels, they help treat anxiety and pain management.

Green Vein Kratom

Green vein kratom comes from leaves in the middle stage of maturity. These are mood boosters, tend to have a long time of action, and are ideal for anyone wanting a balance between the white and red strains.

Yellow Vein Kratom

Yellow vein kratom is prepared by mixing various other strains of kratom. The mixture is fermented and dried. This form helps to control anxiety and is well-balanced, similar to green strains.

Key Takeaways: Is it Safe to Mix Kratom & Tamsulosin?

Kratom and tamsulosin have a moderate level of interaction. An antagonistic reaction occurs between them.

Kratom and tamsulosin both affect the alpha-adrenergic system. Kratom can reduce tamsulosin’s ability to relax smooth muscles in the genitourinary system and blood vessels. The same enzyme metabolizes kratom and tamsulosin. So there may be an accumulation of these drugs in the bloodstream.

Seek medical advice before using these drugs together.

References

  1. White C. M. (2019). Pharmacologic and clinical assessment of kratom: An update. American journal of health-system pharmacy: AJHP: official journal of the American Society of Health-System Pharmacists, 76(23), 1915–1925.
  2. Troost, J., Tatami, S., Tsuda, Y., Mattheus, M., Mehlburger, L., Wein, M., & Michel, M. C. (2011). Effects of strong CYP2D6 and 3A4 inhibitors, paroxetine, and ketoconazole, on the pharmacokinetics and cardiovascular safety of tamsulosin. British journal of clinical pharmacology, 72(2), 247–256.
  3. Perumal, C., Chowdhury, P. S., Ananthakrishnan, N., Nayak, P., & Gurumurthy, S. (2015). A comparison of the efficacy of naftopidil and tamsulosin hydrochloride in medical treatment of benign prostatic enlargement. Urology annals, 7(1), 74–78.
  4. Wang, R. C., Smith-Bindman, R., Whitaker, E., Neilson, J., Allen, I. E., Stoller, M. L., & Fahimi, J. (2017). Effect of Tamsulosin on Stone Passage for Ureteral Stones: A Systematic Review and Meta-analysis. Annals of emergency medicine, 69(3), 353–361.e3.
  5. Lee, K. S., Han, D. H., Lee, Y. S., Choo, M. S., Yoo, T. K., Park, H. J., Yoon, H., Jeong, H., Lee, S. J., Kim, H., & Park, W. H. (2010). Efficacy and safety of tamsulosin for the treatment of non-neurogenic voiding dysfunction in females: a 8-week prospective study. Journal of Korean medical science, 25(1), 117–122.
  6. Michel, M. C. (2017). Tamsulosin. 

Learn More About Kratom-Drug Interactions