Q: I am a 62 years old diabetic man having problem of frequent urination. I underwent flowmetry (uroflow) test and was diagnosed as obstructed flow with slightly enlarged prostate (size 3.8 by 3.6 by 3.1 cm). The doctor advised Urimax 0.4 mg. Microalbuminuria test showed urine protein - 15 mg %, urine creatine - 377.5 mg and ratio - 39.7 mcg/mg, which is slightly higher than the normal range as per the Nephrologist. I am taking Tamsulosin, Glynase, Walaphse and vitamin and calcium supplements. What is the best time to take the medication (after meals or before)? For how long do the medicines remain effective? Please advise.

A:It seems that you have been diagnosed as Lower Urinary Tract Symptoms (LUTS) due prostate enlargement and you have been prescribed Tamsulosin for it. According to your description you have also been evaluated by nephrologist, most probably due to diabetic nephropathy. Tamsulosin is an alpha 1 receptor blocker and commonly used for LUTS. Blockade of these receptors causes relaxation of smooth muscles in bladder neck and prostate and therefore improvement in urinary symptoms. Tamsulosin is usually taken at bed time with or without food. Its effect usually starts within few days and symptoms often come back once medication is stopped. In most cases it is necessary to take tamsulosin for long duration (many months or years) if it continues to be effective. If Tamsulosin is not working then you need to be reevaluated by urologist to rule out other causes of LUTS.