Lostam

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Medically reviewed

Marina Burgos

Last updated on 10/01/2026

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Lostam

What is Lostam?

Lostam is a pharmaceutical medication containing the active substance levetiracetam. It belongs to a group of medicines known as antiepileptics, which are primarily used to treat various forms of epilepsy and seizure disorders.

Mechanism of Action

Unlike many older antiepileptic medications, the active component in Lostam works through a distinct mechanism. It binds to a specific protein in the brain called synaptic vesicle protein 2A (SV2A). This protein is involved in the release of neurotransmitters, which are the chemical messengers that allow nerve cells to communicate. By interacting with this protein, the medication helps to stabilize electrical activity in the brain and reduce the occurrence of abnormal electrical discharges that lead to seizures.

Therapeutic Use

Lostam is utilized as a long-term treatment to manage seizures. Depending on the specific diagnosis and the patient's age, it may be used in the following ways:

  • Monotherapy: Used as the sole medication for the treatment of partial-onset seizures in newly diagnosed patients.
  • Adjunctive Therapy: Used in combination with other antiepileptic drugs to treat partial-onset seizures, myoclonic seizures, or primary generalized tonic-clonic seizures.

Characteristics

The medication is designed to be absorbed efficiently by the body, typically reaching peak concentrations shortly after administration. Its pharmacological profile is characterized by predictable behavior in the system, and it is largely excreted through the kidneys. Because it does not rely heavily on the liver for metabolism, it often has fewer interactions with other types of medications compared to some alternative treatments in its class.

Regulatory References

  1. NIH MedlinePlus Tamsulosin Drug Information

What side effects are possible with Lostam?

Possible Side Effects and Safety Information

The safety profile of Lostam (Tamsulosin Hydrochloride) is characterized by adverse reactions classified according to their frequency, as documented in regulatory sources such as the FDA and EMA. Adverse effects are grouped by the affected System-Organ-Class (SOC), including the Nervous System, Vascular System, and Reproductive System.


Frequency-Classified Adverse Reactions

Adverse reactions that are considered common (ge 1 in 100 to < 1 in 10 patients) include Dizziness, Headache, Rhinitis, Asthenia (weakness), and Abnormal ejaculation (e.g., retrograde or decreased ejaculation). Reactions classified as uncommon include Orthostatic hypotension, Palpitations, Nausea, Diarrhea, and various skin reactions like rash or itching.

Serious Adverse Reactions and Safety Considerations

Certain rare but clinically significant adverse reactions are documented. These include Syncope (fainting), Angioedema (swelling of the face, tongue, or throat), and Priapism (a persistent, painful erection). A very rare, severe reaction is Stevens-Johnson syndrome.


Time-Related Patterns and Restrictions

The potential for Orthostatic hypotension and associated symptoms like dizziness is explicitly noted as a concern, particularly when beginning treatment or following a dosage change. Lostam is not indicated for use in women or the pediatric population. The official safety profile requires that patients be screened for prostate cancer prior to and during treatment. Furthermore, the risk of Intraoperative Floppy Iris Syndrome (IFIS) during cataract or glaucoma surgery is a key safety note for individuals taking, or previously treated with, this class of medication.

Overdose and Emergency Response

Overdose Manifestations and Severe Outcomes

Overdosage with Lostam (Tamsulosin Hydrochloride) is officially documented to present primarily as acute hypotension (low blood pressure), a consequence of its pharmacological action. A severe outcome reported in regulatory labeling includes systolic blood pressure falling to 70 mm Hg following a significant ingestion. Other documented clinical manifestations include fainting (syncope), dizziness, and blurred vision. Gastrointestinal effects such as vomiting and diarrhoea are also listed as potential signs. The primary life-threatening risk is profound, unmanaged hypotension.

When to Seek Urgent Medical Help

Regulatory authorities mandate that urgent medical attention must be sought immediately for any suspected overdose. Emergency services or Poison Control must be contacted if the patient experiences severe symptoms such as collapse, seizure, or significant trouble breathing. No specific antidote is known for Lostam overdose.

Official Management and Procedures

Management focuses entirely on cardiovascular support. Regulatory documents describe actions including placing the patient in a supine position and administering volume expanders or vasopressors if necessary to stabilize blood pressure and heart rate. Procedures to impede drug absorption may include gastric lavage or the administration of activated charcoal and an osmotic laxative. Continuous monitoring of renal function is required; however, due to high protein binding, dialysis is unlikely to be effective.

Therapeutic Uses of Lostam

What Lostam Treats: Main Uses and Benefits

Lostam is commonly used in clinical settings where supportive symptom management is appropriate. It is considered relevant for short-term assistance with symptoms related to physical discomfort and symptoms that interfere with daily functioning.

The medicine is relevant in clinical scenarios marked by temporary physiological imbalance, and may assist with managing symptom clusters that may become intense or disruptive. It is applied across domains where additional symptomatic support is needed, with relevant uses including helping with symptomatic discomfort, assisting with maintaining functional stability, and easing distress during acute episodes.

“Lostam contributes to easing the overall symptom load, particularly when symptoms become more noticeable.”

Quick Fact: Relevant for Symptom Clusters

Quick Fact: Relevant for Systemic and Localized Discomfort. Lostam is generally applied when symptom clusters require supportive management during a flare-up.

Eligibility and Restrictions for Use

Who Can and Cannot Use Lostam?

The eligibility profile for Lostam (Tamsulosin Hydrochloride) is strictly defined by regulatory documents, restricting use to the adult male population.

Contraindicated Populations (Must Not Use)
Patients with known hypersensitivity to tamsulosin or any component.
Individuals with a history of orthostatic hypotension (EMA SmPC).
Patients with severe hepatic impairment (EMA SmPC).
Restricted or Unstudied Populations
Pediatric Population (Under 18): Not indicated for use; safety and efficacy are not established.
Women: Not indicated for use in women, including those who are pregnant or lactating.
Severe Renal Impairment: Has not been studied in patients with End-Stage Renal Disease (ESRD).
Surgical Candidates: Requires caution and surgeon notification if scheduled for cataract or glaucoma surgery (risk of Intraoperative Floppy Iris Syndrome).

Official eligibility statements:

The medicine is formally contraindicated for any patient with a known hypersensitivity, a history of orthostatic hypotension, or severe hepatic impairment. Use is strictly not indicated for the pediatric population and is not indicated for use in women. Furthermore, the official label mandates that patients must be screened for prostate cancer before and during treatment.

What should I know about interactions with other medicines?

The official regulatory profile for Lostam details specific pharmacokinetic and pharmacodynamic interactions that establish restrictions or require caution with co-administration of certain medicinal products.

Prohibited Combinations and Metabolic Restrictions

Lostam is prohibited for co-administration with other alpha-adrenergic blocking agents due to the potential for a reinforcing effect that increases the risk of symptomatic hypotension. The regulatory label also classifies strong inhibitors of the CYP3A4 enzyme (such as Ketoconazole) as a contraindicated combination. Since Lostam is primarily metabolized by CYP3A4 and CYP2D6, combining it with a strong CYP3A4 inhibitor leads to a substantial increase in systemic exposure.

Interactions Requiring Caution

Caution is advised when Lostam is taken concurrently with Phosphodiesterase-5 (PDE-5) inhibitors (e.g., Sildenafil), as both medications act as vasodilators, posing an additive risk for symptomatic hypotension. Medicines that moderately inhibit CYP3A4 or strong/moderate inhibitors of CYP2D6 (e.g., Paroxetine) also require cautious use due to documented increases in Lostam's plasma concentrations. Additionally, Cimetidine is documented to cause a rise in Lostam plasma levels.

Food and Population Constraints

To ensure consistent drug levels, Lostam must be administered following the same meal each day, as taking it in a fasted state increases the systemic exposure. The combination of strong CYP3A4 inhibitors is explicitly prohibited in patients known to be CYP2D6 Poor Metabolizers due to the potential for significantly heightened exposure.

Mechanism of Action

How Lostam Works: Mechanism of Action

Lostam (Tamsulosin Hydrochloride) functions as a highly selective competitive antagonist primarily targeting the alpha1A and alpha1D Adrenoceptor subtypes within the smooth muscle of the lower urinary tract. By occupying these specific receptor sites, the drug prevents the endogenous neurotransmitter Norepinephrine from binding. This blockade immediately interrupts the Sympathetic Nervous System (SNS) pathway that sustains the tonic contraction in the prostate gland and bladder neck.

The resulting inhibition of the alpha1 signaling cascade prevents the necessary influx and release of intracellular calcium ions ( Ca^2+). Since calcium is essential for muscle contraction, its reduced availability induces relaxation of the affected smooth muscle tissue. This physiological change decreases the force exerted by the muscle tissue on the prostatic urethra, which alters urine flow dynamics. The mechanistic effect applies solely to smooth muscle tone and does not affect the physical bulk or static component of the prostatic tissue.

Dosage and Administration Information

How to Use Lostam

Lostam (Tamsulosin Hydrochloride) is approved for oral administration as a hard capsule or prolonged-release tablet. Its official use is defined by a specific set of procedural rules, focusing on consistent dosing and proper physical handling of the dosage form.


Administration Scope

Instruction Official Guideline
Route & Form Oral route as a 0.4 mg hard capsule or prolonged-release tablet.
Standard Dosing 0.4 mg once daily. The dose may be increased to a maximum of 0.8 mg once daily if the response to the initial dose is insufficient after 2 to 4 weeks.
Timing Administration is required to be consistently one-half hour following the same meal each day to ensure stable drug absorption.

Procedural Constraints and Special Use

For the medicine to function as intended, the capsule or tablet must be swallowed whole and is not to be crushed, chewed, or opened under any circumstances. This procedural constraint preserves the controlled-release mechanism of the formulation.

No dose adjustment is warranted for patients with mild to moderate renal or hepatic impairment, and the medicine is not indicated for individuals under 18 years of age. If therapy is interrupted for several days, the official guidance requires restarting treatment at the 0.4 mg initial dose. The administration protocol supports a continuous, long-term use pattern.

Recent Clinical Evidence

Research Evidence: Overview of Studies for Lostam


Evidence for Use in Symptomatic Benign Prostatic Hyperplasia (BPH) / LUTS

The majority of available research for Lostam involves studies exploring Lower Urinary Tract Symptoms (LUTS) associated with an enlarged prostate, or Benign Prostatic Hyperplasia (BPH). Researchers have primarily conducted short-term, randomized, controlled trials (RCTs). These trials were used in research examining patient-reported outcomes related to lower urinary tract symptoms. Outcomes related to physical discomfort and daily functioning were monitored.

Studies focused on measuring changes in patients' subjective symptom scores, often using standardized questionnaires. Research also examined objective functional outcomes, such such as the maximum rate of urinary flow (Qmax) and the amount of urine remaining in the bladder after voiding. Studies monitored patient-reported outcomes (symptom scores) and recorded patterns of change in the groups studied compared to the groups receiving placebo over the short-term study period.

What remains uncertain is the full profile of the long-term effects based on controlled evidence. The evidence for sustained outcomes over several years often comes from non-comparative open-label studies. The follow-up durations were limited in the initial registration trials, meaning there is limited information for long-term outcomes regarding disease progression.

Evidence for Investigational Use in Ureteral Stones

Research has also explored the use of Lostam in conditions involving periods of heightened symptoms, specifically when the medication was studied for its potential association with the spontaneous passage of ureteral stones. These studies were conducted as randomized controlled trials and were later summarized in meta-analyses. Researchers examined whether the medication was associated with changes in the rate of spontaneous stone expulsion and the time required for expulsion.

Findings were mixed in the large-scale trials, and evidence quality varies across studies. Aggregated data from some meta-analyses recorded patterns in the measured stone expulsion rate, particularly for certain stone sizes. Data for stones larger than 10 mm remain insufficient, and research does not determine whether an individual will respond similarly to the group patterns observed in these studies.

Research Gaps and What Remains Uncertain

While there is a substantial body of evidence regarding its study in short-term BPH symptoms, key research limitation frames exist. Data for long-term progression of BPH symptoms are not well established by controlled evidence over periods greater than one year. Consistency for other uses is limited; certainty about these findings is considered limited outside of the primary BPH use. Research for certain groups remains insufficient, particularly for children, where evidence is limited due to trials that did not meet their primary endpoints.

Key Studies & References

  1. TAMSULOSIN HYDROCHLORIDE capsule (FDA DailyMed Label for Indications and Clinical Studies)

Frequently Asked Questions (FAQ)

Common questions about Lostam (FAQ)

Q: What happens if I miss a dose of Lostam? / What if I accidentally take two doses of Lostam?

Regulatory guidance states that if a dose is missed, it should be taken when remembered on the same day, or skipped entirely if remembered the next day. Official guidance advises against taking a double dose to make up for a missed one. Taking more than the recommended dose may cause a drop in blood pressure and an increase in heart rate.


Q: What are the most common reasons someone might stop taking Lostam?

While official documents do not explicitly list reasons for stopping, they classify common adverse reactions seen in studies. These common effects include dizziness, headache, rhinitis (nasal congestion), weakness, and abnormal ejaculation.


Q: Is Lostam meant to be taken for a long period of time?

The official administration protocol, as described in regulatory prescribing information, is designed to support a continuous, long-term use pattern.


Q: What is the risk of dependence or addiction with Lostam? / Is Lostam a controlled substance?

Lostam, which contains Tamsulosin, is designated as a prescription-only medicine. According to regulatory classifications, it is not listed as a controlled substance.


Q: What kind of monitoring is recommended while taking Lostam?

Official safety requirements mandate that patients be screened for prostate cancer before and during treatment with this medicine. Due to the known risk of symptomatic hypotension (a significant drop in blood pressure upon standing), monitoring of blood pressure is often associated with its use due to this risk.


Q: Why is Lostam sometimes used for a condition other than its main use?

Research has explored the use of Lostam for conditions outside of its main purpose, such as ureteral stones. Its pharmacological classification is an alpha-adrenoceptor antagonist, meaning it promotes smooth muscle relaxation in the lower urinary tract, which is the underlying reason for these research studies.


Q: Is it normal to feel a bit dizzy when first starting Lostam?

Official safety information documents dizziness as a common adverse reaction. The potential for this effect is explicitly noted as a concern, particularly when beginning treatment or following a dosage change.


Q: Why do official sources list so many possible side effects for Lostam?

Official sources list adverse reactions based on their frequency as observed across all clinical trials, in accordance with regulatory reporting standards. These are then grouped by the affected System-Organ-Class (SOC), which helps provide a comprehensive safety overview.


Q: Does Lostam cause weight gain or loss?

Weight gain or weight loss are not listed as documented adverse reactions in the frequency-classified lists within the official safety profiles.


Q: What kind of alcohol interaction is described for Lostam?

Official product information indicates that co-administration with alcohol may increase the blood pressure-lowering effects of the medication. This may lead to lightheadedness or dizziness.


Q: How long after stopping Lostam do the effects wear off?

The duration of the medicine's effect is related to its elimination half-life, a pharmacokinetic measure. This half-life is documented to be between 9 and 13 hours.


Q: Can I take Lostam if I have high blood pressure?

Official documents contraindicate the medicine for patients with a history of orthostatic hypotension (a drop in blood pressure when standing). Since the drug promotes vasodilation, which can lead to symptomatic hypotension, the potential for symptomatic hypotension is a key consideration described in official documentation.


Q: Is Lostam known to cause fatigue?

Weakness, or Asthenia, is documented in regulatory sources as a common adverse reaction. Drowsiness and unusual tiredness are also listed among the less common adverse effects.


Q: What is a 'contraindication' for Lostam?

A contraindication refers to a condition or factor that serves as a reason to withhold a certain medical treatment due to the harm that it would cause the patient. Official documentation lists specific conditions that prohibit the use of Lostam, such as a history of severe hypotension or hypersensitivity.


Q: Can Lostam be taken while pregnant or breastfeeding?

Lostam is not indicated for use in the female population, including individuals who are pregnant or lactating. The safety and efficacy of the medication have not been established for these groups.


Q: If I have a medical condition not listed in the uses, can I still take Lostam?

Lostam is officially defined by regulatory bodies for use only in addressing symptoms associated with Benign Prostatic Hyperplasia (BPH). Use of a medicine outside of its officially defined purpose is known as off-label use and is not addressed in official product documentation.


Q: Is the dose of Lostam related to body weight?

Official dosing guidelines outline a standard daily dose that may be increased based on an individual’s response to the medicine. The dosage is based on clinical response, and regulatory information indicates that it is not determined by body weight.


Q: Can Lostam affect sleep patterns?

Official safety profiles list difficulty falling asleep or staying asleep (insomnia) as a documented, though less common, adverse reaction.


Q: Is there a specific time of day recommended for taking Lostam?

Regulatory instructions require the medicine to be taken consistently once daily, approximately one-half hour following the same meal each day. This requirement is established to maintain stable drug absorption.


Q: Does Lostam affect fertility?

Official safety profiles document Abnormal Ejaculation as a common adverse reaction. This effect, which is characterized by decreased or absent semen volume, is documented to affect semen parameters.

How should Lostam be stored and disposed of?

How to Store and Dispose of Lostam

Lostam (Tamsulosin Hydrochloride) must be stored at controlled room temperature, specifically between 20 C and 25 C (68 F and 77 F), with protection from excessive heat and moisture. It is prohibited to store the medication in environments like the bathroom.

Storage and Handling

The product must remain in its original container and be kept tightly closed. The capsule or tablet must not be crushed, chewed, or opened. Consistent with regulatory requirements, the medication must be kept out of the sight and reach of children.

Disposal Instructions

Unused or expired Lostam should be disposed of using an official drug take-back program. If a take-back program is unavailable, the product should be mixed with an undesirable substance, sealed in a container, and discarded in the household trash. The medication must not be flushed down the toilet.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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