Molecular genetic predictors of the efficacy and safety of tamsulosin therapy

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access


Individual differences in efficacy and safety of drugs between patients are a significant problem in modern pharmacotherapy. The body’s pharmacological response to the administration of a particular drug is determined by multiple factors, where up to 50% of the variability of the pharmacological response may be determined by the genetic variability of the body. The article presents an up-to-date review of the data on genetic polymorphisms influencing the efficacy and safety of tamsulosin therapy in patients with lower urinary tract symptoms associated with benign prostatic hyperplasia.

Full Text

Restricted Access

About the authors

S. P. Abdullaev

Russian Medical Academy of Continuous Professional Education

postgraduate student in the department of endoscopic urology Moscow, Russia

M. N Shatokhin

Russian Medical Academy of Continuous Professional Education

Doct. Med. Sci., Full Professor, Professor at the Department of endoscopic urology Moscow, Russia

O. V Teodorovich

Russian Medical Academy of Continuous Professional Education

Doct. Med. Sci., Full Professor, Head of the Department of Endoscopic Urology Moscow, Russia

D. A Sychev

Russian Medical Academy of Continuous Professional Education

Doct. Med. Sci., Full Professor, Academician of the Russian Academy of Sciences, Head of the Department of Clinical Pharmacology and Therapy of Academician B.E. Votchal Moscow, Russia


  1. Cai T., Cui Y., Yu S., Li Q., Zhou Z., Gao Z.Comparison of Serenoa repens With Tamsulosin in the Treatment of Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis. Am J Mens Health. 2020;14(2):155798832090540. doi: 10.1177/1557988320905407.
  2. Narayan P. Tunuguntla HSGR. Long-term efficacy and safety of tamsulosin for benign prostatic hyperplasia. Rev Urol. 2005;7 Suppl 4:S42-48.
  3. Vickman R.E., Franco O.E., Moline D.C., Vander Griend D.J., Thumbikat P., Hayward S.W. The role of the androgen receptor in prostate development and benign prostatic hyperplasia: A review. Asian J Urol. 2020;7(3):191- 202. doi: 10.1016/j.ajur.2019.10.003.
  4. Nimeh T., Magnan B., Almallah Y. Benign Prostatic Hyperplasia: Review of Modern Minimally Invasive Surgical Treatments. Semin Intervent Radiol. 2016;33(03):244-250. doi: 10.1055/s-0036-1586148.
  5. Abrams P., Kelleher C.J., Kerr L.A., Rogers R.G. Overactive bladder significantly affects quality of life. Am J Manag Care. 2000;6(11 Suppl):S580-590.
  6. Dugan E., Cohen S.J., Bland D.R., ,Preisser J.S., Davis C.C.,Suggs P.K., McGann P. The Association of Depressive Symptoms and Urinary Incontinence Among Older Adults. J Am Geriatr Soc. 2000;48(4):413- 416. doi: 10.1111/j.1532-5415.2000.tb04699.x.
  7. Bachmann A., Descazeaud A., Emberton M., Gravas S., Michel M.C. Nordling J. EAU: Guidelines on Male Lower Urinary Tract Symptoms ( LUTS ), including Benign Prostatic Obstruction ( BPO ). Eur Assoc Urol. 2015;(February):123-144. doi: 10.1016/j.eururo.2013.03.004.
  8. Michel M., Kenny B., Schwinn D. Classification of a1-adrenoceptor subtypes. Naunyn Schmiedebergs Arch Pharmacol. 1995;352(1). doi: 10.1007/BF00169183.
  9. Яровой С.К. Силодозин - новый препарат группы селективных. Экспериментальная и клиническая уролога. 2012;3:57-62).
  10. Novara G., Tubaro A., Sanseverino R., Spatafora S., Artibani W., Zattoni F., Montorsi F., Chapple C.R. Systematic review and meta-analysis of randomized controlled trials evaluating silodosin in the treatment of non-neurogenic male lower urinary tract symptoms suggestive of benign prostatic enlargement. World J Urol. 2013;31(4):997-1008. doi: 10.1007/s00345-012-0944-8.
  11. Roehrborn C.G. Efficacy of alpha-Adrenergic Receptor Blockers in the Treatment of Male Lower Urinary Tract Symptoms. Rev Urol. 2009;11(Suppl 1): S1-58.
  12. Мартов А.Г., Ергаков Д.В. Терапия симптомов нижних мочевых путей, обусловленных доброкачественной гиперплазией предстательной железы: что нового в 2016 году. Эффективная фармакотерапия 2016;(353):6-12.
  13. Сычёв Д.А. Рекомендации по применению фармакогенетического тестирования в клинической практике. Качественная Клиническая Практика. 2011;(1):3-10.
  14. Ahmad T., Valentovic M.A., Rankin G.O. Effects of cytochrome P450 single nucleotide polymorphisms on methadone metabolism and pharmacodynamics. Biochem Pharmacol. 2018; 153:196-204. doi: 10.1016/j.bcp.2018.02.020.
  15. Lindh J.D., Holm L., Andersson M.L., Rane A. Influence of CYP2C9 genotype on warfarin dose requirements-a systematic review and meta analysis. Eur J Clin Pharmacol. 2009;65(4):365-375. doi: 10.1007/s00228-008-0584-5.
  16. Pare G., Mehta S.R., Yusuf S., Anand S.S., Connolly S.J., Hirsh J., Simonsen K., Bhatt D.L., Fox K.A.A., Eikelboom J.W. Effects of CYP2C19 Genotype on Outcomes of Clopidogrel Treatment. N Engl J Med. 2010;363(18):1704-1714. doi: 10.1056/NEJMoa1008410.
  17. The SEARCH Collaborative Group. SLCO1B1 Variants and Statin-Induced Myopathy - A Genomewide Study. N Engl J Med. 2008;359(8):789-799. doi: 10.1056/NEJMoa0801936.
  18. Blake C.M., Kharasch E.D., Schwab M., Nagele P. A Meta-Analysis of CYP2D6 Metabolizer Phenotype and Metoprolol Pharmacokinetics. Clin Pharmacol Ther. 2013;94(3):394-399. doi: 10.1038/clpt.2013.96.
  19. Waade R.B., Solhaug V., Hoiseth G. Impact of CYP2D6 on serum concentrations of flupentixol, haloperidol, perphenazine and zuclopenthixol. Br J Clin Pharmacol. 2021 ;87(5) :2228-2235. doi: 10.1111/bcp.14626.
  20. Kim K.-A., ParkI.-B, Park J.-Y. Effects of CYP2D6 and CYP3A5 genetic polymorphisms on steady-state pharmacokinetics and hemodynamic effects oftamsulosin in humans. Eur J Clin Pharmacol. 2018;74(10):1281- 1289. doi: 10.1007/s00228-018-2501-x.
  21. Van Hoogdalem E.J., Soeishi Y., Matsushima H., Higuchi S. Disposition of the Selective a1A-Adrenoceptor Antagonist Tamsulosin in Humans: Comparison with Data from Interspecies Scaling. J Pharm Sci. 1997;86(10):1156-1161. doi: 10.1021/js960303k.
  22. Lowe F.C. Summary of clinical experiences with tamsulosin for the treatment of benign prostatic hyperplasia. Rev Urol. 2005;7 Suppl 4:S13-21.
  23. Michel M.C., Korstanje C., Krauwinkel W. Cardiovascular Safety of Tamsulosin Modified Release in the Fasted and Fed State in Elderly Healthy Subjects. Eur Urol Suppl. 2005;4(2):9-14. doi: 10.1016/j.eursup.2004.11.003.
  24. Soeishi Y., Matsushima H., Watanabe T., Higuchi S., Cornelissen K., Ward J. Absorption, metabolism and excretion of tamsulosin hydrochloride in man. Xenobiotica. 1996;26(6):637-645. doi: 10.3109/00498259609046739.
  25. Kamimura H., Oishioe S., Matsushima H., Watanabe T., Higuchi S., Hall M., Wood S.G., Chasseaud L.F. Identification of cytochrome P450 isozymes involved in metabolism of the a1-adrenoceptor blocker tamsulosin in human liver microsomes. Xenobiotica. 1998;28(10):909- 922. doi: 10.1080/004982598238985.
  26. Bertz R.J., Granneman G.R. Use of In Vitro and In Vivo Data to Estimate the Likelihood of Metabolic Pharmacokinetic Interactions. Clin Pharmacokinet. 1997;32(3):210-258. doi: 10.2165/00003088199732030-00004.
  27. Guengerich F.P. Cytochromes P450, Drugs, and Diseases. Mol Interv. 2003;3(4):194-204. doi: 10.1124/mi.3.4.194.
  28. Thorn C.F., Klein T.E., Altman R.B. Pharm GKB: The Pharmacogenetics and Pharmacogenomics Knowledge Base. In: Pharmacogenomics. Humana Press; :179-192. doi: 10.1385/1-59259-957-5:179.
  29. Park P-W., Seo Y.H., Ahn J.Y., Kim K-A., Park J-Y. Effect of CYP3A5*3 genotype on serum carbamazepine concentrations at steady-state in Korean epileptic patients. J Clin Pharm Ther. 2009;34(5):569-574. doi: 10.1111/j.1365-2710.2009.01057.x.
  30. Kuehl P., Zhang J., Lin Y., Lamba J., Assem M., Schuetz J., Watkins P.B. et al. Sequence diversity in CYP3A promoters and characterization of the genetic basis of polymorphic CYP3A5 expression. Nat Genet. 2001;27(4):383-391 doi: 10.1038/86882.
  31. Zanger U.M., Raimundo S., Eichelbaum M. Cytochrome P450 2D6: overview and update on pharmacology, genetics, biochemistry. Naunyn Schmiedebergs Arch Pharmacol. 2004;369(1):23-37. doi: 10.1007/s00210-003-0832-2.
  32. Crews K.R., Monte A.A., Huddart R., Caudle K.E., Kharasch E.D., Gaedigk A., Dunnenberger H.M. et al. Clinical Pharmacogenetics Implementation Consortium Guideline for CYP2D6, OPRM1, and COMT Genotypes and Select Opioid Therapy. Clin Pharmacol Ther. 2021;110(4):888-896. doi: 10.1002/cpt.2149.
  33. FDA (1997). Flomax® (tamsulosin hydrochloride) capsules - Drug Label. Available at: (Accessed 01/23/2019).
  34. Choi C.-I., Bae J.-W., Jang C.-G., Lee S.-Y. Tamsulosin Exposure Is Significantly Increased by the CYP2D6*10/*10 Genotype. J Clin Pharmacol. 2012;52(12):1934-1938. doi: 10.1177/0091270011432168.
  35. Villapalos-Garcia G., Zubiaur P., Navares-Gomez M., et al. Effects of Cytochrome P450 and Transporter Polymorphisms on the Bioavailability and Safety of Dutasteride and Tamsulosin. Front Pharmacol. 2021;12:718281. doi: 10.3389/fphar.2021.718281.
  36. Takata R., Matsuda K., Sugimura J., Obara W., Fujioka T., Okihara K., Takaha N. et al. Impact of four loci on serum tamsulosin hydrochloride concentration. J Hum Genet. 2013;58( 1):21-26. doi: 10.1038/jhg.2012.126.
  37. Bradford L.D. CYP2D6 allele frequency in European Caucasians, Asians, Africans and their descendants. Pharmacogenomics. 2002;3(2):229-243. doi: 10.1517/14622416.3.2.229.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies