Finasteride vs. Tamsulosin

June 4, 2025/Andrew Le

“Do I pick a treatment that kicks in fast, or one that stops problems before they start?” 

That’s exactly the choice between finasteride and tamsulosin. While one digs in to address the underlying cause over time, the other brings quicker relief from irritating symptoms. 

In the sections ahead, we’ll break down how each works, what you can expect, and how costs compare, so you can decide with confidence.

🔑Key Takeaways

➤ Finasteride takes time to work but helps shrink the prostate and lower the risk of future problems like urinary retention and surgery. As a secondary benefit, it can help with male pattern baldness.

➤ Tamsulosin provides faster relief from urinary symptoms by relaxing muscles but does not shrink the prostate or stop it from growing.

➤ Finasteride is taken once daily at the same time, and missing doses can affect its long-term results, especially for hair loss and prostate issues.

➤ Tamsulosin should be taken after the same meal each day, and if stopped for several days, it must be restarted at the lowest dose to avoid side effects like dizziness.

➤ Finasteride is more affordable than tamsulosin.

➤ Common side effects of finasteride include sexual problems and mood changes, while tamsulosin may cause dizziness, weakness, and fainting when standing up too quickly.

➤ Serious but rare side effects of both medicines include life-threatening allergic reactions, requiring immediate medical attention if they occur.

➤ Some people may benefit from using both medicines together to achieve faster symptom relief and better long-term control of prostate growth.

Mechanism of Action

Finasteride slowly lowers DHT levels to shrink the prostate and slow hair loss, while tamsulosin works faster by relaxing muscles to help with urine flow but doesn’t shrink the prostate.

Finasteride

According to a book, finasteride works by blocking the type II and III isoenzymes of 5-alpha reductase. These enzymes are responsible for converting testosterone into dihydrotestosterone (DHT), a hormone that contributes to prostate growth and male pattern baldness. By inhibiting this conversion, finasteride lowers DHT levels significantly. 

Tamsulosin

According to research, tamsulosin is a selective alpha-1 adrenergic receptor blocker that primarily targets the alpha-1A and alpha-1D receptors. These receptors are found in high concentrations in the prostate, bladder neck, and ureter. By blocking them, tamsulosin relaxes the smooth muscles in these areas, improving urine flow and relieving lower urinary tract symptoms associated with BPH.

💡 Did You Know?

Tamsulosin is also used off-label to manage urolithiasis, or kidney stones. The ureter, especially its lower segment, has a high density of alpha-1A and alpha-1D receptors. Blocking these receptors relaxes the ureter’s smooth muscle, which may help pass stones more easily.

Dosage and Administration

Finasteride is taken once a day to treat BPH or hair loss, while Tamsulosin is taken once a day after the same meal to relieve prostate symptoms, and both medicines must be swallowed whole without crushing or chewing.

MedicationStandard DoseMaximum DoseAdministration InstructionsMissed Dose Instruction
Finasteride5 mg once daily (BPH)1 mg once daily (Hair Loss)5 mg once daily (BPH)Take at the same time daily.
Can be taken with or without food.Swallow whole; do not crush or split.		Take immediately if within 6 hours.
Otherwise, skip the missed dose.
Tamsulosin0.4 mg once daily0.8 mg once dailyTake 30 minutes after the same meal each day.Swallow whole; do not crush, chew, or open.Resume at 0.4 mg if interrupted for several days.

Finasteride

According to a book, the recommended dose of Finasteride depends on its intended use. 

  • For treating BPH, the standard dosage is 5 mg once daily. This can be taken with or without food, and the tablets should be swallowed whole with water. Crushing or splitting the tablets is not advised.
  • For androgenic alopecia (male pattern hair loss), the dose is lower at 1 mg once daily. It’s important to take Finasteride at the same time each day to maintain consistent blood levels. 

Treatment is usually long-term, often requiring several months before noticeable improvements appear. If a dose is missed and remembered within six hours, it should be taken immediately. Otherwise, the missed dose should be skipped to avoid doubling the next dose.

Patients are advised not to discontinue therapy without consulting their physician, as stopping the medication typically results in the return of symptoms within 12 months for hair loss and within 3 months for BPH.

Tamsulosin

The standard starting dose of Tamsulosin is 0.4 mg once daily, administered approximately 30 minutes after the same meal each day. The capsule must be swallowed whole and should not be crushed, chewed, or opened to maintain the controlled release of the medication.

If the initial dose of 0.4 mg does not provide sufficient symptom relief after 2 to 4 weeks, the dose may be increased to 0.8 mg once daily. However, caution is advised when increasing the dose, especially in patients prone to orthostatic hypotension.

If treatment is interrupted for several days, regardless of the previous dose, therapy should be restarted at 0.4 mg once daily to minimize the risk of adverse effects such as dizziness and fainting.

Concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole) is contraindicated at the 0.4 mg dose, and Tamsulosin should not be combined with other alpha-adrenergic blockers due to the increased risk of hypotension.

Efficacy

Finasteride works slowly but helps shrink the prostate and prevent future problems, while tamsulosin gives fast relief from urinary symptoms and keeps working well even after years of use.

Finasteride

According to research, finasteride is highly effective at shrinking the prostate and improving urinary symptoms by blocking the production of DHT, the hormone responsible for prostate growth. Long-term use lowers prostatic hormone levels by up to 90% and serum levels by about 70%, leading to a noticeable reduction in prostate size.

This directly improves urinary symptoms and helps prevent complications like acute urinary retention. Research shows that finasteride can reduce the risk of this condition by more than half and delay the need for prostate surgery. 

Finasteride is most helpful for men with larger prostates, as it directly reduces gland size and relieves pressure on the urinary tract. 

While finasteride does not provide fast relief like tamsulosin, it is important for long-term control of prostate growth and reducing the risk of future complications. This makes it a valuable option for preventing disease progression rather than providing immediate symptom relief.

Tamsulosin

According to research, tamsulosin at 0.4 mg once daily significantly improved urinary symptoms in men with BPH. The International Prostate Symptom Score dropped from a baseline of 26.73 to 15.73 after the first month and further down to 9.13 by the third month, showing statistically significant improvement. 

In addition to symptom relief, the post-void residual urine volume decreased from 78.16 mL at baseline to 20.83 mL after three months, helping patients empty their bladders more completely.

Uroflowmetry results also showed impressive improvements. The maximum urine flow rate increased from 7.37 mL/s at the start to 14.47 mL/s after the first month, and further improved to 25.83 mL/s by the third month, showing an overall improvement of over 250%.

Long-term results were equally encouraging. A study found that patients who continued using tamsulosin for up to six (6) years maintained significant symptom relief and improved urine flow. Symptom scores consistently improved each year, and most patients maintained these benefits without needing to adjust their dose.

One study also reported that 75% of patients continued to show reduced symptoms, and up to 30% experienced a major improvement in urine flow rate even after two years. This shows that tamsulosin provides quick relief and long-term benefits without losing its effectiveness over time.

Side effects

Finasteride and tamsulosin can both cause side effects, ranging from mild issues like dizziness and low sex drive to serious problems like chest pain, swelling, and life-threatening allergic reactions.

Finasteride

Finasteride may lead to a range of side effects. Some are common and manageable, while others require immediate medical attention.

Common side effects:

  • Inability to have or maintain an erection
  • Decreased sexual desire
  • Problems with ejaculation, including low semen volume
  • Pain in the testicles
  • Depression

Serious side effects:

  • Breast changes such as enlargement, lumps, pain, or nipple discharge
  • Rash and itching
  • Hives
  • Swelling of the lips and face
  • Difficulty breathing or swallowing

Finasteride has also been linked to an increased risk of high-grade prostate cancer and male breast cancer. These are serious concerns, so regular medical checkups are advised while using this medication.

Other reported side effects:

  • Cold sweats and chills
  • Dizziness or fainting when standing up
  • Confusion
  • Rapid or unusual weight changes
  • Tingling sensations in hands or feet
  • Runny or stuffy nose
  • Back pain
  • Headaches
  • Stomach pain
  • Testicular pain

Although these side effects can be troubling, some may improve over time as the body adjusts. However, if they persist or worsen, it’s best to consult a healthcare provider immediately.

Tamsulosin

Tamsulosin also presents both common and serious side effects. These effects are often related to how the drug relaxes muscles and impacts blood pressure.

Common side effects:

These typically affect more than 1 in 100 people and are usually mild:

  • Dizziness, especially when standing up
  • Sleepiness or drowsiness
  • Weakness
  • Back pain
  • Runny or stuffy nose
  • Difficulty ejaculating
  • Blurred vision
  • Pain or pressure in the face
  • Sore throat and cough

Serious side effects include when immediate medical attention is needed if these symptoms appear:

  • Painful erection lasting for hours (priapism)
  • Rash, itching, or hives
  • Swelling of the eyes, face, lips, tongue, throat, arms, or legs
  • Fainting or passing out
  • Rapid or irregular heartbeat

Severe allergic reactions (Anaphylaxis):

  • Swelling of the lips, mouth, throat, or tongue
  • Difficulty breathing or choking sensation
  • Tightness in the chest or throat
  • Blue or pale skin, lips, or fingertips
  • Sudden confusion or extreme drowsiness
  • Unresponsiveness or fainting

Patients should inform their doctor immediately if these reactions occur. Also, anyone taking tamsulosin should be cautious when standing up from a seated or lying position due to the risk of dizziness or fainting.

Cost

Based on prices from Cost Plus Drugs, Finasteride is cheaper than Tamsulosin, with the 1 mg tablets costing only $5.82 for 30 days, while Tamsulosin costs $6.32 for the same supply.

MedicationStrengthQuantityCostRetail PriceSavings
Finasteride1 mg30 tablets$5.82$70.20$64.38
Finasteride5 mg30 tablets$6.16$50.10$43.94
Tamsulosin0.4 mg30 capsules$6.32$64.20$57.88

Finasteride

The cost of Finasteride depends on its strength and quantity. For the 1 mg tablets, a 30-count supply costs only $5.82. This price offers a significant savings of $64.38 compared to the retail price of $70.20 at other pharmacies. 

If a higher dose is prescribed, the 5 mg tablets are also affordable. A 30-count supply of 5 mg Finasteride costs $6.16, saving patients $43.94 off the typical retail price of $50.10.

Tamsulosin

The cost of Tamsulosin is slightly higher than Finasteride. A 30-count supply of 0.4 mg Tamsulosin capsules costs $6.32. This pricing results in a savings of $57.88 compared to the usual retail price of $64.20 at other pharmacies.

Both medications are offered at significantly lower prices through the Mark Cuban Cost Plus Drug Company. Finasteride is the more budget-friendly option overall, especially at the 1 mg dosage, while Tamsulosin remains affordable but costs slightly more per supply.

Wrap Up

Choosing between finasteride and tamsulosin depends on what outcome matters most. Finasteride helps reduce prostate size and lowers the chance of future problems, but it takes time to work. Tamsulosin provides quick relief from symptoms, making it ideal when discomfort needs fast attention. 

However, it does not stop the prostate from growing. Some people may benefit from using both medicines together for better long-term control and faster symptom relief. 

Frequently Asked Questions

Can I drink alcohol while taking finasteride or tamsulosin?

Yes, but drink moderately. Tamsulosin can cause dizziness, and alcohol may make this worse. Finasteride has no direct interaction with alcohol.

Is it safe to drive after taking tamsulosin?

Be careful. Tamsulosin may cause dizziness or fainting, especially when standing up quickly. Avoid driving if you feel lightheaded.

Can women take finasteride?

No, this medication is indicated for men. Finasteride is especially unsafe for women who are or may become pregnant.

Sources

  • Pourmand, A., Nadendla, R., Mazer-Amirshahi, M., & O’Connell, F. (2016). Tamsulosin for urolithiasis: A review of the recent literature and current controversies. American Journal of Emergency Medicine, 34(8), 1653-1658. https://doi.org/10.1016/j.ajem.2016.09.009
  • Praveen, R., & Kumar, T. N. (2020). Evaluation of efficacy and safety profile of tamsulosin in benign prostatic hyperplasia. International Journal of Basic & Clinical Pharmacology, 9(2), 332–335. https://doi.org/10.18203/2319-2003.ijbcp20200186
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