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Problems With Flomax for Kidney Stones

Discussion in 'Emergency Medicine' started by docB, May 9, 2008.

  1. docB

    docB Chronically painful Physician Moderator Emeritus Lifetime Donor Classifieds Approved 10+ Year Member

    Nov 27, 2002
    Las Vegas, NV
    I’ve been having lots of difficulties with pharmacies and Flomax for kidney stones. The fist thing I ran into was a batch of pharmacists calling me and saying they can’t give Flomax to a female. I then had one that called saying that she couldn’t dispense it for an off label use like kidney stones. Finally, I had one who said that it was not on the patient’s formulary and I had to change it to Urispas (flavoxate). I asked if that has the same promotility characteristics as Flomax and he didn’t know. I didn’t know either so I told him to just keep it as Flomax. Nothing annoys pharmacists more than not changing things to accommodate formularies. So the Flomax for kidney stone thing is turning into a real pain. Is anyone else having similar issues?
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  3. spyderdoc

    spyderdoc Physician Moderator Emeritus Lifetime Donor Classifieds Approved 15+ Year Member

    Jul 30, 2002
    SF Bay Area
    I've been writing for it as well..Haven't known of any problems so far.
  4. coldcoldworld

    coldcoldworld 2+ Year Member

    Oct 27, 2006
    Cleveland, OH
    I've had similar problems with Flomax in women. Pharmacist said the script would be like $100 b/c it "wasn't indicated for kidney stones". Ended up just switching her to Hytrin. In theory, I think you may get a bit more orthostatic as its not as selective as Flomax but I just have them take it qhs.

    Interestingly, that last review in Annals didn't specify the use of the newer "selective" blockers like Flomax but rather took all comers, so I think you still see benefit with some of the older and CHEAPER drugs.
  5. Apollyon

    Apollyon Screw the GST Physician Lifetime Donor Classifieds Approved 10+ Year Member

    Nov 24, 2002
    It's a 2008 AUA guideline/recommendation, so it has legs.
  6. Tiger26

    Tiger26 Senior Member Physician 10+ Year Member

    Mar 13, 2004
    One of my friends in our class just got a Rx for it from the ED for kidney stones
  7. kungfufishing

    kungfufishing Senior Member 7+ Year Member

    Mar 7, 2003
    I know of people who had pharmacists question the flomax in a female. I've been specifying that it was for a kidney stone on the script and havent heard anything about it. The other problems I have not encountered.
  8. EctopicFetus

    EctopicFetus Keeping it funky enough 10+ Year Member

    May 3, 2004
    Here in az our state medicaid/medicare wont pay for it for women.. plain and simple.. literature or not..
  9. Jeff698

    Jeff698 EM/EMS nerd 15+ Year Member

    Aug 11, 2000
    Salado, Texas
    The only problem I've had is when telling the patient. I've had women who've seen the TV commercials or something look at me like I'm smoking crack. One got this condescending look on her face and informed me that women didn't have prostate glands (even after I'd painfully pointed out why I was prescribing it).

    Sometimes it just isn't worth chewing through the restraints in the morning to come to work.

    Take care,
  10. Arcan57

    Arcan57 Junior Member 10+ Year Member

    Nov 21, 2003
    I've started running into Flomax on the MARs of elderly females with incontinence. I've seen it three times and still can't figure out why it would help.

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