• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor, pharmacist or nurse.
• This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
• If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. See section 4.

1. What Flomaxtra XL is and what it is used for
2. What you need to know before you use Flomaxtra XL
3. How to use Flomaxtra XL
4. Possible side effects
5. How to store Flomaxtra XL
6. Contents of the pack and other information

Flomaxtra XL contains the active substance tamsulosin hydrochloride. It acts by relaxing the muscles in the prostate and urethra (the tube that carries urine to the outside), and lets urine pass more readily through the urethra and aids urination.

In the prostate gland, bladder and urethra there are specialised cells containing alpha1A-receptors that cause the muscles in the urethra to tighten. Flomaxtra XL is an alpha1A-adrenoceptor blocker, which reduces the action of these specialised cells and relaxes the muscles making it easier to pass water.

Flomaxtra XL is used to treat the symptoms associated with benign prostatic hyperplasia (BPH) which is enlargement of the prostate gland. These symptoms include difficulty in starting to pass water, frequent trips to the toilet to pass water, a feeling of not completely emptying the bladder and having to get up several times in the night to pass water.

• are allergic to tamsulosin or any of the other ingredients of Flomaxtra XL (listed in section 6)
• have a severe liver condition
• have ever fainted or felt dizzy when suddenly sitting or standing up. Dizziness can sometimes occur when taking Flomaxtra XL, particularly if you are also taking other alpha1- blockers. If you do feel weak or dizzy make sure you sit or lie down straight away until the symptoms have disappeared.

Talk to your doctor before using Flomaxtra XL

• If you have kidney problems
• If you are undergoing or have been scheduled for eye surgery because of cloudiness of the lens (cataract) or increased pressure in the eye (glaucoma).

Please inform your eye specialist that you have previously used, are using or are planning to use tamsulosin hydrochloride. The specialist can then take appropriate precautions with respect to medication and surgical techniques to be used. Ask your doctor whether or not you should postpone or temporarily stop taking this medicine when undergoing eye surgery because of a cloudy lens (cataract) or increased pressure in the eye (glaucoma).

Do not give this medicine to children or adolescents under 18 years because it does not work in this population.

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. This is because Flomaxtra XL can affect the way that some other medicines work and some other medicines can affect the way that Flomaxtra XL works.

In particular tell your doctor or pharmacist if you are taking:

• Medicines to lower your blood pressure such as verapamil and diltiazem
• Medicines to treat HIV such as ritonavir or indinavir.
• Medicines to treat a fungal infection such as ketaconazole or itraconazole
• Other alpha blockers such as doxazosin, indoramin, prazosin or alfuzosin
• Erythromycin, an antibiotic used to treat infections

Please inform your doctor that you are on Flomaxtra XL before any operation or dental procedure as there is a potential that your medicine may interfere with the effects of the anaesthetic.

Flomaxtra XL is not indicated for use in women.

In men, abnormal ejaculation has been reported (ejaculation disorder). This means that the semen does not leave the body via the urethra, but instead goes into the bladder (retrograde ejaculation) or the ejaculation volume is reduced or absent (ejaculation failure). This phenomenon is harmless.

There is no information available on whether Flomaxtra XL affects the ability to drive or to operate machinery or equipment. However, it is known that Flomaxtra XL may cause drowsiness, blurred vision, dizziness and fainting. If you suffer from these do not drive or operate machinery.

If you have taken too many tablets, contact your doctor immediately or go to the nearest hospital casualty department taking any remaining medication and this patient information leaflet with you.

You may take your tablet later the same day if you have forgotten to take it earlier. If you have missed a day, just continue to take your daily tablet from the next day. Do not take a double dose to make up for a missed dose.

Rare (affects less than 1 in 1000 people)

• Swelling of the face, throat or tongue with breathing problems linked to allergy

Very rare (affects less than 1 in 10,000 people)

• Persistent painful erection usually unrelated to sexual activity.
• Rash, inflammation and blistering of the skin and/or mucous membranes of the lips, eyes, mouth, nasal passages or genitals (Stevens-Johnson syndrome).
• Abnormal irregular heart rhythm (atrial fibrillation, arrhythmia, tachycardia), difficult breathing (dyspnoea).

Common (affects less than 1 in 10 people)

• dizziness
• abnormal ejaculation (ejaculation disorder). This means that semen does not leave the body via the urethra, but instead goes into the bladder (retrograde ejaculation) or the ejaculation volume is reduced or absent (ejaculation failure). This phenomenon is harmless.

Uncommon (affects less than 1 in 100 people)

• weakness
• headache
• runny or blocked nose
• dizziness as you sit or stand up
• palpitations (rapid or irregular heart beat)
• gastro-intestinal symptoms such as nausea and vomiting (feeling or being sick), diarrhoea or constipation
• hypersensitivity reactions such as rash, itching, redness, local swelling and breathing problems

Rare (affects less than 1 in 1000 people)

• fainting

Not known (frequency cannot be estimated from the available data):

• blurred vision
• impaired vision
• nose bleeds (epistaxis)
• serious skin rashes (erythema multiforme, dermatitis exfoliative)
• dry mouth

As with other medicines of this type, drowsiness, blurred vision or swelling of the hands and feet can occur.

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

By reporting side effects you can help provide more information on the safety of this medicine.

The active substance is tamsulosin hydrochloride. Each prolonged-release tablet contains 400 micrograms tamsulosin hydrochloride which is equivalent to 367 micrograms of tamsulosin.

The other ingredients are macrogol, magnesium stearate, butylhydroxytoluene, hypromellose and yellow iron oxide E172.

Flomaxtra XL tablets are round, yellow tablets with `04´ imprinted on them.

The tablets are supplied in blister packs of 30.

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