This topic is about a person with an ileostomy who is concerned about taking Flomax (tamsulosin HCl) in capsule form. They are wondering if it's safe and effective to open the 0.4 mg capsule before swallowing, as the intact capsules seem to pass through undissolved.

Here are some helpful insights and advice:

1. The person is a female patient whose urologist prescribed Flomax to help relax bladder muscles. Due to a shortage of tablets, she switched to capsules, but noticed the intact shells and granules in her ileostomy pouch.

2. Her doctor advised opening the capsule and swallowing only the granules to prevent a possible small-bowel obstruction from the shell.

3. It's important to note that Flomax capsules are designed for extended release and should not be crushed, chewed, or opened according to the product label. Always check with your doctor or pharmacist before making any changes.

4. Tamsulosin is commonly used for benign prostatic hyperplasia (BPH) and to help pass kidney stones.

5. Opening the capsule can have risks, such as rapid drug release, exposure to stomach acid, a shorter therapeutic window, and a higher chance of side effects.

6. Some information suggests that tamsulosin beads can be sprinkled on acidic soft foods like applesauce or yogurt, but they should not be mixed with water, milk, pudding, or other higher-pH foods.

7. If beads appear in the pouch, it might mean that some of the drug wasn't absorbed, but it's hard to tell how much was lost.

8. One person with an ileostomy for 8 years takes Flomax 0.4 mg twice daily without seeing residue and has good urinary results.

9. Rapid small-bowel transit might cause undissolved shells or pellets. Discuss with a gastroenterologist about possibly slowing output with medications like loperamide (Imodium).

10. Sometimes, granule residue isn't active drug. For example, another medication, DILTIAZEM HCL CD, leaves inert granules even though the drug is absorbed. However, Flomax pellets should dissolve over 24 hours, so visible pellets might mean incomplete absorption.

11. The general advice is to follow your physician's instructions if they specifically direct you to open the capsule. Otherwise, take the intact capsule and consult your doctor and pharmacist if residue continues to appear.