Tamsulosin

What is tamsulosin?

Tamsulosin is a generic name for a drug belonging to the group of alpha-blockers which helps for muscle relaxation in the bladder neck and prostate and help for the easy urinate. Overall, this medication is specially used to progress the urination in men with benign prostatic hyperplasia.

This medication normally sold under the Flomax trade name and was marketed in 1996 and developed by Yamanouchi Pharmaceuticals. It was approved by U.S FDA in March 2010. This medication also helps with the passage of kidney stones.

What is tamsulosin molecular formula,weight and drug class?

This compound belongs to the class of chemical substances known as amphetamines and derivatives. These are organic compounds containing or derived from 1-phenylpropan-2-amine.

Chemicalname: (R)-5-(2-((2-(2-Ethoxyphenoxy) ethyl) amino) propyl)-2-methoxybenzenesulfonamide

Molecular Formula: C20H28N2O5S

Weight: 408.513 g/mol

3D molecular formula of Tamsulosin

Tamsulosin undergoes to a class of drug which is known as alpha blockers and it works effectively for relaxing the bladder neck muscles and help for improvise to urinate. In one word it is a α1a adrenergic receptor antagonist.

How does Tamsulosin work in the body?

The symptoms realtedd with benign prostatic hyperplasia (BPH) are linked to bladder outlet obstruction, which can be comprised of two underlying components: static and dynamic. The static component is associated to an increase in prostate size caused, in part, by a proliferation of smooth muscle cells in the prostatic stroma.

However, the severity of BPH symptoms and the severity of urethral blockage do not correlate well with the size of the prostate. The dynamic component is a function of an increase tone of smooth muscle  in the prostate and bladder neck leading to constriction of the bladder outlet.

Smooth muscle tone is regulated by the sympathetic nervous stimulation of alpha1 adrenoceptors, which are abundant in the prostate, prostatic urethra, prostatic capsule and bladder neck. Blockade of these adrenoceptors can cause smooth muscles in the bladder neck and prostate to relax, resulting in an improvement in urine flow rate and a reduction in symptoms of BPH.

Tamsulosin, an alpha1 adrenoceptor blocking agent, exhibits selectivity for alpha1 receptors in the human prostate. At least three discrete alpha1 adrenoceptor subtypes have been identified: alpha1A, alpha1B, and alpha1D; their distribution differs between human organs and tissue. Approximately 70% of the alpha1receptors in the human prostate are of the alpha1A subtype.

Tamsulosin brand names

Tamsulosin is manufactured by many companies and well available in different forms like tablet, capsule, injection, syrup and cream. All the drugs work same and you can find the same active Tamsulosin ingredient in these drugs but the difference you can find which are like name and price.

Here are some brand names:

• Alfatam
• Bezip
• Contiflo OD
• Dynapres
• Flomax
• Flodart
• Geritam
• Gotam
• Prostop
• Prostulin
• Protam MR
• Tamby
• Tamcontin
• Tamsin
• Ubimax
• Urimax
• Uripro
• Uritin
• Veltam

All these brands offer Tamsulosin medication so you can choose any one brand according to your doctor prescription for your prostate and bladder neck muscle relaxation or kidney stone problems.

What is tamsulosin used for?

Tamsulosin is a kind of alpha blocker which helps to relax the bladder and prostate muscle relaxation and also help those who have kidney stone problems. Most of the doctor prescribes this medication for the easy urinate for men with benign prostatic hyperplasia or enlarge prostate.

Tamsulosin FDA approved indications are:

• Benign Prostatic Hyperplasia (BPH)
• Bladder Outlet Obstruction
• Ureteral Calculus

Tamsulosin and BPH

BPH stands for benign prostatic hypertrophy which is a special condition in which you can find the prostate gland grows larger than normal size. Most of the people think it is cancer but this is not actually cancer. Now it’s quite important to know what prostate gland is. So prostate gland is a small gland which is an important part of men’s reproductive system which wraps around the urethra.

The prostate gland normally creates a fluid which mixes with sperm to make semen. So now the question is what is the cause of BPH and the answer is still not known. This mostly occurs in the men those who are above 45 old.

In such case, the prostate gland grows typically and blocks the flow of urine; as a result the patient may face kidney damage and urinary infections. BPH can be controlled by medications and some serious cases you need operations. The alpha-blocker class drugs are always the first line treatment or medication for BPH. Alpha-blockers work by blocking the alpha-1a receptor in the human bladder and the prostate.

This alpha-blocker medication always helps to relax the prostate and bladder neck muscles and always allow an easier urine flow for the patient. This is always an effective medication for patients and 50% men get the good result after using this medication within 48 hours.

As Tamsulosin is an alpha-blocker, you can use this medication for your BPH problem and can get relief from your urinary problem but it’s always better to consult your doctor before using any medication for better result and safety purpose.

Tamsulosin dosage forms and strengths

Tamsulosin is well known as the generic form of the popular brand name drug which is known as Flomax. This is normally used for the treatment for enlarged prostate or known as BPH or kidney stone. This medication belongs to a class of drugs which is known as alpha-1receptor blockers. This helps to relax the muscles of prostate and bladder neck as a result patient can feel more comfortable to urinate.

This is an FDA approved drug, which is well available in various strengths starting from 0.4 mg to 0.8mg. For BPH, the initial dose is 0.4 mg orally once a day and the maximum dose is 0.8 mg orally once a day. If in the case, the use is discontinued for several days then the treatment should be again initiated with the 0.4 mg once a day.  Tamsulosin medication is well available in various forms like tablet, capsule, injection, syrup and cream.

Tamsulosin dosage for different indications

It’s always recommended that take medicines as per your doctor prescription. Here you can get some tamsulosin dose information for different indications which may be helpful for you.

Tamsulosin for Enlarge prostate or BPH (benign prostatic hypertrophy):

The normal adult dose of Tamsulosin is 0.4 milligrams and you can take it after the 30 minutes of eating. For better result, it’s recommended to take at the same time every day. The maximum dose for you can be 0.8 mg and it’s only after the after the evaluation of your health condition by your doctor because excess dose can serious damage to your body.

Tamsulosin for Kidney stone:

For kidney stone, a doctor usually prescribes 0.4mg of Tamsulosin once per day orally. Once you have passed the kidney stones then you may continue the medication up to one or two weeks and it totally depends on the prescription of your doctor according to your health condition.

Tamsulosin for Bladder Obstruction:

Women who normally take Tamsulosin to get relief from bladder obstruction problems normally prescribed for 0.4 mg dose on regular basis. For effective result always take medicine in a particular time and check up your health condition immediately for any side effects and other problems.

Tamsulosin highest dose

0.8 mg per day is the highest dose of Tamsulosin Never try to take any excess dose because it may cause a serious issue to your body. Immediately take medical attention if by mistakenly you take the higher dose or if you face any type of side effects.

Tamsulosin side effects

Taking Tamsulosin may cause some unwanted side effects never neglect any type of side effects, because these side effects can cause serious damage to your health. Always go for medical checkup and take proper steps as per your physician suggestion.

Major side effects:

If any of the below mentioned side effects occur then you need immediate check up

More common:

• Lower back or side pain
• Hoarseness or cough
• Difficult or painful urination
• Chills or fever

Less common:

• Chest pain

Rare:

• Sensation of spinning
• Prolonged or painful erection of the penis
• Fainting
• Dizziness or lightheadedness
• Feeling of constant movement of surrounding or self

Incident not known:

• Itching
• Blurred vision
• Diarrhea
• Muscle pain or joint pain
• Confusion
• Blistering, loosening of the skin
• Tightness of chest
• Sore throat
• Tiredness or unusual weakness
• Red, irritated eyes
• sweating

Minor side Effects:

In this section, you don’t need any medication for these side effects because these side effects may occur at the initial stage of the medication intake then when your body gets used to the medicines then it may disappear. Your doctor may help you to reduce the side effects so if you can go for medical checkup then it’s always good for you otherwise no issue.

More common:

• Back pain
• Headache
• Loss or lack of strength
• Body pain or aches
• Abnormal ejaculation
• Congestion
• Sneezing
• Voice changes
• Trouble swallowing
• Runny or stuffy nose

Less common:

• Nausea
• Tooth disorder
• Sleeping trouble
• Pin around the eyes and cheekbones
• Sexual ability loss
• Increased cough
• Drowsiness
• Decreased interest in sexual intercourse
• Unable to keep an erection
• Sleepiness or unusual drowsiness

Incident not known:

• Vomiting
• Redness of the skin
• Constipation
• Skin rash, hives or welts

How to take Tamsulosin?

It’s always better to take Tamsulosin every day at the same time. You can take this medication after your meal. One more thing! Always take medicines according to your physician which is always important. You can take this medication orally through the water. The dose of the medicine always varies and it totally depends upon your health issue and condition so never take any extra dose as per your own choice.

Always follow the direction which is on the label of the medicine. Never crush, chew or open the capsule of the tamsulosin always swallow it whole. Never stop this medication suddenly if you mark any side effects always check up your blood pressure and discuss your problems with your doctor. Always store your medication at room temperature and try to avoid heat, moisture. Never keep it in your bathroom.

Is Tamsulosin addictive?

Tamsulosin drug found among people who take, normally those who sixty plus old male, have been taking this drug for 1 to 2 years, also take oxycontin medication and have pain. This is the addiction review of people so yes Tamsulosin can be addictive.

Can I abrupt Tamsulosin therapy suddenly?

No, you can’t abrupt tamsulosin therapy suddenly. In some case, Tamsulosin may cause low blood pressure, which can be very dangerous for you and affect your blood vessels. If you face any difficulties or side effects it’s always better to go for immediate medical attention for the treatment.

Can Tamsulosin cause withdrawal effects?

According to the medical research withdrawl effects is found who takes tamsulosin.

Especially the people who are sixty plus male and have been taking medicines for two to five years. According to the report around 15,412 people have this side effect when taking this medication from FDA.

Precautions and warnings during Tamsulosin use

If you are allergic to tamsulosin then you can’t use Flomax or Tamsulosin. Never take Tamsulosin with other parallel medicines like silodosin, terazosin, prazosin, alfuzosin and doxazosin. At the beginning of this medication, it can cause fainting or dizziness but once it got addicted to your body then its work as normal.

If for any reason you stop taking Tamsulosin and want to continue it again then take permission from your physician don’t take it as usual because you may need a dose adjustment according to your recent health condition.

If you have cataract surgery then tamsulosin can affect to your pupils so in such case you need to contact your surgeon before taking this medication. Never stop this medication before surgery unless your doctor gives you the suggestion.

If you have other health issues like low blood pressure, liver or kidney disease, prostate cancer or an allergy to sulfa drugs then discuss with a health specialist before using this medication.

In any case, don’t stop using tamsulosin, in such case say your problem to your physician if he/she suggest then you can take otherwise don’t take and never take the high dose if your doctor has not suggested you. You can’t use Tamsulosin if your age is under 18 years and this medication not for use in women.

If you feel or mark any type of serious side effects after taking tamsulosin then immediately go for a medical checkup for quick medication. Just discuss all the details regarding your side effects may be you need any type of dose adjustment.

How long does Tamsulosin take to work?

Tamsulosin works better after you take it on regular basis for 14 to 30 days. If it works perfectly for you then you can mark the better urine flow within one to three days after taking this medication. If you are suffering from kidney stones then it should analyze according to the condition of your kidney stone.

How long does Tamsulosin stay in your system, urine, blood, saliva?

The half-life of Tamsulosin is approximately 9 to 13 hours in healthy volunteers and almost 14 to 15 hours in the targeted population. But how long the tamsulosin will stay in your system, blood, saliva and urine is totally depends upon the medication preparation like if you take it for immediate release or controlled released. So overall it should clear from your system almost in 83 hours.

Can Tamsulosin affect a drug test?

Yes, tamsulosin can affect drug test in some cases. According to the study false positive drug test is reported only by few people who take flomax.

Tamsulosin during pregnancy

Tamsulosin is totally not indicated for the use of women. As per the animal studies, it reduced fertility in males. Many cases Ejaculation disorders have been reported in human clinical studies.

Yes, AU TGA pregnancy category B2 drug can be taken by only some pregnant women of childbearing age. According to the study and data, there is no such evidence of an increased happening of fetal damage. Overall, there are no such clear studies in pregnant women. 

Tamsulosin during breastfeeding

First of all his medication is not approved for use in women so there is no such clear information about the breastfeeding. It is clear that tamsulosin can cause harm to the fetus but yes if you are using category B then it has no such effect on milk so you can breastfeed as normal while taking this medication.

Can geriatric patients use Tamsulosin safely?

Yes, geriatric patients can use tamsulosin safely but according to the study pharmacokinetic disposition of tamsulosin it may be a little bit delayed to take action in the case of geriatric males as compare to the young age. So there is no such risk for geriatric patients to use this medication.

Can patients with congestive heart failure take tamsulosin safely?

No, if a patient with congestive heart failure can’t take tamsulosin safely because it can harmful or sometime it leads dangerous side effects because in such condition you need to check up your body on regular basis and should be adjust the dose according to your present health condition.

Tamsulosin overdosage

If you take too much tamsulosin then immediately call your local poison control center or healthcare provider for emergency medical attention. It’s always very dangerous of an overdose of tamsulosin and you may mark some side effects also like headaches and low blood pressure as result you may feel lightheadedness, fainting and dizziness.

Tamsulosin absorption, metabolism and elimination

Absorption:

Absorption of tamsulosin hydrochloride from 0.4 mg Flomax capsules is basically complete more than ninety percents following oral administration under fasting circumstances. Tamsulosin hydrochloride normally shows linear kinetics following multiple and single dosing, with steady-state concentrations by the fifth day of once per day with a single dose.

Metabolism:

There is nothing like enantiomeric bioconversion from tamsulosin hydrochloride to the isomer in Human. Tamsulosin is widely metabolized by cytochrome P450 enzymes in the human liver and almost less than ten percent of the dose is excreted in urine unmoved. It is extensively metabolized by CYP2D6, CYP3A4 and by some other CYP isoenzymes.

Elimination:

As per the study, the half-life of Tamsulosin is approximately 9 to 13 hours in healthy volunteers and almost 15 hours in case of the targeted population. But the full elimination of Tamsulosin always depends upon the medication like you take it for immediate release or controlled released. So, overall, Tamsulosin should clearly eliminate from your system in around 83 hours.

Can patients with renal disorder take Tamsulosin safely?

Yes, patients with the renal disorder can take tamsulosin and it’s safe. Patients with renal impairment never need any type of dose adjustment in Flomax capsule but if you are suffering from end-stage renal disease then it could be risky as according to the report renal failure is found who take tamsulosin especially males who are above the age of 60. In such case, your doctor will prescribe you whether you will take this medicine or not.

Can patients with liver disorder take Tamsulosin safely?

Yes, you can take Tamsulosin if you have any type of liver disorder because according to the medical study there are no such instances of acute liver failure or liver injury by tamsulosin or any other alpha adrenergic blockers.

There is no such information on cross reactivity regarding liver disorder among different adrenergic receptor antagonists like doxazosin, terazosin, alfuzosin and silodosin. As the chemical structures are quite similar, it suggests that may be cross sensitivity present.

Can I drink alcohol while taking Tamsulosin

No, you can’t take alcohol while taking tamsulosin because it may be dangerous for you.  If you are using alcohol together with Tamsulosin then it may lower your blood pressure; as a result, you may feel dizziness.

This normally occurs at the initial stage of medication intake. So if you feel odd then ask physician because you may need a dose adjustment. You may feel several problems like warmth, flushing and tingly feeling after taking alcohol with Tamsulosin.

How Tamsulosin affect blood pressure?

If you are taking Tamsulosin then you may face low blood pressure as a result, you may feel dizziness, weak and fainting. So if you feel any of these symptoms then immediately check up your health and discuss all your problems to your physician with details because you may need any changes in your dose. Never stop this medication immediately it can be harmful for you.

What is Orthostasis? Can Tamsulosin cause it?

Orthostatic hypotension which is also known as postural hypotension is a form of low blood pressure which occurs when you stand up from sitting or lying down. If you have this problem then you may feel lightheaded, faint or dizziness.

This normally happens up to some seconds or minutes but if you feel it for a longer time then you need to say your problem to your physcian because this problem can cause a serious problem in future. Now the question is can Tamsulosin cause it? The answer is yes, this may be caused by Tamsulosin because taking this medication can lower your blood pressure and orthostatic occurs because of low blood pressure.

What is Priapism? Can Tamsulosin cause painful penile erection?

Priapism is a condition in which a human penis remains erect for a long time in the absence of stimulation or after the end of stimulation. This is of three kinds like Ischemic, recurrent ischemic and nonischemic. This is a painful problem for men and in this problem, the penis stays harder. This problem occurs normally in certain groups, like those people who have sickle cell anemia.

In such case, you need prompt treatment because it may damage your tissue which may cause erectile dysfunction in future. Mostly the people in the age of 30s face this problem. So, if you have any problem then immediately go for quick treatment.

Yes, Tamsulosin can cause the painful penile erection. If you are taking tamsulosin then you may have an erection of penis for long time than normal which is very painful and affect your sexual life. It’s true that this problem is very rare but if you mark this problem in you then never delay in such condition because it may put bad effect to your health.

Can diabetics safely take Tamsulosin?

No, you can’t take tamsulosin safely if you have diabetes because according to the medical research tamsulosin can cause hyperglycaemia in diabetic patients. This hyperglycaemia cause when you have high blood sugar and it happens due to less insulin in your body which is always a common warning sign of pre diabetes so be careful to it.

Can patients with prostate cancer use tamsulosin?

No, patients with prostate cancer can’t use tamsulosin as per your own choice it’s always recommended that make clear from the doctor before using this medication if you have prostate cancer because it can be harmful for you.

Tamsulosin and intraoperative floppy iris syndrome

Intraoperative Floppy Iris Syndrome normally occurs during the cataract extraction in some patients. Tamsulosin is a special kind of alpha blocker which normally uses for prostatic Hyperplasia because it helps to relax the bladder and prostate muscle. This same medication also relaxes the iris dilator muscle so most of the doctor prescribes Tamsulosin for Intraoperative Floppy Iris Syndrome problems.

Can Tamsulosin cause allergy? What is sulfa allergy related to tamsulosin?

Tamsulosin can cause allergy but according to the report there is no such allergy found by using Tamsulosin but that doesn’t mean it has no allergy. If you feel any type of allergy then check up your body. The patient with sulfa allergy reaction to Tamsulosin has been quite rarely reported but if the patient reports serious allergy then you need to take proper precaution during medical administration.

Can I take paroxetine and Tamsulosin together?

No, you can’t take paroxetine and      Tamsulosin together if it is not prescribed to you. There is moderate interaction found between these two medications which may be risky for your health. These two medications can augment the level of serotonin in your body, as a result, you may feel many side effects like nausea, dizziness, headache and it also can change the body temperature and blood pressure.

Can I take ketoconazole and Tamsulosin together?

Yes, you can take ketoconazole and Tamsulosin together because according to the medical record there are no such known interactions found between these two medications but that doesn’t mean there is no interaction exists. If you mark any side effects then immediately go for emergency medical checkup.

Can I take Warfarin and Tamsulosin together?

Yes, you can take Warfarin and Tamsulosin together as there is no such interaction known till the date but that doesn’t mean there is no such interaction between these two medications so never stop any medication without a physician’s advice.

Can I take Aspirin and Tamsulosin together?

Yes, you can take Aspirin and Tamsulosin together because according to medical report till the date there is no such interaction happens between these two drugs.

Can I take Digoxin and Tamsulosin together?

No, you can’t take Dioxin and Tamsulosin together because it can be harmful for your health. As per the record and study, there are drug interactions found between these medications especially in the case of male. This can cause many side effects like heart palpitations; weakness, night sweats, anorexia and many more. So never take these two medications together as per your own choice.

Can I take Lasix and Tamsulosin together?

Yes, you take Lasix and Tamsulosin together because there are a minor interaction between Lasix and Tamsulosin. These minor interactions are not harmful to human or there is no need to change in therapy sometimes you may also need some dose adjustment according to your health condition.

Can I take Nifedipine and Tamsulosin together?

Yes, you can take Nifedipine and Tamsulosin together because there is no interaction known till now as per the record. But it’s not clear, however; an interaction may still exist.

Can I take beta blockers and Tamsulosin together?

Yes, you can take beta blockers and tamsulosin together because there are no such interactions found by research till now that does not mean that there is no possibility so take it cautiously.

Can I take Enalapril and Tamsulosin together?

As per the study and research, there is no such type of interaction found between Enalapril and Tamsulosin till now, so you can use these two drugs together but there may be any interactions exist, so take it according to your prescription.

Can I take Doxazosin and Tamsulosin together?

If you are taking dozazosin and tamsulosin together then it can cause the drop in your blood pressure which may lead many side effects like weakness, breathing problems, headache and much more but don’t worry if you need this medication in any way then you can take this medication under close check up of your blood pressure on regular basis for safety purpose.

Can I take Viagra and Tamsulosin together?

According to the medical data base there are no such serious interactions between Viagra and tamsulosin so yes, you can take tamsulosin and Viagra together but there are very normal interactions happen between these two medicines. You may feel dizziness, lightheadedness and congestion by using these two medications together.

Can I take Cialis and tamsulosin together?

It is not recommended taking Cialis and Tamsulosin together because if you take these two medications together then you may drop your blood pressure which always leads many side effects so it is not a good choice to take these two medications at a time if you have already low BP or blood pressure varies.

Is tamsulosin used for kidney stones?

Commonly Tamsulosin is used for the treatment of enlarged prostate, but in some cases, doctor also prescribes tamsulosin for the kidney stones because it helps to clear or pass the kidney stones in the human body. So the answer is yes, tamsulosin can be used for kidney stones.

Is Flomax considered a diuretic?

As you know Flomax is a special kind of drug which is used for the treatment of the prostate. This drug contains alpha-1 blockers so it may provide a diuretic effect like frequent urination on someone after taking this medication. But if you ask is Flomax considered a diuretic? Then the answer is always negative.

Can Flomax cause urinary incontinence?

Flomax is an alpha-adrenergic blocker which is normally used for benign prostatic hyperplasia. It can cause urinary incontinence by over-relaxing the muscle of the human bladder. So, the answer is yes Flomax can cause urinary incontinence. 

What happen if you miss the dose of tamsulosin?

You can take the medication immediately as soon as you remember if you miss the dose but never take an overdose. But if it is almost the time for your next dose then just skip that dose and continue with the next dose and try to take it on regular basis. In the case of overdose, immediately contact to your nearest poison help line or emergency medical attention.

Can I take Tamsulosin if I have asthma?

No, you can’t take Tamsulosin if you have asthma problem because it can enhance the asthma effect which can be very serious for you. In such case, it’s better for you to go for medical help for the best medication and accurate dose of medicines. Never take this medicine according to your own choice.

Can Tamsulosin cause Congestive heart failure?

Till the date, there is no such report found in the case of any people who take Tamsulosin. That doesn’t mean you are fully secure if you will mark any kind of side effects then check up your body for the safety purpose.

Can I take Tamsulosin and metformin together?

Yes, you can use Tamsulosin and Metformin together as there is no such interaction or side effects found in medical records but still there may be interaction exist.

Can patients take Tamsulosin and hydralazine together?

Tamsulosin is in drug class of peripherally active, antiadrenergic and especially used for the treatment of prostatic Hyperplasia, Urinary Tract stones and Overactive bladder. Hydralazine is in drug class of antihypertensive miscellaneous combination and used for heart failure treatment. Till now there is no such interaction found in between these two medications.

Can I take tamsulosin and amlodipine together?

There is no such interaction between Tamsulosin and amlodipine found in medical research so you can take these medications together but it’s not 100% sure that there is no interaction exists. If you are feeling any side effects then immediately go for the treatment.

Can I use Tamsulosin and verapamil together?

No, you can’t take Tamsulosin and verapamil together. According to the medical research there is a moderate interaction between these two medications. Verapamil may increase the effects of tamsulosin and blood levels which may lead low blood pressure. In such case, you may face several side effects like lightheadedness, fainting, nasal congestion, priapism and headache.

Can I use Tamsulosin and lisinopril together?

There is no such interaction found in the data base of the medical research between Tamsulosin and Lisinopril but this doesn’t mean that there is no interaction exists in between these two medications. So take these two medicines cautiously.

What happens if I miss a dose of tamsulosin?

If you missed a dose in any reason then take it as soon as you remember. If the time is almost for the next dose then just skip that dose and continue for the next dose. Never take any extra dose to adjust it because it can be very harmful for your health and always try to take the medicine on time according to your schedule.

All about Storage information of Tamsulosin medication

Always keep these medicines in a closed container at room temperature away from direct sunlight, heat and moisture. Try to keep it away out of the reach of children and your pets. If it is outdated then never keep these medicines in your home. For disposal information, better you can discuss with a healthcare professional.
“What is Imodium made of? Is loperamide a controlled substance?”
“Can you take gabapentin with morphine in neuropathic pain?”