Alfuzosin

Oral
Benign prostatic hyperplasia

Initially, 2.5 mg bid. Adjust dose according to response.

Mild to moderate: Initially, 2.5 mg daily, may increase to 2.5 mg bid according to response. Severe: Contraindicated.

Should be taken with food.
Extended-Release: Should be taken with food. Take immediately after the same meal each day. Swallow whole, do not chew/crush.

History of orthostatic hypotension. Severe hepatic impairment. Concurrent use w/ potent CYP3A4 inhibitors (e.g. ketoconazole, itraconazole, ritonavir).

Prostatic carcinoma should be ruled out before starting therapy. Patient w/ acquired or congenital QT prolongation, prostate cancer, coronary artery disease, symptomatic hypotension. Renal and mild to moderate hepatic impairment. Not intended for use in women and childn. Pregnancy and lactation.

Intraoperative Floppy Iris Syndrome (IFIS) during cataract surgery, postural hypotension, tachycardia, angina pectoris in patient w/ pre-existing coronary artery disease, chest pain oedema, diarrhoea, upper resp tract infection, rhinitis, bronchitis, sinusitis, pharyngitis, hepatocellular and cholestatic liver injury including jaundice, dizziness, headache, fatigue, rash, pruritus, urticaria. Rarely, priapism can occur.

PO: B

May impair ability to drive, operate machinery or perform hazardous tasks.

Monitor BP regularly and urine flow.

Symptoms: Hypotension. Management: Maintain patient in supine position to restore BP. IV fluids and/or vasopressors may be needed.

Additive effect on QT interval prolongation when used w/ QT-prolonging drugs. Concomitant admin w/ other α₁-adrenergic blocking agents, atenolol or diltiazem may result in additive CV effects. Increased plasma alfuzosin concentrations w/ cimetidine.
Potentially Fatal: Concurrent use w/ potent CYP3A4 inhibitors (e.g. ketoconazole, itraconazole, ritonavir) increase plasma alfuzosin levels.

Description: Alfuzosin is a quinazoline derivative which exhibits selectivity for α₁-adrenergic receptors in the lower urinary tract. Blockade of these adrenoreceptors causes relaxation of smooth muscle in the bladder neck and prostate, resulting in improvement in urine flow and a reduction in symptoms of benign prostatic hyperplasia (BPH).
Pharmacokinetics:
Absorption: Readily absorbed. Bioavailability: Approx 64%. Time to peak plasma concentration: 0.5-3 hr.
Distribution: Plasma protein binding: 90%.
Metabolism: Extensively metabolised in the liver, mainly by the CYP3A4 isoenzyme, to inactive metabolites.
Excretion: In faeces via bile (69%) and via urine (24%; approx 11% as unchanged drug). Elimination half-life: 3-5 hr.

Store between 20-25°C. Protect from light and moisture.

Drugs for Bladder & Prostate Disorders

Alfuzosin Hydrochloride Extended Release Tablet (Exelan Pharmaceuticals, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 09/01/2014.

Anon. Alfuzosin. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 09/01/2014.

Buckingham R (ed). Alfuzosin Hydrochloride. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 09/01/2014.

McEvoy GK, Snow EK, Miller J et al (eds). Alfuzosin Hydrochloride. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 09/01/2014.

Uroxatral (Concordia Pharmaceuticals Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 09/01/2014.

Xatral 2.5 mg Film Coated Tablet (Aventis Pharma Limited). MHRA. https://products.mhra.gov.uk. Accessed 09/01/2014.