Alfuzosin

Indications

Alfuzosin is used for: Benign prostatic hyperplasia (BPH)

Adult Dose

Oral Benign prostatic hyperplasia Adult: 2.5 mg tid. Max: 10 mg/day. 1st dose should be given before bedtime. Extended-release: 10 mg once daily. Elderly: Initially, 2.5 mg bid. Acute urinary retention: Extended-release: 10 mg once daily to be taken from 1st day of catheterisation. Duration: 3-4 days. Hepatic impairment: Mild to moderate: Initially, 2.5 mg daily, may increase to 2.5 mg bid according to response. Severe: Contraindicated.

Child Dose

Renal Dose

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

Administration

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

Contra Indications

Severe hepatic impairment; history of postural hypotension and micturition syncope; intestinal occlusion; severe renal insufficiency; lactation.

Precautions

Elderly; hypertension; coronary insufficiency; angina (discontinue); renal or hepatic impairment. Monitor BP regularly. May affect ability to drive or operate machinery.

Pregnancy-Lactation

Pregnancy Category: B Lactation: Not indicated for use in women

Interactions

Additive effect on QT interval prolongation when used w/ QT-prolonging drugs. Concomitant admin w/ other ?1-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.

Adverse Effects

Side effects of Alfuzosin : 1-10% Abdominal pain (1-2%), Back pain (1-2%), Brochitis (1-2%), Constipation (1-2%), Dizziness (5.7%), Dyspepsia (1-2%), Fatigue (2.7%), Headache (3%), Impotence (1-2%), Nausea (1-2%), Pharyngitis (1-2%), URT infection (3%), Sinusitis (1-2%), Upper respiratory infection (3%)

Mechanism of Action

Alfuzosin is a quinazoline derivative which exhibits selectivity for alpha1-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).