Alfuzosin is an alpha-receptor blocker. It inhibits the activation of alpha receptors present primarily in the smooth muscles of the lower urinary tract. Inhibition of alpha receptors relaxes the smooth muscles relieving symptoms of prostatic hyperplasia and improving urinary flow. It is also used to facilitate the expulsion of small ureteral stones.

Alfuzosin Dose in Adults

Alfuzosin dosage:

• Benign prostatic hyperplasia (BPH):

  • Oral tablets: 10 mg once daily

• Off-label Use in Ureteral stones:

  • Oral tablets: 10 mg once daily.
  • The drug should be stopped after stone expulsion from the body.

Use in Children:

Not recommended in chidren

Pregnancy Risk Factor B

• The baby has not been adversely affected by Alfuzosin during pregnancy.

Use during breastfeeding:

• It is unknown whether breastmilk contains any drug excreted. Take care.   

Alfuzosin dose in kidney disease:

• The manufacturer has not provided any dose adjustment in renal impairment. 
• It should be used with caution in patients with severe renal impairment.

Alfuzosin Dose in Liver disease:

• In patients with mild hepatic impairment (Child-Pugh class A), the manufacturer has not provided any dose adjustment.
• Alfuzosin is contraindicated in patients with moderate or severe hepatic impairment (Child-Pugh class B or C).

Common side effects of alfuzosin (Uroxatral):

• Central nervous system:

  • Dizziness,
  • fatigue,
  • headache, and
  • pain

• Gastrointestinal:

  • Abdominal pain,
  • constipation,
  • dyspepsia, and
  • nausea

• Genitourinary:

  • Impotence

• Respiratory:

  • Upper respiratory tract infection,
  • bronchitis,
  • pharyngitis, and
  • sinusitis

Rare side effects:

• Angina pectoris (pre-existing CAD),
• angioedema,
• chest pain,
• atrial fibrillation,
• diarrhea,
• edema,
• flushing,
• hepatic injury (including cholestatic),
• hypotension,
• intraoperative floppy iris syndrome (with cataract surgery),
• jaundice,
• priapism,
• pruritus,
• rhinitis,
• skin rash,
• systolic hypotension,
• tachycardia,
• thrombocytopenia,
• toxic epidermal necrolysis,
• urticaria, and
• vomiting

Contraindications to alfuzosin (Uroxatral):

• Severe allergic reactionsAfter alfuzosin or any other component of the formulation intake
• Moderate to severe liver disease(Child Class C and B)
• Concurrent useAlfuzosin and CYP3A4-inhibitorsItraconazole and ketoconazole are some examples.Ritonavir(
• Concurrent useOther alpha1-blockers

Warnings and Precautions

• Angina
  • If the patient experiences symptoms of angina, or worsening of angina pre-existing, discontinue treatment.
• CNS depression
  • Alfuzosin can cause CNS depression, which may lead to impaired mental or physical abilities.
  • Patients who use heavy machinery need to be extra cautious
• Floppy iris syndrome:
  • Intraoperative Floppy Iris Syndrome may occur in patients who have had cataract surgery.
  • Alpha-blockers patients may need to be modified in their surgical procedure.
• Orthostatic hypotension and syncope:
  • Alfuzosin can relax the vascular tone, and may cause orthostatic hypotension or syncope.
  • You should increase the dose gradually and avoid simultaneous use of antihypertensive medications such as nitrates or phosphodiesterase inhibitors, like sildenafil.
• Priapism:
  • A sustained painful erection or priapism may occur.
  • If the condition persists for more than four hours, it is important to seek medical advice.
• Cardiovascular disease
  • Patients with heart disease should be cautious as the drug may cause myocardial ischemia and tachyarrhythmias.
• Prostate cancer:
  • Prostatic carcinoma should not be treated as it can cause similar symptoms.
• Extension of QT
  • Patients at high risk of developing prolonged QT-intervals should not take Alfuzosin.
  • Patients withGrave renal impairmentYou should take the drug with caution.
• Use restrictions:
  • AlfuzosinShould not be used in conjunction with antihypertensive medication.

Alfuzosin: Drug Interaction

Note: Drug Interaction Categories:

• Risk Factor C: Monitor When Using Combination
• Risk Factor D: Consider Treatment Modification
• Risk Factor X: Avoid Concomitant Use

Monitor:

• Urine flow,
• blood pressure, and
• PSA (Prostate specific antigen) levels periodically

How to take alfuzosin (Uroxatral)?

Take the tablet whole (do not chew or crush), after meals at the same time each day.

Alfuzosin mechanism of Action:

• Alfuzosin, an alpha-adrenergic antagonist receptor blocker, is one example. 
• It works by blocking the alpha receptors, which are primarily found in the smooth muscle of the lower urinary track.
• This causes relaxation. This causes a decrease in urine flow symptoms such as hesitancy and urgency, poor stream, post-micturition dizziness, and poor stream.
• Patients with an enlarged prostate often experience all of these symptoms.

Absorption is reduced by 50% under fasting conditions It is 82% to 90% protein bound.

Metabolism is primarily via the liver.

Bioavailability is 49% after a meal.

Half-life elimination is about 10 hours

Time to peak plasma concentration is 8 hours following a meal

Excretion is via feces (69%) and urine (24% Old patients and patients with impaired hepatic function have a 3 - 4 fold increase in the plasma levels.   

International Brand Names of alfuzosin:

• Alfasin XR
• Alfirum
• Alfron XL
• Alfsin XL
• Alfu
• Alfu-Kal XL
• Alfumax
• Alfurix XL
• Alfusin
• Alfutor ER
• Alfuzo XL
• Alfuzon XL
• Alsiful S.R.
• Azosin SR
• Benestan
• Benestan OD
• Benprostex
• Bundisarin
• Dalfaz
• Danafusin
• Flotral
• Fozal
• Fuzocim
• Lafunomyl
• Lafuzo
• Lura XL
• Mittoval
• Nuo Shu An
• Profuzosin
• Prosterol
• Ranfuzosin
• Tevax
• Unibenestan
• Urion
• Uritab XL
• Uriten
• Uroxatral
• Uroxatral OD
• Uroxatral uno
• WeiPing
• Xatger
• Xatosin XL
• Xatral
• Xatral LP
• Xatral OD
• Xatral Retard
• Xatral SR
• Xatral XL
• Xatral XL PR
• Xatral XR 10
• Zapros XL
• Apo-Alfuzosin
• Sandoz-Alfuzosin
• Teva-Alfuzosin PR

Alfuzosin brand names in Pakistan: