Alfuzosin ER

Class
Adrenergic receptor blockers
Subclass
Selective α1-blockers
Substance name
Alfuzosin hydrochloride ER
Brand names
Uroxatral®
Common formulations
Tablet
Dosage and administration
Adults patients
BPH
•
10 mg PO daily
Taken with the same meal each day.
Acute urinary retention in patients with BPH • Off-label
•
10 mg PO daily
Taken with the same meal each day.
Chronic prostatitis/chronic pelvic pain syndrome • Off-label
•
10 mg PO daily
Taken with the same meal each day.
Erectile dysfunction with BPH • Off-label
•
10 mg PO daily
Taken with the same meal each day.
Ureteral stones • Off-label
•
10 mg PO daily
Taken with the same meal each day.
Alternative
•
5 mg PO BID
Taken with the same meal each day.
Indications for use
Labeled indications
Adults
•
Treatment of BPH
Off-label indications
Adults
•
Treatment of acute urinary retention in patients with BPH
•
Treatment of chronic prostatitis/chronic pelvic pain syndrome
•
Treatment of erectile dysfunction with BPH
•
Treatment of ureteral stones
Safety risks
Contraindications
Hypersensitivity to alfuzosin or its components
Concomitant use of other α-blockers
Concomitant use of potent CYP3A4 inhibitors
•
Do not use alfuzosin with potent CYP3A4 inhibitors, such as ketoconazole, itraconazole, or ritonavir.
Warnings and precautions
Exacerbation of prolonged QT interval
•
Use caution in patients with acquired or congenital QT prolongation or taking medications prolonging the QT interval.
Intraoperative floppy iris syndrome
•
Use caution in patients undergoing cataract surgery. Be prepared to modify the surgical technique if needed, such as use iris hooks, iris dilator rings, or viscoelastic substances.
Mask symptoms of prostate cancer
•
Maintain a high level of suspicion, as prostate cancer can present with symptoms of BPH, and the two disorders frequently coexist. Exclude prostate cancer before initiating alfuzosin.
Orthostatic hypotension, syncope
•
Use caution in patients taking antihypertensive medications, nitrates, or PDE5 inhibitors.
Priapism, angina pectoris
•
Maintain a high level of suspicion, as alfuzosin has been associated with an increased risk for these adverse events. Discontinue if angina pectoris occurs or worsens.
Specific populations
Renal impairment
CrCl ≥ 30 mL/min
•
Use acceptable. No dose adjustment required.
CrCl < 30 mL/min
•
Use with caution.
Renal replacement therapy
Continuous renal replacement
•
Use with caution.
Intermittent hemodialysis
•
Use with caution.
Peritoneal dialysis
•
Use with caution.
Hepatic impairment
Child-Pugh A (mild)
•
Use with caution.
Child-Pugh B (moderate)
•
Do not use.
Child-Pugh C (severe)
•
Do not use.
Pregnancy and breastfeeding
Pregnancy
All trimesters • Australia Category: B2
•
Do not use.
Breastfeeding
Do not use during breastfeeding.
Unknown amount excreted in breastmilk.
Unknown drug levels in breastfed infants.
Adverse reactions
Common 1-10%
•
Bronchitis, sinusitis, abdominal pain, constipation, dyspepsia, nausea, erectile dysfunction, pharyngitis, dizziness, fatigue, headache, tachycardia, upper respiratory tract infections
Uncommon < 1%
•
Angioedema, cholestasis, ↓ platelet count, hypotension, intraoperative floppy iris syndrome, orthostatic hypotension, diarrhea, priapism, pruritus, skin rash, syncope, vomiting, rhinitis, toxic epidermal necrolysis, urticaria
Unknown frequency
•
Angina pectoris
Interactions
Drug(s)
Check Interactions
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