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alfuzosin (Alfutral, UroXatral, Xatral)

 

Classes: BPH, Alpha Blockers

Dosing and uses of Alfutral, UroXatral (alfuzosin)

 

Adult dosage forms and strengths

tablet, extended release

  • 10mg

 

Benign Prostatic Hyperplasia (BPH)

10 mg PO qDay taken after same meaL

 

Pediatric dosage forms and strengths

Safety & efficacy not established

 

Alfutral, UroXatral (alfuzosin) adverse (side) effects

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%)

 

Postmarketing Reports

General disorders: Edema

Cardiac disorders: Tachycardia, chest pain, angina pectoris in patients with pre-existing coronary artery disease, atrial fibrillation

Gastrointestinal disorders: Diarrhea

Hepatobiliary disorders: Hepatocellular and cholestatic liver injury (including cases with jaundice leading to drug discontinuation)

Upper respiratory system: Rhinitis

Reproductive system: Priapism

Dermatology: Rash, pruritus, urticaria, angioedema, toxic epidermal necrolysis

Vascular disorders: Flushing

Blood and lymphatic system disorders: Thrombocytopenia

 

Warnings

Contraindications

Hypersensitivity

Moderate to severe liver impairment

Coadministration with potent CYP3A4 inhibitors (eg, ketoconazole, itraconazole, ritonavir) or other alpha1-blocking agents

 

Cautions

Caution in coronary artery disease, liver disease, symptomatic orthostatic hypotension or coadministration with other drugs that lower blood pressure

May cause syncope (first-dose effect)

Discontinue treatment if angina occurs or worsens

Rule out prostate cancer before initiating therapy (symptoms similar)

Priapism may occur with use

Rule out prostate cancer prior to treatment

Caution with renal impairment (ieg, CrCl <30 mL/min)

Caution with history of prolonged QT syndrome (shown to prolong QT interval)

Intraoperative floppy iris syndrome during cataract surgery reported Advise patient regarding risk of priapism

Do not chew or crush tablets

Not for use as antihypertensive drug

 

Pregnancy and lactation

Pregnancy category: B

Lactation: Not indicated for use in women

 

Pregnancy categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

 

Pharmacology of Alfutral, UroXatral (alfuzosin)

Mechanism of action

Selective antagonist of postsynaptic alpha-1-adrenoceptors; blockade of adrenoreceptors in the prostate, prostatic capsule, bladder neck and prostatic urethra

 

Absorption

Bioavailability: 49%

Peak Plasma Time: 8 hr

Peak Plasma Concentration: 13.6 ng/mL

AUC: 194 ng.hr/mL

 

Distribution

Protein Bound: 82-90%

Vd: 3.2 L/kg

 

Metabolism

Hepatic P450 enzyme CYP3A4

 

Elimination

Half-life: 5-10 hr

Excretion: Feces (69%); urine (24%)