Generic Name

Alfuzosin Hydrochloride

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Classification

FDA Approved Indications

• Benign prostatic hyperplasia (BPH)

Mechanism of Action

Alfuzosin selectively blocks alpha-1 adrenergic receptors in the smooth muscle of the prostate, bladder neck, and urethra, leading to relaxation of these muscles and improved urine flow.

Dosage and Administration

Adult: Starting dose is usually 10 mg once daily after a meal. Dose adjustment may be based on response and tolerability.

Pediatric: Not indicated for pediatric use.

Geriatric: No specific dosage adjustments solely based on age, but renal and hepatic functions should be considered.

Renal Impairment: Use with caution; no specific dosage adjustment recommended, but renal function should be monitored.

Hepatic Impairment: Use with caution; dose adjustment may be necessary.

Pharmacokinetics

Absorption: Well absorbed after oral administration.

Distribution: Approximately 90% bound to plasma proteins.

Metabolism: Extensively metabolized in the liver, primarily by CYP3A4 and CYP2D6.

Excretion: Excreted mainly via feces (65%) and urine (20%).

Half Life: about 13 hours.

Contraindications

• History of hypersensitivity to alfuzosin or other alpha-1 blockers.

Precautions

• Use with caution in patients with hepatic impairment, severe renal impairment, or cardiovascular disease. Initiate at low doses in the elderly.

Adverse Reactions - Common

• Dizziness (Common)
• Headache (Common)
• Fatigue (Common)
• Weakness (Common)

Adverse Reactions - Serious

• Orthostatic hypotension (Uncommon)
• Syncope (Rare)
• Liver function abnormalities (Rare)
• Priapism (Rare)

Drug-Drug Interactions

• PDE5 inhibitors (e.g., sildenafil) may increase risk of hypotension.
• CYP3A4 inhibitors like ketoconazole can increase alfuzosin levels.

Drug-Food Interactions

• Avoid concomitant use with grapefruit juice, which inhibits CYP3A4.
• Take after a meal to reduce orthostatic hypotension risk.

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Take medication with food, usually after a meal.
• Rise slowly from sitting or lying positions to minimize dizziness.
• Report any dizziness, lightheadedness, or signs of allergic reactions.
• Do not discontinue without consulting a healthcare provider.

Special Considerations

Black Box Warnings:

• None.

Genetic Factors: No specific pharmacogenetic considerations.

Lab Test Interference: May cause orthostatic changes affecting blood pressure readings.

Overdose Management

Signs/Symptoms: Severe hypotension, dizziness, syncope.

Treatment: Supportive care, position patient supine, monitor vital signs, and administer fluids as needed.

Storage and Handling

Storage: Store at room temperature, 20°C to 25°C (68°F to 77°F).

Stability: Stable when stored properly.