General

Pronunciation
al-FYOO-zo-sin

Trade Name(s)

• Uroxatral

Pregnancy Category
Category B

Ther. class.
urinary tract antispasmodics

Pharm. class.
peripherally acting antiadrenergics

Indications

Management of symptomatic benign prostatic hyperplasia (BPH)

Action

Selectively blocks alpha₁- adrenergic receptors in the lower urinary tract to relax smooth muscle in the bladder neck and prostate

Therapeutic Effect(s):
Increased urine flow and decreased symptoms of BPH

Pharmacokinetics

Absorption: 49% absorbed following oral administration; food enhances absorption

Distribution: Unknown

Metabolism and Excretion: Mostly metabolized by the liver (CYP3A4 enzyme system); 69% eliminated in feces, 24% in urine

Half-life: 10 hr

TIME/ACTION PROFILE

ROUTE	ONSET	PEAK	DURATION
PO-ER	within hr	8 hr	24 hr

Contraindication/Precautions

Contraindicated in:

• Hypersensitivity

• Moderate to severe hepatic impairment

• Potent inhibitors of the CYP3A4 enzyme system

• Concurrent use of other alpha-adrenergic blocking agents

• Severe renal impairment

• OB: No indications for women and children

Use Cautiously in:

• Congenital or acquired QTc prolongation or concurrent use of other drugs known to prolong QTc

• Mild hepatic impairment

• Geri: Consider age-related changes in body mass, cardiac, renal and hepatic function when prescribing

Adverse Reactions/Side Effects

CNS: dizziness, fatigue, headache.

Resp: bronchitis, sinusitis, pharyngitis.

CV: postural hypotension.

GI: abdominal pain, constipation, dyspepsia, nausea.

GU: erectile dysfunction.

*CAPITALS indicates life-threatening.
*italic indicates most frequent.

Interactions

Drug-Drug

• Ketoconazole, itraconazole, and ritonavir metabolism and significantly levels and effects (concurrent use in contraindicated)

• Levels are also by cimetidine, atenolol, and diltiazem

• Alfuzosin levels and may effects of atenolol and diltiazem (monitor blood pressure and heart rate)

• risk of hypotension with antihypertensives, nitrates, and acute ingestion of alcohol

Route/Dosage

• PO (Adults): 10 mg once daily.

Availability

• Extended-release tablets: 10 mg

» Cost: $229.96/90.

Assessment

• Assess patient for symptoms of benign prostatic hyperplasia (urinary hesitancy, feeling of incomplete bladder emptying, interruption of urinary stream, impairment of size and force of urinary stream, terminal urinary dribbling, straining to start flow, dysuria, urgency) before and periodically during therapy

» Assess patient for orthostatic reaction and syncope. Monitor BP (lying and standing) and pulse frequently during initial dose adjustment and periodically thereafter. May occur within a few hrs after initial doses and occasionally thereafter

» Rule out prostatic carcinoma before therapy; symptoms are similar

Potential Nursing Diagnoses

• Risk for injury (Side Effects)

• Noncompliance (Patient/Family Teaching)

Implementation

PO: Administer with food at the same meal each day. Tablets must be swallowed whole; do not crush, break, or chew

Patient/Family Teaching

Instruct patient to take medication with the same meal each day. Take missed doses as soon as remembered. If not remembered until next day, omit; do not double doses

» May cause dizziness or drowsiness. Advise patient to avoid driving or other activities requiring alertness until response to the medication is known

» Caution patient to avoid sudden changes in position to decrease orthostatic hypotension

» Advise patient to consult health care professional before taking any cough, cold, or allergy remedies

» Instruct patient to notify health care professional of medication regimen before any surgery

» Advise patient to notify health care professional if frequent dizziness or fainting occurs

» Emphasize the importance of follow-up exams to evaluate effectiveness of medication

» Geri: Assess risk for falls; implement fall prevention program and instruct patient and family in preventing falls at home

Evaluation/Desired Outcomes

Decreased symptoms of benign prostatic hyperplasia

alfuzosin is a sample topic found in Davis's Drug Guide. All other sections of this record are viewable by clicking on the index in the left column, or by clicking on "Display all Sections" in the "Content Manager".

To find other Davis's Drug Guide topics, please login or purchase a subscription.