alfuzosin hydrochloride

(al foo zow' sin)

Uroxatral

Pregnancy Category B

Drug classes
Alpha adrenergic blocking agent
BPH drug

Therapeutic actions
Blocks the smooth muscle alpha-1 adrenergic receptors in the prostate, prostatic capsule,
prostatic urethra, and bladder neck, leading to the relaxation of the bladder and prostate
and improving the flow of urine and improvement in symptoms in patients with BPH.

Indications
• Treatment of the signs and symptoms of BPH

Contraindications and cautions

• Contraindicated with allergy to any component of the product; hepatic
insufficiency, pregnancy, lactation.
• Use cautiously with hypotension, renal insufficiency, prolonged QTc interval,
CAD.

Available forms
ER tablets—10 mg

Dosages
ADULTS
10 mg/d PO after the same meal each day.
PEDIATRIC PATIENTS
Safety and efficacy not established.

Pharmacokinetics
Route Onset Peak
Oral Varies 8 hr
Metabolism: Hepatic; T1/2: 10 hr
Distribution: Crosses placenta; may enter breast milk
Excretion: Urine and feces

Adverse effects
CNS: Dizziness, headache
CV: Orthostatic hypotension, syncope, tachycardia, chest pain
GI: Abdominal pain, dyspepsia, constipation, nausea
GU: Impotence, priapism
Respiratory: Cough, bronchitis, sinusitis, pharyngitis, upper respiratory tract infection
Other: Fatigue, pain

Interactions
Drug-drug
• Increased serum levels and risk of adverse effects of alfuzosin if combined with
CYP3A4 inhibitors, ketoconazole, itraconazole, ritonavir; use of these
combinations is contraindicated
• Increased risk of orthostatic hypotension and syncope if combined with
antihypertensive medications; monitor patient closely and adjust antihypertensive
dosage accordingly
• Increased risk of adverse effects if combined with other adrenergic blockers;
monitor patients closely and adjust dosages as needed

Nursing considerations
Assessment
• History: Allergy to alfuzosin, hepatic or renal dysfunction, CAD, prolonged QTc
interval, pregnancy, lactation
• Physical: Body weight; skin color, lesions; orientation, affect, reflexes; P, BP,
orthostatic BP; R, adventitious sounds; PSA level; voiding pattern, normal output,
urinalysis
Interventions
• Ensure that patient does not have prostatic cancer before beginning treatment;
check for normal PSA levels.
• Administer once a day, after the same meal each day.
• Ensure that patient does not crush, chew, or cut tablet. Tablet should be swallowed
whole.
• Store tablets in a dry place, protected from light.
• Monitor patient carefully for orthostatic hypotension; chance of orthostatic
hypotension, dizziness, and syncope are greatest with the first dose. Establish
safety precautions as appropriate.

Teaching points
• Take this drug exactly as prescribed, once a day. Do not chew, crush, or cut
tablets; tablets must be swallowed whole. Use care when beginning therapy;
dizziness and syncope are most likely at the beginning of therapy. Change
position slowly to avoid increased dizziness. Take the drug after the same meal
each day. Do not take the drug on an empty stomach.
• These side effects may occur: Dizziness, weakness (these are more likely to occur
when you change position, in the early morning, after exercise, in hot weather,
and when you have consumed alcohol; some tolerance may occur after you have
taken the drug for a while. Avoid driving a car or engaging in tasks that require
alertness while you are experiencing these symptoms; remember to change
position slowly, use caution when climbing stairs, lie down for a while if
dizziness persists); GI upset (eat small, frequent meals); impotence (you may wish
to discuss this with your health care provider); fatigue.
 • Report frequent dizziness or fainting, worsening of symptoms, chest pain.

Adverse effects in Italic are most common; those in Bold are life-threatening.