Alfuzosin
UROXATRAL
Pronunciation: al-FYOO-zoe-sin (yoo-ROX-a-tral)
What it isAlpha-1 antagonist with functional uroselectivity; benign prostatic hyperplasia.
Why this oneLess ejaculatory dysfunction than tamsulosin, and no titration is needed.
What limits itOrthostatic hypotension and QT prolongation. CYP3A4-dependent, so strong inhibitors are contraindicated.
FDA-approved for
- BPH (2003)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Benign prostatic hyperplasia | Men | 10 mg QD with food (same meal each day) | 10 mg QD |
Renal Use with caution in severe impairment (CrCl <30 mL/min); no specific dose adjustment
Hepatic Contraindicated in moderate-severe impairment (Child-Pugh B/C); use caution in mild (not studied)
Instructions
- Take with food, with the same meal each day
- Swallow whole; do not chew or crush
Available strengths
- ER tab 10 mg
- tab 10 mg
Contraindications
- Moderate or severe hepatic impairment (Child-Pugh B/C)
- Concomitant potent CYP3A4 inhibitors (e.g., ketoconazole, itraconazole, ritonavir)
Cautions
- Postural hypotension/syncope, especially with antihypertensives or nitrates
- Intraoperative floppy iris syndrome during cataract surgery
- Priapism (rare)
- Rule out prostate carcinoma before treatment
- Caution in congenital/acquired QT prolongation
- Discontinue if symptoms of angina appear or worsen
- Do not combine with other alpha-adrenergic antagonists
Adverse reactions
- Dizziness, upper respiratory tract infection, headache, fatigue
Pregnancy Not indicated for use in women.
Lactation Not indicated for use in women.
Cost
| Strength | #/mo | generic $/mo | CostPlus | |
|---|---|---|---|---|
| 10 mg | ER tab | 30 qd | $3.15 | offered |
Generic entry2011
NO BOXED WARNINGS
Principal riskOrthostatic hypotension; QT prolongation
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityGenerally tolerated at therapeutic doses; clinically important risks are agent-specific and increase with interactions or organ impairment.