Alpha-1 Blocker
Pregnancy: Not applicable (male condition)
Alfuzosin
Brand names: Xatral
Adult dose
Dose: 10 mg
Route: oral
Frequency: once daily
Max: 10 mg/day
Modified-release tablet; take after same meal each day; less orthostatic hypotension than tamsulosin; avoid in severe hepatic impairment
Paediatric dose
Route:
Not licensed in children
Dose adjustments
Renal
Caution if eGFR <30 ml/min; start at lowest dose
Hepatic
Avoid in severe hepatic impairment
Clinical pearls
- Intraoperative floppy iris syndrome — inform ophthalmologist before cataract surgery
- Modified release formulation reduces peak plasma levels and orthostatic hypotension
- Effect on ejaculation less than tamsulosin (pharmacological advantage)
Contraindications
- Hypersensitivity
- Severe hepatic impairment
- History of orthostatic hypotension
- Concomitant potent CYP3A4 inhibitors
Side effects
- Dizziness
- Orthostatic hypotension
- Headache
- Fatigue
- Rhinitis
- Intraoperative floppy iris syndrome
Interactions
- Antihypertensives (hypotension)
- PDE5 inhibitors (orthostatic hypotension)
- CYP3A4 inhibitors (ketoconazole, ritonavir)
Monitoring
- Blood pressure (first dose)
- Symptoms of BPH
Reference: BNFc; BNF 86; NICE NG97. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators