Alfuzosin Hydrochloride

How it works

It selectively blocks alpha-1 adrenoceptors in the smooth muscle of the prostate, bladder neck and prostatic urethra, reducing outflow resistance and improving urinary flow.

Prescribing in practice

• It can cause postural hypotension, dizziness and syncope, especially with the first dose, in the elderly and when combined with antihypertensives or PDE5 inhibitors, so advise caution on standing.
• Stop before cataract surgery is planned and inform the ophthalmologist, as it is associated with intraoperative floppy iris syndrome even after discontinuation.
• Avoid co-administration with potent CYP3A4 inhibitors, which raise its plasma levels, and use cautiously in hepatic impairment.

Monitoring

Monitor blood pressure, particularly after initiation and dose changes, and review symptom relief.

Counselling the patient

• Stand up slowly, especially when starting treatment, as you may feel faint or dizzy.
• Tell your eye surgeon you take or have taken this medicine before any cataract operation.
• Take it consistently after the same meal each day as advised.

Evidence & guidelines

Alfuzosin is an established treatment for benign prostatic hyperplasia symptoms, supported by the SPC and NICE guidance on lower urinary tract symptoms.