Alfuzosin adverse effects

The benefit of combining an alpha-adrenoceptor antagonist with a 5-alpha-reductase inhibitor has been assessed in men with benign prostatic hyperplasia (23). Modified-release alfuzosin was more effective than finasteride, with no additional benefit in combining the drugs. The adverse effects of alpha-blockade were postural hypotension, hypotension, headache, dizziness, and malaise the adverse effects of finasteride were ejaculatory disorders and impotence. 

Alfuzosin is a uroselective alphai-adrenoceptor antagonist used to relieve the symptoms of prostatic hyperplasia (1). Its safety has been investigated in a large prospective 3-year open trial in 3228 patients with benign prostatic hyperplasia. There were no unexpected adverse effects. Only 4.2% of the patients dropped out owing to adverse effects. 

Alfuzosin is considered to be functionally and clinically urose-lective in that usual doses used to treat BPH are less likely than other second-generation agents to cause cardiovascular adverse effects in animal or human models. This clinical observation has more often been seen with the once-daily, extended-release formulation of alfuzosin, which is the only commercially available formulation in the United States, as compared to the immediate-release formulation that is dosed three times a day that is available in Europe. It has been postulated that this may be due to higher concentrations of alfuzosin achieved in the prostate versus serum after usual doses, decreased blood-brain barrier penetration of alfuzosin, and the absence of high peak serum levels with the extended-release formulation." Extended-release alfuzosin dosing is EDA-approved for 10 mg daily, with no titration increase." " This is convenient for physician prescribers and patients who are started on the medication. 

Prazosin, terazosin, doxazosin, tamsulosin, and alfuzosin have been studied extensively and used widely in patients with benign prostatic hyperplasia. With the exception of tamsulosin, the comparative efficacies of each of these drugs, especially in comparison with relative adverse effects such as postural hypotension, appear similar, although direct comparisons are limited. Tamsulosin at the recommended dose of 0.4 mg daily is less likely to cause orthostatic hypotension than the other drugs. There is growing evidence that the predominant a,-receptor subtype expressed in the human prostate is the a,-receptor. Developments in this area will provide the basis for the selection of Ct receptor antagonists with specificity for the relevant subtype of aj-receptor. However, the possibility remains that some of the symptoms of BPH are due to aj-receptors in other sites, such as bladder, spinal cord, or brain. 

Sexual function There was a clear association between a-adrenoceptor antagonists and ejaculatory dysfunction (pain/discom-fort) in an observational study in Spanish men with benign prostatic hyperplasia and/or lower urinary tract symptoms [106 ]. The presence and severity of symptoms were assessed using the male sexual health questionnaire there was an 83% prevalence of ejaculatory dysfunction in patients taking a-adrenoceptor antagonists. Most cases of ejaculatory dysfunction were mild and severe dysfunction occurred in only 4% of cases. Although the adverse effects on sexual function were seen with all of the a-adrenoceptor antagonists, alfuzosin was associated with better ejaculatory function than tamsulosin, terazosin, or doxazosin. 

---