Last Updated on June 12, 2023
Alfuzosin is a medicine used to treat symptoms of an enlarged prostate, also known as benign prostatic hyperplasia (BPH). This condition can cause problems with urination, such as frequent or urgent urination, weak urine stream, and difficulty emptying the bladder completely. Alfuzosin works by relaxing the muscles in the prostate and bladder neck, which can relieve these symptoms and improve urinary function.
Although alfuzosin is a prescription medicine, there are some countries where it is available over the counter without a doctor’s prescription. However, in the UK it is not possible to buy alfuzosin over the counter. This means that people who need this medication to treat their symptoms must obtain a prescription from a healthcare professional.
If you have symptoms of BPH and are interested in taking alfuzosin, it is important to speak to your doctor. They will be able to assess your condition and determine whether alfuzosin is an appropriate treatment option for you. Although it may be more convenient to buy medication over the counter, it is important to prioritise safety and ensure that you are taking the correct dosage and that there are no contraindications.
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What is alfuzosin?
Alfuzosin is used to treat symptoms of benign prostatic hyperplasia. Benign prostatic hyperplasia (BPH) is a condition that often affects older men. It causes symptoms such as incomplete emptying of the bladder, difficulty urinating and sometimes incontinence. Find out what you need to know about alfuzosin: its use, possible interactions and side effects.
How does alfuzosin work?
Epinephrine and norepinephrine are two important hormones of the so-called sympathetic nervous system. The sympathetic nervous system, which is part of the autonomic nervous system, is responsible for getting the body ready to perform when needed (such as during exercise). Using messengers such as epinephrine and norepinephrine, it then ensures that important organs such as the heart and skeletal muscles are supplied with plenty of oxygen and energy in the form of sugar. Digestion and excretion are secondary in this situation and are therefore slowed down. Excitation of the sympathetic nervous system also means that the walls of the urethra and prostate gland in men can become swollen.
The latter can become a problem even at low levels of sympathetic stimulation if a man has a benign enlarged prostate: This can lead to urinary problems, incomplete emptying of the bladder or an urge to urinate. This can be very uncomfortable for older men.
Alfuzosin is an alpha-blocker. It binds to the receptors of epinephrine and norepinephrine, preventing them from working. The muscles of the urinary tract relax, reducing the symptoms of benign prostatic hyperplasia. Alfuzosin works from the first dose.
Pharmacokinetics and metabolism of alfuzosin
After being absorbed from the intestine, the drug is absorbed into the blood and reaches the muscles of the urethra and prostate. In the blood, it reaches its highest level one to two hours after ingestion.
The active ingredient is converted by liver enzymes into inactive breakdown products, which are mainly excreted in the faeces. Only a small proportion of alfuzosin leaves the body unchanged in the urine. About five hours after ingestion, only half of the drug is left in the body.
When is alfuzosin used?
Alfuzosin is currently only used to relieve symptoms associated with benign prostatic hyperplasia. Its former use to lower blood pressure has been replaced by more modern drug therapies.
As the effect only lasts as long as that of a muscle relaxant, alfuzosin must be taken on a long-term basis.
How alfuzosin is taken?
Alfuzosin is usually taken as a tablet. People under 65 years of age usually take one and a half milligrams of alfuzosin three times a day with a full glass of water. The dose may be increased to four times a day if needed.
Patients who are over 65 years of age, have kidney problems or are undergoing treatment may only need to take the medicine twice a day.
What are the side effects of alfuzosin?
Alfuzosin side effects occur in one in ten to one hundred treated patients and include feeling unwell, nausea, abdominal pain or diarrhoea. Most of these side effects occur early in treatment and improve with time.
Occasionally, rapid heartbeat, palpitations, blurred vision, chest pain, fluid retention, drowsiness, circulatory collapse, rhinitis, rash, hot flushes and urinary incontinence may occur.
What should I watch for while taking alfuzosin?
You should not take alfuzosin if you are taking other alpha-blockers. These include other medicines for benign prostatic hyperplasia (BPH), some antihypertensives, the antidepressants mirtazapine and mianserin, and certain Parkinson’s medicines (dopamine agonists such as bromocriptine, cabergoline, pergolide, apomorphine).
Patients with severe liver impairment should not take alfuzosin.
Caution should be exercised when taking alfuzosin concomitantly with other antihypertensive or antianginal drugs. These include nitrates (ISDN, nitroglycerin, molsidomine), beta-blockers (metoprolol, bisoprolol), calcium channel blockers (verapamil, diltiazem, nifedipine), ACE inhibitors (captopril, enalapril, ramipril) and sartans (candesartan, valsartan).
Alfuzosin is metabolised by the liver enzyme cytochrome 3A4. This enzyme also breaks down other drugs. Concomitant use of such drugs may inhibit the breakdown of alfuzosin, resulting in accumulation of the drug in the body and an increased hypotensive effect. Examples of such drugs are antifungals (ketoconazole, itraconazole) and HIV medicines (ritonavir).
Alfuzosin should be discontinued at least one day before scheduled surgery under general anaesthesia. During anaesthesia it may cause unpredictable fluctuations in blood pressure.
The effect of alfuzosin on children and adolescents is not known and it should not be used in them.
It should not be used by pregnant or breastfeeding women. It is only approved for men (with benign prostatic hyperplasia).
How to get alfuzosin?
Medicines containing alfuzosin are available only on prescription. So you can only get it from a pharmacy with a doctor’s prescription.
When was alfuzosin introduced?
The active ingredient alfuzosin was patented in 1979 as a blood pressure medication by the French pharmaceutical company Synthelabo (now Sanofi), which was part of the cosmetics company L’Oreal. It was first approved for the treatment of enlarged prostates in Germany in 1994 and in the United States in 2003. Today there are many generics containing alfuzosin.