Uroxatral


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alfuzosin

(al-fyoo-zo-sin) ,

Uroxatral

(trade name),

Xatral

(trade name)

Classification

Therapeutic: urinary tract antispasmodics
Pharmacologic: peripherally acting antiadrenergics
Pregnancy Category: B

Indications

Management of symptomatic benign prostatic hyperplasia (BPH).

Action

Selectively blocks alpha1- adrenergic receptors in the lower urinary tract to relax smooth muscle in the bladder neck and prostate.

Therapeutic effects

Increased urine flow and decreased symptoms of BPH.

Pharmacokinetics

Absorption: 49% absorbed following oral administration; food enhances absorption.
Distribution: Unknown.
Metabolism and Excretion: Mostly metabolized by the liver (CYP3A4 enzyme system); 11% excreted unchanged in urine.
Half-life: 10 hr.

Time/action profile

ROUTEONSETPEAKDURATION
PO-ERwithin hr8 hr24 hr

Contraindications/Precautions

Contraindicated in: Hypersensitivity;Moderate to severe hepatic impairment;Potent inhibitors of the CYP3A4 enzyme system;Concurrent use of other alpha-adrenergic blocking agents;Severe renal impairment; Pediatric: Children.
Use Cautiously in: Congenital or acquired QTc prolongation or concurrent use of other drugs known to prolong QTc;Mild hepatic impairment;Symptomatic hypotension;Concurrent use of antihypertensive agents, phosphodiesterase type 5 inhibitors, or nitrates (↑ risk of postural hypotension);Previous hypotensive episode with other medications; Geriatric: Consider age-related changes in body mass and cardiac, renal, and hepatic function when prescribing.

Adverse Reactions/Side Effects

Central nervous system

  • dizziness
  • fatigue
  • headache

Ear, Eye, Nose, Throat

  • intraoperative floppy iris syndrome

Respiratory

  • bronchitis
  • sinusitis
  • pharyngitis

Cardiovascular

  • postural hypotension

Gastrointestinal

  • abdominal pain
  • constipation
  • dyspepsia
  • nausea

Genitourinary

  • erectile dysfunction
  • priapism

Hematologic

  • thrombocytopenia

Interactions

Drug-Drug interaction

Ketoconazole, itraconazole, and ritonavir ↓ metabolism and significantly ↑ levels and effects (concurrent use contraindicated).Levels are ↑ by cimetidine, atenolol, and diltiazem.May ↑ levels and effects of atenolol and diltiazem (monitor BP and heart rate).↑ risk of hypotension with antihypertensives, nitrates, phosphodiesterase type 5 inhibitors (including sildenafil, tadalafil, and vardenafil ) and acute ingestion of alcohol.

Route/Dosage

Oral (Adults) 10 mg once daily.

Availability (generic available)

Extended-release tablets: 10 mg

Nursing implications

Nursing assessment

  • Assess for symptoms of benign prostatic hyperplasia (urinary hesitancy, feeling of incomplete bladder emptying, interruption of urinary stream, impairment of size and force of urinary stream, terminal urinary dribbling, straining to start flow, dysuria, urgency) before and periodically during therapy.
    • Assess for orthostatic reaction and syncope. Monitor BP (lying and standing) and pulse frequently during initial dose adjustment and periodically thereafter. May occur within a few hr after initial doses and occasionally thereafter.
    • Rule out prostatic carcinoma before therapy; symptoms are similar.

Potential Nursing Diagnoses

Risk for injury (Side Effects)
Noncompliance (Patient/Family Teaching)

Implementation

  • Oral: Administer with food at the same meal each day. Tablets must be swallowed whole; do not crush, break, or chew.

Patient/Family Teaching

  • Instruct patient to take medication with the same meal each day. Take missed doses as soon as remembered. If not remembered until next day, omit; do not double doses.
    • May cause dizziness or drowsiness. Advise patient to avoid driving or other activities requiring alertness until response to the medication is known.
    • Caution patient to avoid sudden changes in position to decrease orthostatic hypotension.
    • Advise patient to consult health care professional before taking any cough, cold, or allergy remedies.
    • Instruct patient to notify health care professional of medication regimen before any surgery, especially cataract surgery.
    • Advise patient to notify health care professional if priapism, angina, frequent dizziness, or fainting occurs.
    • Emphasize the importance of follow-up exams to evaluate effectiveness of medication.
    • Geriatric: Assess risk for falls; implement fall prevention program and instruct patient and family in preventing falls at home.

Evaluation/Desired Outcomes

  • Decreased symptoms of benign prostatic hyperplasia.
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References in periodicals archive ?
Uroxatral Tablets had US sales of approximately USD241m for the 12 months ending 30 June 2011, according to IMS Health.
Active drug and placebo were provided by Sanofi-Aventis, which makes Uroxatral. Dr.
The 5-ARIs include finasteride (Proscar) and dutasteride (Avodart), while alpha-blockers include alfuzosin (Uroxatral), tamsulosin (Flomax), and si.lodosin (Rapaflo).
Selective alpha-blockers--alfuzosin (Uroxatral), silodosin (Rapaflo) and tamsulosin (Flomax)--relax the smooth muscles in the bladder neck and prostate to improve urine flow.
Selective alpha-blockers, including alfuzosin (Uroxatral) and tamsulosin (Flomax), are among the first-line treatments for BPH.
If you have urinary symptoms, drugs known as selective alpha-blockers--alfuzosin (Uroxatral) or tamsulosin (Flomax)--or anticholinergic drugs like tolterodine (Detrol) or oxybutynin (Ditropan) may be prescribed.
Although commonly prescribed to treat chronic prostatitis/chronic pelvic pain syndrome, alfuzosin (Uroxatral), a member of a class of drugs known as alpha blockers, did not significantly reduce symptoms in recently diagnosed men who had not previously used an alpha blocker, according to a study published Dec.
The study also found a slightly higher use of BPH drugs known as alpha blockers--such as alfuzosin (Uroxatral) and tamsulosin (Flomax)--in the hip fracture group.
Selective alpha blockers--alfuzosin (Uroxatral) and tamsulosin (Flomax)--relax the smooth muscles in the bladder neck and prostate to improve urinary flow.
Obstructive urinary symptoms after radiation or brachytherapy usually can be treated with pain relievers and drugs known as alpha blockers--alfuzosin (Uroxatral), tamsulosin (Flomax), doxazosin (Cardura) or terazosin (Hytrin)--which improve urine flow.
Leonard said that although most people tolerate saw palmetto better than some prescription BPH drugs, you may find relief more quickly from prescription medications known as alpha blockers, such as tamsulosin (Flomax), alfuzosin (Uroxatral), doxazosin (Cardura) and terazosin (Hytrin).
Drugs known as alpha blockers--newer types such as tamsulosin (Flomax) and alfuzosin (Uroxatral) and older ones such as doxazosin (Cardura) and terazosin (Hytrin)--relax the smooth muscles in the bladder neck to improve urine flow.