Further Product Information

CONTENTS

Summary
Introduction
Pharmacology
Clinical efficacy
Safety and tolerability
Key points
References

SUMMARY

The lower urinary tract symptoms which characterise benign prostatic hyperplasia (BPH) are the result not only of physical obstruction by an enlarged prostate but also contraction of the smooth muscle in the prostatic capsule, bladder neck and proximal urethra. Alfuzosin hydrochloride is an antagonist of alpha1-adrenoceptors, which mediate this smooth muscle contraction. Treatment with alfuzosin, therefore, relieves the obstructive and irritative symptoms of BPH, as well as mediating impressive improvements in quality-of-life scores. It has been demonstrated that the drug preferentially distributes to prostatic tissue and this most likely contributes to the low rate of adverse events related to the cardiovascular and central nervous systems, which might be expected following global alpha1-adrenoceptor inhibition. The once-daily formulation of alfuzosin is also effective in improving the success rate of a trial without catheter following an episode of acute urinary retention related to BPH. Alfuzosin offers similar levels of efficacy to other drugs in the class, though is perhaps less effective than doxazosin. Alfuzosin is well tolerated - the once-daily formulation, in particular, has a similar side-effect profile to placebo and is associated with fewer vasodilatory adverse events than a formulation which requires more frequent dosing. The a1-antagonist tamsulosin also carries a lower risk of vasodilatory changes than this latter formulation of alfuzosin, but is associated with an increased risk of sexual dysfunction. Alfuzosin is reported to be superior in both efficacy and tolerability to finasteride, a drug which targets the physical obstruction to urinary flow caused by hyperplastic prostatic tissue. However, the lack of a cut-off criterion for prostate size in this trial may have limited the potential benefit obtained from finasteride. The data presented in this review reflect the effectiveness of alfuzosin as a first-line option amongst pharmacological treatments for BPH.

Quick Reference Pages For more information, you can download a free-of-charge Quick Reference Guide to the Alfuzosin in Benign prostatic hyperplasia issue of Drugs in Context which is designed to give you an insight into the numerous key points of information and practical guidance contained in each issue, via carefully selected quotations taken directly from each part of the publication.