Alfuzosin

Benjamin Clanner-Engelshofen is a freelance writer in the medical department. He studied biochemistry and pharmacy in Munich and Cambridge / Boston (USA) and noticed early on that he particularly enjoyed the interface between medicine and science. That is why he went on to study human medicine.

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The active ingredient alfuzosin helps against symptoms of benign prostate enlargement. This so-called “benign prostatic hyperplasia” (BPH) often affects older men. It causes symptoms such as incomplete emptying of the bladder, problems urinating, and sometimes incontinence. Here you can read everything you need to know about alfuzosin: use, mode of action and possible interactions and side effects.

This is how alfuzosin works

Adrenaline and noradrenaline are two important hormones of the so-called sympathetic system. The sympathetic nervous system, a part of the autonomic nervous system, has the task of getting the body ready to perform when needed (e.g. during sport). With the help of messenger substances such as adrenaline and noradrenaline, 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 elimination are secondary in this situation and are therefore throttled. The stimulation of the sympathetic nervous system also causes the urethral and prostate walls to constrict in men.

The latter can become a problem even with low sympathetic stimulation if a man has a benign enlarged prostate: Problems with urination, incomplete bladder emptying or urinary retention can easily occur. This can be very uncomfortable for older men.

The active ingredient alfuzosin belongs to the group of alpha blockers. It binds to the docking sites (receptors) of adrenaline and noradrenaline so that they can no longer develop their effect. The muscles of the lower urinary tract relax, which reduces the symptoms of benign prostate enlargement. Alfuzosin works after the first dose.

Absorption, breakdown and excretion of alfuzosin

After ingestion, the active ingredient is absorbed from the intestine into the blood and thus also reaches the muscles of the urethra and the prostate. It reaches the highest levels in the blood one to two hours after ingestion.

The active ingredient is converted into ineffective breakdown products by liver enzymes, which are mainly excreted in the stool. Only a small part of alfuzosin leaves the body unchanged, namely via the urine. About five hours after ingestion, only half of the active ingredient is in the body.

When is alfuzosin used?

The active ingredient alfuzosin is currently only used to relieve the symptoms of benign prostate enlargement. The previous application for lowering blood pressure has been replaced by therapies with more modern active ingredients.

Since the effect only lasts as long as the active ingredient acts on the muscles, alfuzosin must be taken long-term.

This is how alfuzosin is used

Alfuzosin is usually taken as a tablet. Patients under the age of 65 usually take two and a half milligrams of alfuzosin three times a day with a glass of water. The dosage can be increased to four times a day if necessary.

Patients over 65 years of age who have kidney problems or who are being treated for high blood pressure are only allowed to take the active ingredient twice a day.

What are the side effects of alfuzosin?

Alfuzosin side effects in one in ten to one hundred people are low blood pressure after getting up from a lying or sitting position (orthostatic hypotension), fainting, dizziness, drowsiness, headache, malaise, nausea, abdominal pain or diarrhea. Usually these side effects occur especially at the beginning of the treatment and get better as the treatment progresses.

Occasionally, palpitations, palpitations, visual disturbances, chest pain, water retention, drowsiness, circulatory collapse, runny nose, rash, hot flashes and urinary incontinence can also occur.

What should be considered when taking alfuzosin?

The active ingredient alfuzosin must not be taken if other alpha blockers are being taken. These include, for example, other drugs for benign prostate enlargement, some antihypertensive drugs, the antidepressants mirtazapine and mianserine, and certain Parkinson's drugs (dopamine agonists such as bromocriptine, cabergoline, pergolide, apomorphine).

Patients with severe hepatic impairment should not take alfuzosin.

The combined intake of alfuzosin and other antihypertensive drugs or angina pectoris drugs should only be used with caution. These drugs include in particular nitrates (ISDN, nitroglycerin, molsidomine), beta blockers (metoprolol, bisoprolol), calcium antagonists (verapamil, diltiazem, nifedipine), ACE inhibitors (captopril, enalapril, ramipril) and sartans (candesartan), valsartan.

Alfuzosin is broken down by the liver enzyme cytochrome 3A4. This also breaks down other drugs. If such medicinal substances are used at the same time, the breakdown of alfuzosin can be inhibited, so that the active substance can accumulate in the body and trigger an increased antihypertensive effect. Examples of such drugs are primarily antifungal agents (ketoconazole, itraconazole) and HIV drugs (ritonavir).

If operations are planned under anesthesia, alfuzosin should be discontinued at least one day in advance. Otherwise, unpredictable fluctuations in blood pressure may occur during anesthesia.

The effect of alfuzosin in children and adolescents has not been established, which is why the active substance should not be used in them.

The active ingredient should not be used by pregnant or breastfeeding women. It is also only approved for men (with benign prostate enlargement).

How to get medication with alfuzosin

Preparations with the active ingredient alfuzosin require a prescription. So you can only get them in the pharmacy after a doctor's prescription.

How long has alfuzosin been known?

The active ingredient alfuzosin was patented as a blood pressure medication by the French pharmaceutical company Synthélabo (now Sanofi), which belonged to the cosmetics group l’Oréal, in 1979. It was first approved for the treatment of enlarged prostate in Germany in 1994, in the USA only in 2003. Today there are numerous generic drugs with the active ingredient alfuzosin.

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