Alfuzosin Disease Interactions

Alfuzosin is contraindicated for use in patients with moderate or severe hepatic impairment (Child Pugh B and C). The pharmacokinetics of alfuzosin have not been studied in patients with mild hepatic impairment and caution should be exercised if it is administered to such patients.

Alfuzosin should be used with caution in patients with acquired or congenital QT prolongation, or who are taking medications that prolong the QT interval.

Caution should be exercised when alfuzosin is administered in patients with severe renal impairment as safety data is limited on these patients (CrCl < 30 mL/min).

Peripheral alpha 1- adrenergic receptor blocking agents (aka alpha 1- blockers) cause vasodilation and can produce marked hypotension, especially orthostatic hypotension with syncope or other postural symptoms such as dizziness, lightheadedness, and palpitations. Orthostatic effects are most common during initiation of therapy and often occur within 90 minutes after the first dose. However, they can also occur following a dosage increase or resumption of therapy after an interruption of more than a few days. Agents with alpha 1a specificity, such as tamsulosin, act primarily on the prostate but are not devoid of hypotensive effects. Therapy with peripheral alpha-1 blockers should be administered cautiously in patients with or predisposed to hypotensive or syncopal episodes. Caution is also advised in patients who are dehydrated (e.g., due to severe or prolonged diarrhea or vomiting), since they may be more sensitive to the hypotensive effect of the drugs. Therapy should be initiated with the lowest dosage possible and titrated gradually based on patient response and tolerance in accordance with the individual product package labeling. During initiation or reinstitution of therapy and following an increase in dosage, patients should be advised not to rise abruptly from a sitting or recumbent position and to avoid situations where injury could result if syncope occur. Concomitant use of alcohol, extensive periods of standing, prolonged or intense exercise, and exposure to heat can also precipitate orthostatic hypotension and should be minimized. If dizziness, lightheadedness or palpitations occur, the patient should sit or lie down, and seek medical attention if symptoms are recurrent or bothersome.

Intraoperative Floppy Iris Syndrome has been observed during cataract surgery in some patients on or previously treated with antiadrenergic agents. If a patient is undergoing cataract surgery, the ophthalmologist should be prepared for possible modifications of the surgical technique (iris hooks, iris dilator rings). There does not appear to be a benefit in stopping antiadrenergic agents therapy prior to the cataracts surgery.