Alfuzosin selectively blocks alpha-1 adrenergic receptors, specifically the alpha-1A and alpha-1D subtypes, which are predominantly located in the smooth muscle of the prostate, bladder neck, and urethra. The mechanism of action involves:

1. Smooth Muscle Relaxation: By inhibiting alpha-1A and alpha-1D receptors, alfuzosin reduces the tone of the smooth muscles in the prostate and bladder neck.
2. Improved Urine Flow: This relaxation decreases resistance to urine flow, alleviating symptoms such as difficulty starting urination, weak stream, and incomplete bladder emptying.
3. Selectivity: Alfuzosin’s selectivity for alpha-1A and alpha-1D receptors minimizes its effects on blood vessels, reducing the risk of hypotension compared to non-selective alpha-blockers.

Alfuzosin is approved for the following condition:

1. Benign Prostatic Hyperplasia (BPH):
   • Treatment of lower urinary tract symptoms (LUTS) associated with BPH, such as:
     • Difficulty starting urination
     • Weak urine stream
     • Frequent urination (especially at night)
     • Incomplete bladder emptying

The dosage of alfuzosin is standardized, but adjustments may be made based on patient response and tolerability. Below are general guidelines:

1. Adults:
   • Standard Dose: 10 mg taken orally once daily, preferably after the same meal each day.
   • Administration: Swallow the tablet whole; do not crush or chew.
2. Special Populations:
   • Elderly: No dose adjustment is required.
   • Renal Impairment: No dose adjustment is needed for mild to moderate impairment. Use with caution in severe renal impairment.
   • Hepatic Impairment: Avoid use in patients with moderate to severe hepatic impairment.

Alfuzosin is generally well-tolerated, but some side effects may occur. These include:

1. Common Side Effects:
   • Dizziness
   • Headache
   • Fatigue
   • Nausea
   • Abdominal pain
2. Less Common Side Effects:
   • Orthostatic hypotension (dizziness upon standing)
   • Rhinitis (nasal congestion)
   • Dry mouth
3. Rare but Serious Side Effects:
   • Priapism: Prolonged and painful erection. This is a medical emergency and requires immediate treatment.
   • Severe Hypotension: Rare cases of significant blood pressure drops.
   • Angina or Myocardial Infarction: Rare cardiovascular events, particularly in patients with pre-existing heart disease.

1. Contraindications:
   • Hypersensitivity to alfuzosin or any component of the formulation.
   • Moderate to severe hepatic impairment.
   • Concurrent use with strong CYP3A4 inhibitors (e.g., ketoconazole, ritonavir).
2. Warnings:
   • Orthostatic Hypotension: Patients should be cautious when standing up quickly, especially during the initial dose or dose escalation.
   • Pregnancy and Lactation: Alfuzosin is not indicated for use in women.
   • Cataract Surgery: Inform the ophthalmologist about alfuzosin use due to the risk of intraoperative floppy iris syndrome (IFIS).
3. Monitoring:
   • Monitor for signs of hypotension, especially in patients taking antihypertensive medications.
   • Regular assessment of BPH symptoms and urinary flow.

Alfuzosin interacts with several medications, including:

1. Other Alpha-Blockers (e.g., doxazosin): Increased risk of hypotension.
2. Antihypertensive Medications: May cause additive hypotensive effects.
3. Strong CYP3A4 Inhibitors (e.g., ketoconazole, ritonavir): Increase alfuzosin levels, increasing the risk of side effects. Concurrent use is contraindicated.
4. Phosphodiesterase-5 Inhibitors (e.g., sildenafil): May cause additive hypotensive effects.
5. Alcohol: May enhance the hypotensive effects of alfuzosin.

Alfuzosin is available under its generic name as well as brand names. Some common formulations include:

• Generic Name: Alfuzosin hydrochloride

Brand Names: Xatral (commonly used in the UK and Europe), Uroxatral (commonly used in the US), and others depending on the region.