• Management of symptomatic benign prostatic hyperplasia (BPH).

Contraindicated in:

• Hypersensitivity
• Moderate to severe hepatic impairment
• Concurrent use of strong CYP3A4 inhibitors
• Concurrent use of other alpha-adrenergic blocking agents
• Severe renal impairment.

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
• Geri: Consider age-related changes in body mass and cardiac, renal, and hepatic function when prescribing in older adults.

CV: postural hypotension.

Derm: TOXIC EPIDERMAL NECROLYSIS.

EENT: intraoperative floppy iris syndrome.

GI: abdominal pain, constipation, dyspepsia, nausea.

GU: erectile dysfunction, priapism.

Hemat: thrombocytopenia.

Neuro: dizziness, fatigue, headache.

Resp: bronchitis, pharyngitis, sinusitis.

Drug-Drug:

• Strong CYP3A4 inhibitors, including ketoconazole, itraconazole, and ritonavir, may significantly ↑ levels and risk of toxicity; concurrent use contraindicated.
• Cimetidine, atenolol, and diltiazem may ↑ levels and risk of toxicity.
• May ↑ levels and risk of toxicity 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.

(Generic available)

• Extended-release tablets: 10 mg;

• PO (Adults): 10 mg once daily.

Uroxatral

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

• Increased urine flow and decreased symptoms of BPH.

Therapeutic Classification: urinary tract antispasmodics

Pharmacologic Classification: peripherally acting antiadrenergics

Absorption: 49% absorbed following oral administration; food enhances absorption.

Distribution: Unknown.

Metabolism/Excretion: Mostly metabolized by the liver via the CYP3A4 isoenzyme system; 11% excreted unchanged in urine.

Half-life: 10 hr.

Xatral

• 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, rash, or fainting occurs.
  • Emphasize the importance of follow-up exams to evaluate effectiveness of medication.
  • Geri: Assess risk for falls; implement fall prevention program and instruct patient and family in preventing falls at home.

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