Alfuzosin: a clinically uroselective α₁-blocker

A once-daily (o.d.) formulation of alfuzosin has recently been developed in order to improve the convenience of dosing and to provide optimal pharmacokinetic coverage over a 24-h period. The results of two double-blind, placebo-controlled phase III studies of similar design that included 983 patients with LUTS that suggested BPH have confirmed that alfuzosin 10 mg o.d. is a 24-h effective treatment for both symptoms and flow rates, and that there is no additional benefit in using a higher dosage. In addition, alfuzosin is the only α₁-blocker that has demonstrated a significant decrease in post-void residual urine, a known risk factor for acute urinary retention, as well as the incidence of acute urinary retention in comparison with a placebo. Administered without an initial dose titration, alfuzosin 10 mg o.d. is well tolerated, with a low incidence of postural hypotension (<1%) and no significant changes in blood pressure compared with a placebo, even in elderly and hypertensive patients. Ejaculation disorders were rarely reported and did not show an evident causal relationship to treatment. Alfuzosin 10 mg o.d. also exhibits an excellent sexual side-effect profile, with no deleterious impact on this important aspect of quality of life for BPH patients.