Mittoval (Alfuzosin Hydrochloride)

Alfuzosin is used to manage conditions related to prostate enlargement and lower urinary tract obstruction.

• Benign prostatic hyperplasia: improves urinary flow and reduces nocturia, hesitancy and weak stream.
• Lower urinary tract symptoms due to BPH: alleviates urgency, frequency and incomplete bladder emptying.
• Bladder outlet obstruction from enlarged prostate: relaxes smooth muscle to facilitate voiding.

• Alfuzosin selectively antagonizes alpha‑1 adrenergic receptors located in the prostate, bladder neck and urethra. By blocking these receptors, it reduces smooth‑muscle tone, leading to relaxation of the prostate and bladder neck, which enhances urinary outflow and eases obstruction associated with benign prostatic hyperplasia.

Adverse reactions may occur with alfuzosin therapy.

Common Side Effects

• Dizziness: light‑headed sensation, especially on standing.
• Headache: mild to moderate intensity.
• Fatigue: feeling of tiredness or reduced energy.
• Nasal congestion: stuffy or runny nose.
• Retrograde ejaculation: semen may flow backward.
• Gastrointestinal discomfort: nausea or abdominal pain.

Serious or Rare Side Effects

• Severe hypotension: marked drop in blood pressure, may cause fainting.
• Syncope: sudden loss of consciousness.
• Priapism: prolonged, painful erection.
• Anaphylactic reaction: severe allergy with swelling, rash, breathing difficulty.
• Cardiac arrhythmia: irregular heart rhythm.
• Liver injury: elevated enzymes or jaundice.

Before initiating alfuzosin, consider the following safety measures.

• Renal impairment: assess kidney function and adjust if necessary.
• Hepatic impairment: use with caution in patients with liver disease.
• Concomitant alpha‑blockers: avoid additive hypotensive effects.
• History of orthostatic hypotension: monitor blood pressure regularly.
• Drug interactions: review all concurrent medications for potential interactions.
• Store at ambient temperature: keep in original packaging, protect from moisture and direct sunlight.

Alfuzosin may interact with several drug classes, requiring attention to avoid adverse outcomes.

Major Interactions (Avoid)

• CYP3A4 inhibitors (e.g., ketoconazole, erythromycin): may increase alfuzosin plasma concentrations.
• Other alpha‑1 blockers (e.g., tamsulosin, prazosin): additive risk of severe hypotension.
• Nitrates (e.g., nitroglycerin): can cause profound blood pressure lowering.

Moderate Interactions (Monitor Closely):\n- CYP3A4 inducers (e.g., rifampin, carbamazepine): may reduce alfuzosin effectiveness.

• Antihypertensives (e.g., ACE inhibitors, ARBs): may enhance blood pressure‑lowering effect.
• Diuretics: increase risk of orthostatic hypotension, especially in the elderly.