What is it used for?

• Relieving the urinary symptoms of an enlarged prostate gland (benign prostatic hyperplasia).

How does it work?

• Xatral tablets contain the active ingredient alfuzosin, which is a type of medicine called an alpha-blocker. It works by blocking alpha receptors that are found in the muscle in the prostate gland. (NB. Alfuzosin is also available without a brand name, ie as the generic medicine.)
• The prostate gland, which is found only in men, lies at the top of the tube connecting the bladder to the outside (urethra). The prostate gland often enlarges with advancing age (benign prostatic hyperplasia), pressing on the urethra and obstructing the flow of urine from the bladder. This can cause various urinary symptoms, such as difficulty passing urine.
• Alfuzosin blocks alpha receptors in the muscle of the prostate gland, which causes the muscle in the prostate to relax. This allows urine to flow freely past the prostate and relieves the urinary symptoms.

How do I take it?

• Xatral tablets should be swallowed whole with a drink of water. They can be taken either with or without food.
• The first dose of this medicine may cause dizziness, light-headedness or fainting. For this reason you should take your first dose just before going to bed at night.
• Xatral tablets are usually taken two or three times a day. The dose prescribed depends on your age, symptoms and any other conditions you may have. Follow the instructions given by your doctor. These will be printed on the dispensing label that your pharmacist has put on the packet of medicine.

Warning!

• This medicine may cause dizziness, light-headedness or fainting, particularly when you first start taking it. Take care when moving from a lying down position to sitting or standing, particularly if you wake up in the night, until you know how this medicine affects you. If you feel dizzy, light-headed, sweaty or suddenly tired at any time during treatment, lie down until the symptoms have completely passed. Some people may find that drinking alcohol makes dizziness worse.
• As this medicine may cause fatigue and dizziness, you should take care when performing potentially hazardous activites, such as driving or operating machinery, until you know how this medicine affects you and are sure you can perform such activities safely.
• Your blood pressure should be monitored regularly during treatment with this medicine.
• If you are scheduled to have eye surgery for cataracts it is important to let your eye specialist know if you are or have been taking this medicine. This is because this type of medicine may make your pupil dilate poorly and the iris (the coloured circular part of the eye) become floppy during the procedure. The specialist needs to know if you have been taking this medicine so they can take appropriate precautions with the medicines and techniques they use during the surgery. You may be asked to stop taking this medicine for a period of time before cataract surgery. Check with your doctor.
• You may also be asked to stop taking this medicine before any other planned surgery where you will be given a general anaesthetic. Check with your doctor.

Use with caution in

• Elderly people.
• Decreased kidney function.
• Decreased liver function.
• Heart failure.
• Coronary artery disease or angina pectoris. If you think your angina has got worse after starting this medicine you should tell your doctor.
• People with an abnormal heart rhythm seen on a heart monitoring trace (ECG) as a "prolonged QT interval".
• People taking medicines that can cause a "prolonged QT interval" (your doctor will know, but examples include medicines for irregular heartbeats and certain antipsychotics).
• People with a history of stroke or other problems involving the blood circulation to the brain.
• People taking blood pressure lowering medication.
• People who have had an allergic reaction or a severe fainting episode after taking another alpha-blocker medicine.

Not to be used in

• Children.
• People already taking other alpha-blocker medicines.
• Severely decreased liver function.
• People with a history of drops in blood pressure that cause dizziness when moving from a lying down or sitting position to sitting or standing (postural hypotension).
• This medicine is not recommended for people who have ever fainted after passing urine (micturition syncope).
• Xatral tablets contain lactose and are not suitable for people with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption.
• This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Common 

• Dizziness.
• Feeling faint.
• Headache.
• Spinning sensation (vertigo).
• A drop in blood pressure that occurs when going from lying down to sitting or standing, which results in dizziness and lightheadedness (postural hypotension).
• Nausea.
• Abdominal pain.
• Diarrhoea.
• Dry mouth.
• Weakness or loss of strength (asthenia).
• General feeling of being unwell (malaise).

Uncommon 

• Drowsiness.
• Fainting.
• Abnormal vision.
• Increased heart rate (tachycardia).
• Awareness of your heartbeat (palpitations).
• Flushing.
• Inflammation of the nasal lining, causing a blocked or runny nose (rhinitis).
• Rash or itching.
• Chest pain.
• Excessive fluid retention in the body tissues, resulting in swelling (oedema).

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.

If this medicine is taken with other medicines that can reduce blood pressure, this effect may be enhanced, with an increased chance of dizziness or fainting. Other medicines that may reduce blood pressure include the following:

• aldesleukin
• alprostadil
• antipsychotics, eg haloperidol
• baclofen
• diuretics, eg furosemide
• general anaesthetics
• medicines for high blood pressure (antihypertensives)
• levodopa
• MAOI antidepressants, eg phenelzine
• nitrates, eg glyceryl trinitrate, isosorbide mononitrate, amyl nitrate (poppers)
• other alpha-blockers, eg prazosin, doxazosin (this medicine must not be taken with other alpha-blocker medicines)
• phosphodiesterase type 5 inhibitors for erectile dysfunction (impotence), eg sildenafil, vardenafil, tadalafil
• tizanidine.

The following medicines may reduce the breakdown of alfuzosin by the liver and could therefore increase the risk of its side effects, including dizziness:

• itraconazole
• ketoconazole
• ritonavir.

References:

https://www.medicines.org.uk/emc/medicine/7056

http://www.netdoctor.co.uk/medicines/liver-kidney-and-urinary-system/a7769/xatral-alfuzosin/

http://www.medicines.ie/medicine/12339/SPC/Xatral+10mg+Prolonged+Release+Tablets/#MACHINEOPS

http://www.medbroadcast.com/drug/getdrug/xatral

http://www.medicines.org.uk/emc/medicine/7061/SPC/Xatral+XL+10mg+prolonged+release+tablets