l RENAL IMPAIRMENT Manufacturers advise avoid use of
modified-release preparations if eGFR less than
30 mL/minute/1.73 m2 as limited experience.
Dose adjustments Initial dose 2.5 mg twice daily and adjust
l PATIENT AND CARER ADVICE Patient should be counselled
Driving and skilled tasks May affect performance of skilled
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug. Forms available
from special-order manufacturers include: oral solution
CAUTIONARY AND ADVISORY LABELS 21, 25
Alfuzosin hydrochloride 10 mg Besavar XL 10mg tablets | 30 tablet P £12.51 DT = £12.51
Alfuzosin hydrochloride 10 mg Fuzatal XL 10mg tablets | 30 tablet P £12.76 DT = £12.51
▶ Vasran XL (Ranbaxy (UK) Ltd)
Alfuzosin hydrochloride 10 mg Vasran XL 10mg tablets | 30 tablet P £11.48 DT = £12.51
Alfuzosin hydrochloride 10 mg Xatral XL 10mg tablets |
30 tablet P £12.51 DT = £12.51
Alfuzosin hydrochloride 10 mg Zochek 10mg modified-release
tablets | 30 tablet P £12.51 DT = £12.51
▶ Alfuzosin hydrochloride (Non-proprietary)
Alfuzosin hydrochloride 2.5 mg Alfuzosin 2.5mg tablets |
Alfuzosin hydrochloride 2.5 mg Xatral 2.5mg tablets | 60 tablet P £20.37 DT = £1.44
▶ BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶ Adult: Initially 1 mg once daily for 1–2 weeks, then
increased to 2 mg once daily, then increased if
necessary to 4 mg once daily; maximum 16 mg per day
▶ BY MOUTH USING MODIFIED-RELEASE MEDICINES
▶ Adult: Initially 4 mg once daily, dose can be adjusted
after 4 weeks, then increased if necessary to 8 mg once
▶ BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶ Adult: Initially 1 mg daily, dose may be doubled at
intervals of 1–2 weeks according to response; usual
maintenance 2–4 mg daily; maximum 8 mg per day
▶ BY MOUTH USING MODIFIED-RELEASE MEDICINES
▶ Adult: Initially 4 mg once daily, dose can be adjusted
after 4 weeks, then increased if necessary to 8 mg once
DOSE EQUIVALENCE AND CONVERSION
▶ Patients stabilised on immediate-release doxazosin
can be transferred to the equivalent dose of modifiedrelease doxazosin.
l CONTRA-INDICATIONS History of micturition syncope (in
patients with benign prostatic hypertrophy). history of
postural hypotension . monotherapy in patients with
syndrome). elderly . heart failure . pulmonary oedema due
l INTERACTIONS → Appendix 1: alpha blockers
▶ Common or very common Arrhythmias . asthenia . chest
dysfunction . stroke . syncope .tinnitus .tremor. vomiting . weight increased
▶ Frequency not known Floppy iris syndrome
l PREGNANCY No evidence of teratogenicity; manufacturers
advise use only when potential benefit outweighs risk.
l BREAST FEEDING Accumulates in milk in animal studies—
l HEPATIC IMPAIRMENT Manufacturer advises caution in
mild to moderate impairment (limited information
available); avoid in severe impairment (no information
l PATIENT AND CARER ADVICE Patient counselling is advised
for doxazosin tablets (initial dose).
Driving and skilled tasks May affect performance of skilled
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug. Forms available
from special-order manufacturers include: capsule, oral
CAUTIONARY AND ADVISORY LABELS 25
Doxazosin (as Doxazosin mesilate) 4 mg Cardura XL 4mg tablets | 28 tablet P £5.00 DT = £5.00
Doxazosin (as Doxazosin mesilate) 8 mg Cardura XL 8mg tablets | 28 tablet P £9.98 DT = £9.98
▶ Doxadura XL (Discovery Pharmaceuticals)
Doxazosin (as Doxazosin mesilate) 4 mg Doxadura XL 4mg tablets
| 28 tablet P £4.75 DT = £5.00
Doxazosin (as Doxazosin mesilate) 4 mg Larbex XL 4mg tablets | 28 tablet P £6.08 DT = £5.00
▶ Raporsin XL (Actavis UK Ltd)
Doxazosin (as Doxazosin mesilate) 4 mg Raporsin XL 4mg tablets
| 28 tablet P £5.70 DT = £5.00
Doxazosin (as Doxazosin mesilate) 4 mg Slocinx XL 4mg tablets | 28 tablet P £5.96 DT = £5.00
Doxazosin (as Doxazosin mesilate) 1 mg Doxazosin 1mg tablets | 28 tablet P £10.56 DT = £0.87
Doxazosin (as Doxazosin mesilate) 2 mg Doxazosin 2mg tablets | 28 tablet P £14.08 DT = £0.86
Doxazosin (as Doxazosin mesilate) 4 mg Doxazosin 4mg tablets |
Doxazosin (as Doxazosin mesilate) 8 mg Doxazosin 8mg tablets | 28 tablet P £1.60
Doxazosin (as Doxazosin mesilate) 1 mg Cardura 1mg tablets | 28 tablet P £10.56 DT = £0.87
Doxazosin (as Doxazosin mesilate) 2 mg Cardura 2mg tablets | 28 tablet P £14.08 DT = £0.86
▶ Doxadura (Discovery Pharmaceuticals)
Doxazosin (as Doxazosin mesilate) 1 mg Doxadura 1mg tablets |
Doxazosin (as Doxazosin mesilate) 2 mg Doxadura 2mg tablets | 28 tablet P £0.75 DT = £0.86
Doxazosin (as Doxazosin mesilate) 4 mg Doxadura 4mg tablets | 28 tablet P £0.90 DT = £1.00
▶ Adult: Initially 25 mg twice daily, increased in steps of
25–50 mg every 2 weeks, maximum daily dose should
be given in divided doses; maximum 200 mg per day
▶ Adult: 20 mg twice daily, increased in steps of 20 mg
every 2 weeks if required, increased if necessary up to
▶ Elderly: 20 mg daily may be adequate, dose to be taken
DOSE ADJUSTMENTS DUE TO INTERACTIONS
▶ Caution with concomitant antihypertensives in benign
prostatic hyperplasia—reduced dosage and specialist
l CONTRA-INDICATIONS Established heart failure . history
micturition syncope (when used for benign prostatic
hyperplasia). history of postural hypotension (when used
for benign prostatic hyperplasia)
l CAUTIONS Cataract surgery (risk of intra-operative floppy
iris syndrome). control incipient heart failure before
initiating indoramin . elderly . epilepsy (convulsions in
animal studies). history of depression . Parkinson’s disease
(extrapyramidal disorders reported)
l INTERACTIONS → Appendix 1: alpha blockers
▶ Rare or very rare Parkinson’s disease exacerbated
l PREGNANCY No evidence of teratogenicity; manufacturers
advise use only when potential benefit outweighs risk.
l BREAST FEEDING No information available.
l HEPATIC IMPAIRMENT Manufacturer advises caution.
l RENAL IMPAIRMENT Manufacturer advises caution.
Driving and skilled tasks Drowsiness may affect
performance of skilled tasks (e.g. driving); effects of
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
CAUTIONARY AND ADVISORY LABELS 2
Indoramin (as Indoramin hydrochloride) 20 mg Indoramin 20mg
tablets | 60 tablet P £61.00 DT = £7.96
Indoramin (as Indoramin hydrochloride) 25 mg Indoramin 25mg
tablets | 84 tablet P £60.26 DT = £60.26
▶ Doralese Tiltab (Chemidex Pharma Ltd)
Indoramin (as Indoramin hydrochloride) 20 mg Doralese Tiltab
20mg tablets | 60 tablet P £11.44 DT = £7.96
▶ Adult: Initially 500 micrograms 2–3 times a day for
3–7 days, the initial dose should be taken on retiring to
bed at night to avoid collapse, increased to 1 mg
2–3 times a day for a further 3–7 days, then increased if
necessary up to 20 mg daily in divided doses
Congestive heart failure (rarely used)
▶ Adult: 500 micrograms 2–4 times a day, initial dose to
be taken at bedtime, then increased to 4 mg daily in
divided doses; maintenance 4–20 mg daily in divided
Raynaud’s syndrome (but efficacy not established)
▶ Adult: Initially 500 micrograms twice daily, initial dose
to be taken at bedtime, dose may be increased after
3–7 days, then increased if necessary to 1–2 mg twice
▶ Adult: Initially 500 micrograms twice daily for
3–7 days, subsequent doses should be adjusted
according to response, maintenance 2 mg twice daily,
initiate with lowest possible dose in elderly patients
DOSE ADJUSTMENTS DUE TO INTERACTIONS
▶ Caution with concomitant antihypertensives in benign
prostatic hyperplasia—reduced dosage and specialist
congestive heart failure due to mechanical obstruction
l CAUTIONS Cataract surgery (risk of intra-operative floppy
iris syndrome). elderly . first dose hypotension
l INTERACTIONS → Appendix 1: alpha blockers
disorders . vertigo . vision blurred . vomiting
discomfort. hyperhidrosis . paraesthesia . sleep disorders . tinnitus
l PREGNANCY No evidence of teratogenicity; manufacturers
advise use only when potential benefit outweighs risk.
l BREAST FEEDING Present in milk, amount probably too
small to be harmful; manufacturer advises use with
l HEPATIC IMPAIRMENT Manufacturer advises caution (no
Dose adjustments Manufacturer advises initial dose
reduction to 500 micrograms daily; increased with caution.
Dose adjustments Initially 500 micrograms daily in
moderate to severe impairment; increased with caution.
First dose effect First dose may cause collapse due to
hypotensive effect (therefore should be taken on retiring
to bed). Patients should be warned to lie down if symptoms
such as dizziness, fatigue or sweating develop, and to
remain lying down until they abate completely.
Driving and skilled tasks May affect performance of skilled
784 Bladder and urinary disorders BNF 78
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug. Forms available
from special-order manufacturers include: tablet, oral
▶ Minipress (Imported (Australia))
Prazosin (as Prazosin hydrochloride) 2 mg Minipress 2mg tablets
Prazosin (as Prazosin hydrochloride) 5 mg Minipress 5mg tablets
Prazosin (as Prazosin hydrochloride) 500 microgram Hypovase
500microgram tablets | 60 tablet P £2.69 DT = £2.69
Prazosin (as Prazosin hydrochloride) 1 mg Hypovase 1mg tablets
| 60 tablet P £3.46 DT = £3.46
▶ BY MOUTH USING MODIFIED-RELEASE MEDICINES
▶ Adult: 400 micrograms once daily
l CONTRA-INDICATIONS History of micturition syncope . history of postural hypotension
l CAUTIONS Cataract surgery (risk of intra-operative floppy
iris syndrome). concomitant antihypertensives (reduced
dosage and specialist supervision may be required). elderly
l INTERACTIONS → Appendix 1: alpha blockers
▶ Common or very common Dizziness . sexual dysfunction
▶ Rare or very rare Angioedema . Stevens-Johnson syndrome . syncope
▶ Frequency not known Dry mouth . epistaxis . vision
l HEPATIC IMPAIRMENT Manufacturer advises avoid in
l RENAL IMPAIRMENT Use with caution if eGFR less than
Driving and skilled tasks May affect performance of skilled
l EXCEPTIONS TO LEGAL CATEGORY Tamsulosin
hydrochloride 400 microgram capsules can be sold to the
public for the treatment of functional symptoms of benign
prostatic hyperplasia in men aged 45–75 years to be taken
for up to 6 weeks before clinical assessment by a doctor.
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
CAUTIONARY AND ADVISORY LABELS 25
▶ Cositam XL (Consilient Health Ltd)
Tamsulosin hydrochloride 400 microgram Cositam XL
400microgram tablets | 30 tablet P £8.89 DT = £10.47
Tamsulosin hydrochloride 400 microgram Faramsil
400microgram modified-release tablets | 30 tablet P £8.89 DT =
Tamsulosin hydrochloride 400 microgram Flectone XL
400microgram tablets | 30 tablet P £9.95 DT = £10.47
▶ Flomaxtra XL (Astellas Pharma Ltd)
Tamsulosin hydrochloride 400 microgram Flomaxtra XL
400microgram tablets | 30 tablet P £10.47 DT = £10.47
CAUTIONARY AND ADVISORY LABELS 25
▶ Tamsulosin hydrochloride (Non-proprietary)
Tamsulosin hydrochloride 400 microgram Tamsulosin
400microgram modified-release capsules | 30 capsule P £3.87–
▶ Contiflo XL (Ranbaxy (UK) Ltd)
Tamsulosin hydrochloride 400 microgram Contiflo XL
400microgram capsules | 30 capsule P £7.44 DT = £3.87
Tamsulosin hydrochloride 400 microgram Diffundox XL
400microgram capsules | 30 capsule P £9.55 DT = £3.87
Tamsulosin hydrochloride 400 microgram Flomax Relief MR
400microgram capsules | 14 capsule p £5.58 | 28 capsule p
▶ Losinate MR (Consilient Health Ltd)
Tamsulosin hydrochloride 400 microgram Losinate MR
400microgram capsules | 30 capsule P £10.14 DT = £3.87 |
▶ Pamsvax XL (Actavis UK Ltd, Almus Pharmaceuticals Ltd)
Tamsulosin hydrochloride 400 microgram Pamsvax XL
400microgram capsules | 30 capsule P £1.28 DT = £3.87
Tamsulosin hydrochloride 400 microgram Petyme 400microgram
MR capsules | 30 capsule P £4.06 DT = £3.87
▶ Pinexel PR (Wockhardt UK Ltd)
Tamsulosin hydrochloride 400 microgram Pinexel PR
400microgram capsules | 30 capsule P £2.50 DT = £3.87
▶ Tabphyn MR (Genus Pharmaceuticals Ltd)
Tamsulosin hydrochloride 400 microgram Tabphyn MR
400microgram capsules | 30 capsule P £4.45 DT = £3.87
Tamsulosin hydrochloride 400 microgram Tamfrex XL
400microgram capsules | 30 capsule P £28.51 DT = £3.87
▶ Tamsumac (Macleods Pharma UK Ltd)
Tamsulosin hydrochloride 400 microgram Tamsumac 0.4mg
modified-release capsules | 30 capsule P £3.87 DT = £3.87
Tamsulosin hydrochloride 400 microgram Tamurex
400microgram modified-release capsules | 30 capsule P £3.50 DT
The properties listed below are those particular to the
combination only. For the properties of the components
please consider, tamsulosin hydrochloride above,
▶ Adult (male): 1 capsule daily.
l INTERACTIONS → Appendix 1: alpha blockers . dutasteride
Driving and skilled tasks May affect performance of skilled
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
CAUTIONARY AND ADVISORY LABELS 25
▶ Combodart (GlaxoSmithKline UK Ltd)
Tamsulosin hydrochloride 400 microgram, Dutasteride
500 microgram Combodart 0.5mg/0.4mg capsules |
30 capsule P £19.80 DT = £19.80
The properties listed below are those particular to the
combination only. For the properties of the components
please consider, tamsulosin hydrochloride p. 785, solifenacin
Moderate to severe urinary frequency, urgency, and
obstructive symptoms associated with benign prostatic
hyperplasia when monotherapy ineffective
▶ Adult (male): 1 tablet daily.
DOSE ADJUSTMENTS DUE TO INTERACTIONS
▶ Manufacturer advises max. 1 Vesomni ® tablet daily
with concurrent use of potent inhibitors of CYP3A4;
avoid concurrent use in patients who also have
moderate hepatic impairment, severe renal
impairment, are poor metabolisers of CYP2D6, or in
patients also taking a potent inhibitor of CYP2D6.
l INTERACTIONS → Appendix 1: alpha blockers . solifenacin
l HEPATIC IMPAIRMENT Manufacturer advises caution in
moderate impairment; avoid in severe impairment (no
Dose adjustments Manufacturer advises max. 1 Vesomni ®
tablet daily in moderate impairment.
Dose adjustments Max. 1 Vesomni ® tablet daily if eGFR less
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
CAUTIONARY AND ADVISORY LABELS 3, 25
▶ Vesomni (Astellas Pharma Ltd)
Tamsulosin hydrochloride 400 microgram, Solifenacin succinate
6 mg Vesomni 6mg/0.4mg modified-release tablets | 30 tablet P £27.62 DT = £27.62
▶ Adult: 1 mg daily for 7 days, then increased if necessary
to 2 mg daily, dose should be taken at bedtime;
maintenance 2–10 mg once daily, doses above 20 mg
▶ Adult: Initially 1 mg daily, dose should be taken at
bedtime, if necessary dose may be doubled at intervals
of 1–2 weeks according to response; maintenance
5–10 mg daily; maximum 10 mg per day
l CONTRA-INDICATIONS History of micturition syncope (in
benign prostatic hyperplasia). history of postural
hypotension (in benign prostatic hyperplasia)
l CAUTIONS Cataract surgery (risk of intra-operative floppy
iris syndrome). elderly . first dose
▶ First dose First dose may cause collapse due to hypotension
within 30–90 minutes, therefore should be taken on
retiring to bed; may also occur with rapid dose increase.
l INTERACTIONS → Appendix 1: alpha blockers
hyperhidrosis . increased risk of infection . insomnia . joint
l PREGNANCY No evidence of teratogenicity; manufacturers
advise use only when potential benefit outweighs risk.
l BREAST FEEDING No information available.
l PATIENT AND CARER ADVICE Patient counselling is advised
for terazosin tablets (initial dose).
First dose effect First dose may cause collapse due to
hypotensive effect (therefore should be taken on retiring
to bed). Patient should be warned to lie down if symptoms
such as dizziness, fatigue or sweating develop, and to
remain lying down until they abate completely.
Driving and skilled tasks May affect performance of skilled
l MEDICINAL FORMS There can be variation in the licensing of
different medicines containing the same drug.
Terazosin (as Terazosin hydrochloride) 2 mg Terazosin 2mg
tablets | 28 tablet P £2.70 DT = £1.73
Terazosin (as Terazosin hydrochloride) 5 mg Terazosin 5mg
tablets | 28 tablet P £3.34 DT = £2.37
Terazosin (as Terazosin hydrochloride) 10 mg Terazosin 10mg
tablets | 28 tablet P £8.01–£8.11 DT = £8.02
Hytrin BPH tablets starter pack | 28 tablet P £10.97
Hytrin tablets starter pack | 28 tablet P £13.00
Terazosin (as Terazosin hydrochloride) 1 mg Hytrin 1mg tablets | 7 tablet P s
Terazosin (as Terazosin hydrochloride) 2 mg Hytrin 2mg tablets | 28 tablet P £2.20 DT = £1.73
Terazosin (as Terazosin hydrochloride) 5 mg Hytrin 5mg tablets | 28 tablet P £4.13 DT = £2.37
Terazosin (as Terazosin hydrochloride) 10 mg Hytrin 10mg tablets
| 28 tablet P £7.87 DT = £8.02
▶ Adult: 10–25 mg 3–4 times a day, to be taken
l CONTRA-INDICATIONS Bradycardia . cardiovascular
disorders . conditions where increased motility of the
gastro-intestinal tract could be harmful . conditions where
l CAUTIONS Autonomic neuropathy (use lower initial dose)
l SIDE-EFFECTS Abdominal pain . hyperhidrosis . nausea . vomiting
l PREGNANCY Manufacturer advises avoid—no information
l BREAST FEEDING Manufacturer advises avoid;
gastrointestinal disturbances in infant reported.
l LESS SUITABLE FOR PRESCRIBING Less suitable for
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