Background Alfuzosin is indicated for the treatment of the symptoms of benign prostatic hyperplasia (BPH) and as adjunctive therapy with ureteral catheterisation for acute urinary retention related to BPH. The alpha blocking properties on the urinary tract are used for various indications not mentioned in the marketing authorisation (MA) for men and women.
Purpose We carried out a retrospective study on alfuzosin 10 mg prescriptions over 1 year, in order to: identify the different off-label indications; quantify the proportion of off-label prescriptions; and determine if good prescribing practices are observed.
Material and methods We analysed 420 computerised prescriptions (software: Pharma) of medicine, geriatric and surgery units, via Excel. Analysed data included: unit; patient’s age—indication for alfuzosin; time of drug intake; renal and hepatic functions; and drug interactions.
Results Our study showed 43% off-label prescriptions, including 17% concerning women. Various off-label indications were:
32% of acute urinary retention related to kidney stone, obstructive pyelonephritis, prostatitis, hypoactive bladder due to the use of a neuroleptic, etc.
6% of mictional disorders caused by prostate cancer—5% of mictional disorders caused by neurogenic bladder in connexion with stroke, Parkinson’s disease, multiple sclerosis, etc.
More than 85% of prescriptions mentioned evening administration, including 100% in the geriatric service where a pharmacist works. 64% of prescriptions were affected by drug interactions (mostly antihypertensive drugs: amlodipine, bisoprolol, urapidil, and also levodopa, phenothiazine and tricyclic antidepressants). Among these, 85% concerned elderly people. In association with alfuzosin, the risk of severe orthostatic hypotension increased and therefore the risk of falling and rehospitalisation. 33 patients suffered from severe renal insufficiency and there were no cases of severe hepatic insufficiency which are considered contraindications according to the summary of characteristics product.
Conclusion Our study revealed various off-label indications, all developed in several scientific papers, and underlined the issue of medicine related illness among the elderly. The improvement process of medicinal treatment has led us to write a summary (for medical and pharmacy interns) of the indications mentioned in the MA and the recommendations linked to the prescription. Another analysis will be done in 1 year.
References and/or acknowledgements Summary of Characteristics Product: Alfuzosin 10 mg prolonged release tablets.
No conflict of interest
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.