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drug adverse effects of alpha-1 adrenergic receptor antagonists
Adverse effects:
1) dizziness, light-headedness, orthostatic hypotension
- falls in the elderly (RR=1.1) [3]
- fractures (RR=1.2) [3]
2) tamsulosin (Flomax) least likely to cause orthostatic hypotension
3) alfuzosin (Uroxatral) least likely to cause abnormal ejaculation
4) adverse ocular effects
a) blurred vision
b) eye pain
c) risk of intraoperative floppy-iris syndrome during cataracts surgery (most frequent with tamsulosin)
- do not initiate alpha-1 adrenergic receptor antagonist therapy prior to scheduled cataract surgery [4]
5) none are likely to cause erectile dysfunction
6) worsening chronic renal failure with progression to ESRD [5]
7) stress urinary incontinence, especially in women with pelvic organ prolapse [4]
* not associated with increased risk of cardiovascular events in contrast to findings of ALLHAT study [5]
Properties
DRUGS: alpha-1 adrenergic receptor antagonist
FORM: drug adverse effects alpha 1 adrenergic receptor antagonist
References
- Prescriber's Letter 10(9):53 2003
- Prescriber's Letter 19(5): 2012
Drug-Induced Adverse Eye Effects
Detail-Document#: 280508
(subscription needed) http://www.prescribersletter.com
- Welk B et al
The risk of fall and fracture with the initiation of a prostate-
selective alpha antagonist: a population based cohort study.
BMJ 2015;351:h5398
PMID: 26502947
http://www.bmj.com/content/351/bmj.h5398
- Geriatric Review Syllabus, 9th edition (GRS9)
Medinal-Walpole A, Pacala JT, Porter JF (eds)
American Geriatrics Society, 2016
- Geriatric Review Syllabus, 11th edition (GRS11)
Harper GM, Lyons WL, Potter JF (eds)
American Geriatrics Society, 2022
- Hundemer GL, Knoll GA, Petrcich W et al.
Kidney, cardiac, and safety outcomes associated with alpha-blockers in
patients with CKD: A population-based cohort study.
Am J Kidney Dis 2021 Feb; 77:178.
PMID: 32920153
https://www.ajkd.org/article/S0272-6386(20)30937-9/fulltext