Alpha-blocker (5/6): Silodosin
Review Literatur: (Chapple, 2004).
General Pharmacology of Silodosin
Mechanism of Action of Silodosin
Silodosin is a new selective alpha1A-blocker with a favourable cardiovascular side effect rate (Cantrell et al, 2010). Alpha-blocker are used for the treatment of lower urinary tract symptoms due to benign prostatic hyperplasia. Please see section general pharmacology of alpha-blocker.
Pharmacokinetics of Silodosin
Bioavailability 32%, high plasma protein binding, hepatic metabolization, elimination half life 13 h, biliary and renal excretion of metabolites.
General Side Effects of Alpha-Blocker
- Hypotension, orthostatic syncope, reflex tachycardia
- Stuffy nose
- Retrograde ejaculation
- Dizziness, weakness
- Overall rate of side effects is between 10–30%, selective alpha1A-blocker like silodosin have a reduced cardiovascular side effect rate.
Contraindications of Alpha-Blocker
Conservative treatment of BPH is not indicated, if surgical treatment is imperative: chronic urinary retention with renal failure, recurrent hematuria due to prostatic enlargement, recurrent infections and bladder stones.
Hypotension, mechanical heart failure (valvular, pulmonary embolism, pericarditis), congestive heart failure.
Silodosin should be paused perioperatively for cataract surgery to prevent an intraoperative floppy iris syndrome.
Specific Contraindications of Silodosin
- Severe renal insufficiency (<30 ml/min)
- Inhibitors of CYP3A4 like ketoconazol
Dosage of Silodosin
8 mg 1-0-0. Reduce dosage to 4 mg in patients with renal insufficiency (<50 ml/min).
Index: 1–9 A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
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- Cantrell, M. A.; Bream-Rouwenhorst, H. R.; Hemerson, P.
& Magera, J. S.
- Silodosin for benign prostatic hyperplasia.
Pharmacother, 2010, 44, 302-310.
Chapple 2004 CHAPPLE, C. R.:
- Pharmacological therapy of benign prostatic hyperplasia/lower urinary
tract symptoms: an overview for the practising clinician.
In: BJU Int
94 (2004), Nr. 5, S. 738–44