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Alpha blocker Silodosin: Side Effects and Dosage

Mechanism of Action of Silodosin

Silodosin is a selective alpha_1A-blocker with a long half-life and favorable cardiovascular side effects (Cantrell et al., 2010). Please see section general pharmacology of alpha blocker.

**Structural formula of silodosin**

Indications for Silodosin

Treatment of lower urinary tract symptoms due to benign prostatic hyperplasia.
Off-label treatment of female LUTS due to neurogenic bladder neck obstruction.
Off-label treatment: improve the spontaneous passage of distal ureteral stones.

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

Decreased side effect profile since silodosin is a selective α1A blocker.

Hypotension, orthostatic syncope, reflex tachycardia
Stuffy nose
Retrograde ejaculation
Dizziness, weakness
Overall rate of side effects is between 10–30%.

Contraindications of Silodosin

Urological Contraindications:

Conservative treatment of BPH with silodosin 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.

Cardiac Contraindications:

Hypotension, mechanical heart failure (valvular diseases, pulmonary embolism, pericarditis), congestive heart failure.

Other contraindications:

Silodosin should be paused perioperatively for cataract surgery to prevent an intraoperative floppy iris syndrome.

Specific Contraindications of Silodosin

Severe chronic kidney disease (<30 ml/min)
Not approved in children.
Inhibitors of CYP3A4 like ketoconazol

Dosage of Silodosin

8 mg orally once daily. Reduce dosage to 4 mg in patients with renal insufficiency (<50 ml/min).

Alfuzosin

Index

Pharmacology

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

References

Cantrell, M. A.; Bream-Rouwenhorst, H. R.; Hemerson, P. & Magera, J. S. Silodosin for benign prostatic hyperplasia.
Ann 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

Deutsche Version: Silodosin

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