Alfuzosin + Atenolol

[pumpkinking]

Hi guys, there are some questions in my head.

How would you view this interaction if someone takes these 2 drugs concomitantly? Synergistic effect? or is it just two drugs that should not be used together?
Any better if these 2 drugs are taken at different times of the day?
What is the usual dose if these 2 drugs are prescribed together?

[pumpkinking]

Also, any precautions need to be highlighted? =)

[crit care]

depends what they are taking it all for. alpha and beta blockers in combination will cause first dose hypotension. Is alfuzosin being used for BPH and helping the patient pass urine? if so and atenolol used for hyertension, i woldn't cause too much of an uproar, maybe counsel patient about potential dizziness if taken together. If going to split doses i'd get them to take alfuzosin in morning and atenolol at night. Or the patient may not even get hypotension from it.

[pumpkinking]

Thanks crit care!!!! Appreciate that!! =) yes alfuzosin is used for BPH... but will there be a need to titrate down the dose? According to the BNF, alfuzosin is prescribed 2.5mg TDS for BPH and atenolol 25-50mg OD for HTN... how would you split the dose in this case? & is this just an example of pharmacodynamic interaction? coz both drugs work towards the same goal in the body i.e. lower BP.

[crit care]

Normally for BPH dise is 10mg daily of the MR prep.....BNF tells you this and gives you advice and counselling and the like.....

[pumpkinking]

Ohh Thanks so much again!!! crit care =) Thanks for pointing out alfuzosin is given as M/R. But when I look at the appendix 1 of BNF about interactions... it has a black dot in front of alpha blocker + beta blocker... it means critical drug interaction doesnt it? Do we really not need to worry about dose adjustment?

[crit care]

i personally wouldn't, but i'm coming from an area where everyone is hooked up to a cardiac monitor showing you ever number possible 24/7. As for community, BNF tells you what to watch out for. Again its risk vs benefit really.

[Nik]

Simplest option is to have the pt on beta blocker and tamsulosin, as this alpha blocker is much less likely than the others to cause first dose hypo, and probably as well tolerated.

[pumpkinking]

Thanks so much crit care & Nik!!!! Appreciate all ur valuable response!!! =)