Alfuzosin, Doxazosin, Indoramin, Prazosin, Tamsulosin, Terazosin |
Issues for Surgery |
For treatment of hypertension – loss of blood pressure (BP) control if omitted. For benign prostatic hyperplasia – risk of acute urinary retention if omitted. Risk of hypotension when continued, particularly with alfuzosin (see Interaction(s) with Common Anaesthetic Agents) Risk of Intraoperative Floppy Iris Syndrome (IFIS) in patients undergoing cataract surgery when continued (see Further Information). Combination product containing solifenacin – risk of QT-interval prolongation if continued (see Antimuscarinics for Urinary Disorders monograph). |
Advice in the Perioperative period |
Elective and Emergency Surgery Continue, including combination product – monitor BP. Combination product:
Patients undergoing Cataract Surgery Post-operative Advice Patients undergoing Transurethral Resection of Prostate (TURP) |
Interaction(s) with Common Anaesthetic Agents |
Hypotension Alpha-adrenoceptor blockers can increase the risk of hypotension when used concomitantly with inhalational or intravenous anaesthetics1. The manufacturer of alfuzosin advises withhold 24 hours prior to surgery2, 3. However, in practice alfuzosin is continued – monitor BP. For combination product containing solifenacin – see Antimuscarinics for Urinary Disorders monograph |
Interaction(s) with other Common Medicines used in the Perioperative Period |
Hypotension Alpha-adrenoceptor blockers can increase the risk of hypotension when used concomitantly with droperidol or prochlorperazine1. For combination product containing solifenacin – see Antimuscarinics for Urinary Disorders monograph |
Further Information |
Intraoperative Floppy Iris Syndrome (IFIS) IFIS has been observed during cataract surgery in some patients on or previously treated with tamsulosin. Isolated reports have also been received with other alpha-adrenoceptor blockers and the possibility of a class effect cannot be excluded. As IFIS may lead to increased procedural complications during the cataract operation current or past use of alpha-adrenoceptor blockers should be made known to the Ophthalmic Surgeon in advance of surgery1, 3, 4, 5, 6, 7, 8.
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References |
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