indoramin

CLINICAL USE

Alpha-adrenoceptor blocker:Hypertension Benign prostatic hyperplasia (BPH)

DOSE IN NORMAL RENAL FUNCTION

Hypertension: 25 mg twice daily initially, increasing to a maximum of 200 mg daily in 2–3 divided dosesBenign prostatic hyperplasia: 20 mg twice daily increasing to a maximum of 100 mg daily in divided doses

PHARMACOKINETICS

Molecular weight :383.9 (as hydrochloride)

%Protein binding :>90

%Excreted unchanged in urine : <2

Volume of distribution (L/kg) :7.4

half-life – normal/ESRD (hrs) :5/Increased by 50% (reduced by 40% in

HD : patients)

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function. See ‘Other Information’

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Not dialysed. Dose as in GFR <10 mL/min

HD :Not dialysed. Dose as in GFR <10 mL/min

HDF/high flux :Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD :Not dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Anaesthetics: enhanced hypotensive effect NSAIDs: antagonism of hypotensive effect

Antidepressants: enhanced hypotensive effect, especially with MAOIs and linezolid – avoid concomitant use

Beta-blockers: enhanced hypotensive effect; increased risk of first dose hypotensive effect

Calcium-channel blockers: enhanced hypotensive effect; increased risk of first dose hypotensive effect

Diuretics: enhanced hypotensive effect; increased risk of first dose hypotensive effect

Moxisylyte: possibly severe postural hypotension when used in combination

Vardenafil, sildenafil and tadalafil: enhanced hypotensive effect – avoid concomitant use

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

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OTHER INFORMATION

For BPH, 20 mg at night may be adequate in the elderlyIn the elderly the half-life can be prolonged to 6.6–32.8 hours with a mean of 14.7 hours due to reduced clearanceSeyffart recommends a maximum dose of 50 mg daily for patients with severe renal impairment if not on dialysis. Dialysis patients should receive a maximum of 100 mg daily on dialysis days, but 50 mg on non-dialysis days.

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