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 &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :383.9 (as hydrochloride)
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :>90
  • %Excreted unchanged in urine &nbsp &nbsp : <2
  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :7.4
  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :5/Increased by 50% (reduced by 40% in

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp : patients)

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function. See ‘Other Information’

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Not dialysed. Dose as in GFR <10 mL/min
  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux &nbsp :Unknown dialysability. Dose as in GFR <10 mL/min
  • CAV/VVHD &nbsp &nbsp &nbsp: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

    Route

    Oral

    Rate of Administration

    Comments

    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.