Uroxatral
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Alfuzosin, sold under the brand name Uroxatral among others, is a
medication Medication (also called medicament, medicine, pharmaceutical drug, medicinal product, medicinal drug or simply drug) is a drug used to medical diagnosis, diagnose, cure, treat, or preventive medicine, prevent disease. Drug therapy (pharmaco ...
of the α1 blocker class. It is used to treat
benign prostatic hyperplasia Benign prostatic hyperplasia (BPH), also called prostate enlargement, is a noncancerous increase in size of the prostate gland. Symptoms may include frequent urination, trouble starting to urinate, weak stream, urinary retention, inability t ...
(BPH). As an
antagonist An antagonist is a character in a story who is presented as the main enemy or rival of the protagonist and is often depicted as a villain.α1-adrenergic receptor, it works by relaxing the muscles in the
prostate The prostate is an male accessory gland, accessory gland of the male reproductive system and a muscle-driven mechanical switch between urination and ejaculation. It is found in all male mammals. It differs between species anatomically, chemica ...
and
bladder The bladder () is a hollow organ in humans and other vertebrates that stores urine from the kidneys. In placental mammals, urine enters the bladder via the ureters and exits via the urethra during urination. In humans, the bladder is a distens ...
neck, making urination easier. Alfuzosin was patented in 1978 and approved for medical use in 1988. It was approved in the US for benign prostatic hyperplasia in 2003. In 2020, it was the 336th-most commonly prescribed medication in the United States, with more than 700thousand prescriptions.


Side effects

The most common side effects are
dizziness Dizziness is an imprecise term that can refer to a sense of disorientation in space, vertigo, or lightheadedness. It can also refer to Balance disorder, disequilibrium or a non-specific feeling, such as giddiness or foolishness. Dizziness is a ...
(due to
postural hypotension Orthostatic hypotension, also known as postural hypotension, is a medical condition wherein a person's blood pressure drops when they are standing up ( orthostasis) or sitting down. Primary orthostatic hypotension is also often referred to as ne ...
),
upper respiratory tract infection An upper respiratory tract infection (URTI) is an illness caused by an acute infection, which involves the upper respiratory tract, including the nose, sinuses, pharynx, larynx or trachea. This commonly includes nasal obstruction, sore throat ...
,
headache A headache, also known as cephalalgia, is the symptom of pain in the face, head, or neck. It can occur as a migraine, tension-type headache, or cluster headache. There is an increased risk of Depression (mood), depression in those with severe ...
,
fatigue Fatigue is a state of tiredness (which is not sleepiness), exhaustion or loss of energy. It is a signs and symptoms, symptom of any of various diseases; it is not a disease in itself. Fatigue (in the medical sense) is sometimes associated wit ...
, and abdominal disturbances. Side effects include
stomach pain Abdominal pain, also known as a stomach ache, is a symptom associated with both non-serious and serious medical issues. Since the abdomen contains most of the body's vital organs, it can be an indicator of a wide variety of diseases. Given th ...
,
heartburn Heartburn is a burning sensation felt behind the breastbone. It is a symptom that is commonly linked to acid reflux and is often triggered by food, particularly fatty, sugary, spicy, chocolate, citrus, onion-based and tomato-based products. Ly ...
, and
congested nose Nasal congestion is the partial or complete blockage of nasal passages, leading to impaired nasal breathing, usually due to membranes lining the nose becoming swollen from inflammation of blood vessels. Background In about 85% of cases, nasal c ...
. Adverse effects of alfuzosin are similar to that of
tamsulosin Tamsulosin, sold under the brand name Flomax among others, is a medication used to treat symptomatic benign prostatic hyperplasia and chronic prostatitis in men. It is also used to help with the passage of kidney stones. The evidence for be ...
, but with 70% lower rate of
retrograde ejaculation Retrograde ejaculation occurs when semen which would be ejaculated via the urethra is redirected to the urinary bladder. Normally, the sphincter of the bladder contracts before ejaculation, inhibiting urination and preventing a reflux of semen ...
.


Chemistry

Alfuzosin contains a
stereocenter In stereochemistry, a stereocenter of a molecule is an atom (center), axis or plane that is the focus of stereoisomerism; that is, when having at least three different groups bound to the stereocenter, interchanging any two different groups cr ...
, so is
chiral Chirality () is a property of asymmetry important in several branches of science. The word ''chirality'' is derived from the Greek language, Greek (''kheir''), "hand", a familiar chiral object. An object or a system is ''chiral'' if it is dist ...
, with two
enantiomer In chemistry, an enantiomer (Help:IPA/English, /ɪˈnænti.əmər, ɛ-, -oʊ-/ Help:Pronunciation respelling key, ''ih-NAN-tee-ə-mər''), also known as an optical isomer, antipode, or optical antipode, is one of a pair of molecular entities whi ...
ic forms, (''R'')- and (''S'')-alfuzosin. The drug is used as a
racemate In chemistry, a racemic mixture or racemate () is a mixture that has equal amounts (50:50) of left- and right-handed enantiomers of a chiral molecule or salt. Racemic mixtures are rare in nature, but many compounds are produced industrially as r ...
, (''RS'')-alfuzosin, a 1:1 mixture of the (''R'')- and (''S'')- forms.Rote Liste Service GmbH (Hrsg.): ''Rote Liste 2017 - Arzneimittelverzeichnis für Deutschland (einschließlich EU-Zulassungen und bestimmter Medizinprodukte)''. Rote Liste Service GmbH, Frankfurt/Main, 2017, Aufl. 57, S. 159, . It is provided as the
hydrochloride In chemistry, a hydrochloride is an acid salt resulting, or regarded as resulting, from the reaction of hydrochloric acid with an organic base (e.g. an amine). An alternative name is chlorhydrate, which comes from French. An archaic alternati ...
salt.


Society and culture


Brand names

It is sold under the brand names Alfosoft, Uroxatral, Xatral, Prostetrol, and Alfural.


Synthesis

The nitration of veratraldehyde 20-14-9(1) gives 6-Nitroveratraldehyde 0357-25-9(2). Oxidation of the aldehyde to the acid, halogenation with thionyl chloride and amide formation with ammonia gives 4,5-dimethoxy-2-nitrobenzamide 959-60-8(3). Béchamp reduction of the nitro group gives 2-amino-4,5-dimethoxybenzamide 004-88-6(4). Reaction with urea leads to 6,7-Dimethoxyquinazoline-2,4-dione 8888-44-0(5). Halogenation with phosphoryl chloride gives 2,4-Dichloro-6,7-dimethoxyquinazoline 7631-29-4(6). Treatment with one equivalent of ammonia yields 4-Amino-2-chloro-6,7-dimethoxyquinazoline
3680-84-4 Year 368 ( CCCLXVIII) was a leap year starting on Tuesday of the Julian calendar. At the time, it was known as the Year of the Consulship of Augustus and Valens (or, less frequently, year 1121 ''Ab urbe condita''). The denomination 368 for this ...
(7). The reaction of 2-Tetrahydrofuroic Acid 6874-33-2(8) with Ethyl chloroformate 41-41-3(9) gives Ethoxycarbonyl oxolane-2-carboxylate, PC10997775 (10). Treatment of the mixed anhydride with 3-Methylaminopropionitrile 93-05-0(11) gives N-(2-Cyanoethyl)tetrahydro-N-methyl-2-furancarboxamide
2104-44-0 1 (one, unit, unity) is a number, numeral, and glyph. It is the first and smallest positive integer of the infinite sequence of natural numbers. This fundamental property has led to its unique uses in other fields, ranging from science to sp ...
(12). Catalytic hydrogenation gives N-(3-Aminopropyl)tetrahydro-N-methyl-2-furancarboxamide
2104-45-1 1 (one, unit, unity) is a number, numeral, and glyph. It is the first and smallest positive integer of the infinite sequence of natural numbers. This fundamental property has led to its unique uses in other fields, ranging from science to sp ...
(13). Migration of the amide methyl group to the terminal position gives N-
-(methylamino)propyl The symbol , known in Unicode as hyphen-minus, is the form of hyphen most commonly used in digital documents. On most keyboards, it is the only character that resembles a minus sign or a dash, so it is also used for these. The name ''hyphen-min ...
xolane-2-carboxamide
1403-67-0 Fourteen or 14 may refer to: * 14 (number), the natural number following 13 and preceding 15 * one of the years 14 BC, AD 14, 1914, 2014 Music * 14th (band), a British electronic music duo * ''14'' (David Garrett album), 2013 *''14'', an unrel ...
(14). Convergent synthesis between the two coutnerparts completed the synthesis of Alfuzosin (15).


References

{{Portal bar , Medicine , Viruses Alpha-1 blockers Carboxamides Quinazolines Tetrahydrofurans