Alfuzosin Hydrochloride and Bromocriptine Mesylate

• Generic Name: alfuzosin
• Dosage Forms: n.a.
• Other Brand Names: Uroxatral

Reduction of urinary obstruction and relief of associated manifestations (e.g., hesitancy, interrupted or weak stream, sensation of incomplete bladder emptying or straining, urgency, nocturia) in patients with symptomatic BPH.

Although drug therapy usually is not as effective as surgical therapy, it may provide adequate symptomatic relief with fewer and less serious adverse effects compared with surgery.

May consider combined therapy with an α1-adrenergic blocker and 5α-reductase inhibitor for men with bothersome moderate to severe BPH and demonstrable prostatic enlargement. Has been more effective than therapy with either drug alone in preventing long-term BPH symptom progression. Men at risk for BPH progression are most likely to benefit from combination therapy.

Manufacturer states that alfuzosin should not be used for the treatment of hypertension.

• Generic Name: bromocriptine
• Dosage Forms: n.a.
• Other Brand Names: Parlodel, Cycloset

Treatment of male and female dysfunctions associated with hyperprolactinemia, including amenorrhea and/or galactorrhea, hypogonadism, and infertility.

Used in patients with prolactin-secreting adenomas (e.g., prolactinoma), including macroadenomas, to decrease tumor size; may be used prior to surgery in patients undergoing excision of the tumor (adenectomy).

Treatment of female infertility associated with hyperprolactinemia; used to induce ovulation in appropriately selected anovulatory women.

Treatment of hypogonadism and galactorrhea that persist following radiation therapy or surgery in hyperprolactinemic males with prolactin-secreting adenomas and adequate testosterone concentrations. Some clinicians consider bromocriptine the treatment of choice for reduction of large tumors (macroadenomas).

Symptomatic management of idiopathic or postencephalitic parkinsonian syndrome.

Used as an adjunct to levodopa for the symptomatic management of parkinsonian syndrome in patients with advanced disease.

Has been used as monotherapy for initial symptomatic management of parkinsonian syndrome. Most clinicians would use levodopa for initial therapy in individuals >70 years of age (less likely than younger individuals to develop levodopa-related motor complications and because of concerns about cognitive dysfunction), in patients with cognitive impairment, and in those with severe disease. A dopamine receptor agonist may be preferred for initial therapy in patients ≤70 years of age.

Treatment of acromegaly, alone or as adjunctive therapy with pituitary irradiation or surgery.

Has been used to increase sperm counts and restore fertility in oligospermic men without hyperprolactinemia who are unresponsive to traditional drug therapy.

Has been used to relieve extrapyramidal reactions, hyperthermia, and hypertension of neuroleptic malignant syndrome (NMS) associated with neuroleptic drug therapy (e.g., haloperidol, fluphenazine).

Has been used in the management of chronic hepatic encephalopathy.

Used in the past for prevention of postpartum breast engorgement; FDA has withdrawn approval of bromocriptine for this indication because the risk of serious, potentially fatal adverse effects outweigh the limited benefits associated with this use. (See Cardiovascular Effects under Cautions.)