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Silodosin

Class
Adrenergic receptor blockers
Subclass
Selective α1-blockers
Substance name
Silodosin
Brand names
Rapaflo®
Common formulations
Capsule
Dosage and administration
Adults patients
BPH
•
8 mg PO daily
Taken with meals.
Ureteral stones • Off-label
•
8 mg PO daily until stone passage or up to 4 weeks
Indications for use
Labeled indications
Adults
•
Treatment of BPH
Off-label indications
Adults
•
Treatment of ureteral stones
Safety risks
Contraindications
Hypersensitivity to silodosin or its components
Concomitant use of potent CYP3A4 inhibitors
Warnings and precautions
Dizziness
•
Use extreme caution in patients performing activities requiring mental alertness, such as driving or operating machinery.
Intraoperative floppy iris syndrome
•
Use caution in patients undergoing cataract surgery.
Mask symptoms of prostate cancer
•
Maintain a high level of suspicion, as prostate cancer can present with symptoms of BPH, and the two disorders frequently coexist. Exclude prostate cancer before initiating silodosin.
Orthostatic hypotension, syncope
•
Maintain a high level of suspicion, as α-blockers may cause postural hypotension, with or without symptoms.
Specific populations
Renal impairment
CrCl > 50 mL/min
•
Use acceptable. No dose adjustment required.
CrCl 30-50 mL/min
•
Use with caution. Reduce dose by 50%.
CrCl < 30 mL/min
•
Do not use.
Renal replacement therapy
Any modality
•
No guidance available.
Hepatic impairment
Child-Pugh A (mild)
•
Use acceptable. No dose adjustment required.
Child-Pugh B (moderate)
•
Use acceptable. No dose adjustment required.
Child-Pugh C (severe)
•
Do not use.
Pregnancy and breastfeeding
Pregnancy
All trimesters • Australia Category: B3
•
Do not use.
Breastfeeding
Do not use during breastfeeding.
Unknown amount excreted in breastmilk.
Unknown drug levels in breastfed infants.
Adverse reactions
Very common > 10%
•
Retrograde ejaculation
Common 1-10%
•
Orthostatic hypotension, diarrhea, abdominal pain, asthenia, insomnia, nasal discharge, ↑ serum PSA, weakness, dizziness, headache, nasopharyngitis, nasal congestion, sinusitis
Unknown frequency
•
Intraoperative floppy iris syndrome, maculopapular rash, skin rash, itching, urticaria, jaundice, priapism, syncope, ejaculation difficulties, purpura, ↑ serum transaminases, tongue swelling
Interactions
Drug(s)
Check Interactions
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